21 results on '"Nefissa Hammache"'
Search Results
2. A Paced-ECG Detector and Delineator for Automatic Multi-Parametric Catheter Mapping of Ventricular Tachycardia
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Philip Hoyland, Nefissa Hammache, Alberto Battaglia, Julien Oster, Jacques Felblinger, Christian de Chillou, and Freddy Odille
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Arrhythmia ,cardiac interventional electrophysiology ,electrocardiography ,radiofrequency catheter ablation ,Electrical engineering. Electronics. Nuclear engineering ,TK1-9971 - Abstract
Ventricular tachycardia (VT) is a life-threatening arrhythmia, which can be treated by catheter intervention. Accurate identification of the underlying reentrant circuit is often challenging, yet it is key to successful ablation of the VT. In practice, the cardiologist often uses electrocardiography (ECG) data provided by various catheter mapping techniques, including parameters acquired during sinus rhythm (voltage maps, presence of fragmented/late potentials) and during controlled pacing from different sites of the ventricle, so-called pace-mapping. A novel method is presented here to automatically extract the key information from pace-mapping data with automated detection of paced heartbeats from the surface ECG signals, using wavelet detection of pacing spikes and combined time/energy criteria, and automated delineation of paced beats, QRS peak, and QRS onset. This allows the generation of correlation gradient maps (indicating QRS morphology changes as the catheter is moved) and stimulus-to-QRS maps (sQRS, indicating the delay between pacing and activation of the healthy myocardium). The delineator is shown to be in good agreement with manual annotations from experts in a retrospective study of 18 VT ablation procedures. Paced-QRS detection had 95.2% sensitivity and 98.4% positive predictive value. Resulting sQRS maps had a mean absolute error of 11.1 ms, which was in the same range as the inter-observer errors (9.7 ms). The automatic processing drastically reduces the need for manual annotations. Therefore it makes it feasible to process and visualize, during the procedure, all the relevant parametric maps, which can be analyzed jointly to identify VT circuits and corresponding ablation targets.
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- 2020
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3. Efficacy and Safety of Second and Third-Generation Laser Balloon for Paroxysmal Atrial Fibrillation Ablation Compared to Radiofrequency Ablation: A Matched-Cohort
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Charles Guenancia, Nefissa Hammache, Clémence Docq, Karim Benali, Darren Hooks, Mathieu Echivard, Nathalie Pace, Isabelle Magnin-Poull, Christian de Chillou, and Jean-Marc Sellal
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atrial fibrillation ,ablation ,laser ,radiofrequency ,paroxysmal ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Laser balloon (LB) has emerged as an interesting strategy for pulmonary vein isolation in paroxysmal atrial fibrillation (AF). A third-generation LB has recently been developed, allowing a continuous ablation set. We aimed to compare the results from our center’s experience with second and third-generation LBs to a cohort of matched patients who had undergone radiofrequency ablation (RFA) with contact-force catheters. This retrospective monocenter case-control study included our first 50 LB paroxysmal AF ablations (26 second and 24 third-generation LB) and 50 RFA controls, matched on age, sex and left atrial dilation. The two groups had similar baseline parameters. LB procedures were significantly shorter than RFA (129 (110–160) vs. 160 (119–198) min, p = 0.007). During AF ablation, two major complications occurred in each group. At the one-year follow-up, AF recurrence was diagnosed in 7 (14%) of the LB group vs. 14 (28%) of the RFA group (p = 0.14). Moreover, we observed that third-generation LB procedures were associated with shorter laser applications (22 (19–29) vs. 69 (55–76) min, p < 0.001) and procedural durations (111 (100–128) vs. 151.5 (128.5–167) min, p < 0.001) compared to second-generation LB procedures. In the context of the major increase in the number of AF ablations, LB demonstrated consistent results in terms of clinical success, complications and also reduced procedure durations compared to RFA.
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- 2021
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4. How to use pace mapping for ventricular tachycardia ablation in postinfarct patients
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Charles Guenancia, Gregory Supple, Jean‐Marc Sellal, Isabelle Magnin‐Poull, Karim Benali, Nefissa Hammache, Mathieu Echivard, Francis Marchlinski, and Christian de Chillou
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Electrocardiography ,Heart Rate ,Physiology (medical) ,Catheter Ablation ,Tachycardia, Ventricular ,Humans ,Cardiology and Cardiovascular Medicine ,Endocardium - Abstract
We aim to describe the technical aspects of pace mapping (PM), as well as the two typical patterns of pacing correlation maps during ventricular tachycardia (VT) ablation. The first main pattern is focal, with a gradual and eccentric decrease of the QRS correlation from the area with the best PM correlation. This focal pattern may be associated with two clinical situations: (1) with some endocardial points showing a good correlation compared to VT morphology: true endocardial exit of VT or endocardial breakthrough of either an intramural or an epicardial circuit; (2) without any endocardial points showing a good correlation compared to VT morphology: the VT may originate from the other ventricle, but the presence of an intramural or an epicardial circuit should be considered in patients with a structural heart disease. The second pattern is the presence of PM points exhibiting a good correlation close to other PM points showing a poor correlation compared to VT morphology: this abrupt change in paced QRS morphology over a short distance indicates divergence of activation wavefronts between these sites and suggests the presence of a slow conduction channel: the VT isthmus.
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- 2022
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5. Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation
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Karim Benali, Paul Khairy, Nefissa Hammache, Adrian Petzl, Antoine Da Costa, Atul Verma, Jason G. Andrade, Laurent Macle, Université de Montréal (UdeM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Montreal Heart Institute - Institut de Cardiologie de Montréal, McGill University Health Center [Montreal] (MUHC), Dr Benali has received grant support from the Group of Pacing and Cardiac Electrophysiology of the French Society of Cardiology. Dr Verma has received grant support, advisory board fees, and lecture fees from Bayer, Biosense Webster, and Medtronic, has received grant support from Biotronik, Bristol Myers Squibb, and Boehringer Ingelheim, has received consulting fees from Boston Scientific, MedLumics, and Thermedical, and has received lecture fees from Servier. Dr Andrade has received grant support from Baylis Medical, and and has received lecture fees from Biosense Webster. Dr Macle has received grant support and honoraria from Biosense Webster, Abbott, and Pfizer-Bristol Myers Squibb. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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meta-analysis ,trend ,catheter ablation ,adverse event ,atrial fibrillation ,complication ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,randomized trials ,Cardiology and Cardiovascular Medicine ,mortality - Abstract
International audience; Background: Catheter ablation of atrial fibrillation (AF) is a commonly performed procedure. However, it is associated with potentially significant complications. Reported procedure–related complication rates are highly variable, depending in part on study design. Objectives: The purpose of this systematic review and pooled analysis was to determine the rate of procedure-related complications associated with catheter ablation of AF using data from randomized control trials and to assess temporal trends. Methods: MEDLINE and EMBASE databases were searched from January 2013 to September 2022 for randomized control trials that included patients undergoing a first ablation procedure of AF using either radiofrequency or cryoballoon (PROSPERO, CRD42022370273). Results: A total of 1,468 references were retrieved, of which 89 studies met inclusion criteria. A total of 15,701 patients were included in the current analysis. Overall and severe procedure-related complication rates were 4.51% (95% CI: 3.76%-5.32%) and 2.44% (95% CI: 1.98%-2.93%), respectively. Vascular complications were the most frequent type of complication (1.31%). The next most common complications were pericardial effusion/tamponade (0.78%) and stroke/transient ischemic attack (0.17%). The procedure-related complication rate during the most recent 5-year period of publication was significantly lower than during the earlier 5-year period (3.77% vs 5.31%; P = 0.043). The pooled mortality rate was stable over the 2 time periods (0.06% vs 0.05%; P = 0.892). There was no significant difference in complication rate according to pattern of AF, ablation modality, or ablation strategies beyond pulmonary vein isolation. Conclusions: Procedure-related complications and mortality rates associated with catheter ablation of AF are low and have declined in the past decade. © 2023 American College of Cardiology Foundation
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- 2023
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6. Mechanism of ventricular tachycardia in a patient with double‐outlet left ventricle
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Christian de Chillou, Charles Guenancia, Karim Benali, and Nefissa Hammache
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Surgical repair ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Catheter ablation ,Ventricular tachycardia ,medicine.disease ,Ablation ,medicine.anatomical_structure ,Ventricle ,Physiology (medical) ,Internal medicine ,Double outlet left ventricle ,cardiovascular system ,Cardiology ,medicine ,Tricuspid annulus ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Pace mapping - Abstract
We report the case of ventricular tachycardia (VT) ablation procedure in a patient with history of surgically repaired double-outlet left ventricle. The electrophysiology procedure revealed a re-entry pattern between the right-ventricle to main-pulmonary-artery conduit and the tricuspid annulus. The re-entrant mechanism was most likely promoted by a fibrous remodeling of this area, related to the surgical repair. This case is the first to describe a re-entry mechanism between fixed anatomical barriers in a repaired right ventricle of a double-outlet left ventricle. A pace mapping technique was used to highlight the VT isthmus.
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- 2021
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7. AB-452642-1 TEMPORAL TREND IN PROCEDURE-RELATED COMPLICATIONS OF CATHETER ABLATION FOR ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND POOLED ANALYSIS OF RANDOMIZED CONTROL TRIALS
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Karim Benali, Paul Khairy, Nefissa Hammache, Adrian Petzl, Antoine Da Costa, Atul Verma, Jason G. Andrade, and Laurent Macle
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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8. Catheter knot around the mitral valve apparatus: An exceptional complication of remote magnetic navigation
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Karim Benali, Nefissa Hammache, Jean‐Marc Sellal, Elfarra Mazen, and Christian Chillou
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2021
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9. Impact of pulmonary veins anatomy on the outcomes of radiofrequency ablation for paroxysmal atrial fibrillation in the era of contact force-sensing ablation catheters
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Karim Benali, Van Duc Lai, Nefissa Hammache, Isabelle Magnin-Poull, Christian de Chillou, and Jean-Marc Sellal
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Pulmonary vein (PV) isolation (PVI) has become the cornerstone of atrial fibrillation (AF) ablation in patients with paroxysmal AF (PAF). PVI durability is influenced by many factors including PVs anatomy. Data regarding the influence of PVs anatomical variations on the outcomes of PAF ablation in the era of contact force-sensing ablation catheters are scarce and contradictory.Consecutive patients referred to our center for a first ablation of PAF using radiofrequency (RF) were included. PVs anatomy was classified into 3 groups: typical anatomy (4 distinct veins), left common ostium (LCO), and right accessory PV (RAPV). The primary outcome was recurrence of atrial arrhythmia episode during a 12-month follow-up after ablation.Two hundred twenty-three patients were included (mean age 58.4 ± 10.8 years and 70.9% male). Among this cohort, 141 patients (63.2%) had typical PV anatomy, 53 (23.8%) had a LCO, and 29 (13.0%) had a RAPV. The existence of a RAPV was not associated with a higher rate of AF recurrences (22 (14.3%) vs. 7 (10.1%), p = 0.519). After multivariate analysis, the presence of an LCO did not appear to be associated with the AF recurrence rate at 12 months (OR = 1.69, 95%CI 0.95-2.49, p = 0.098). Maintenance of antiarrhythmic drugs after ablation was the only factor independently associated with a decreased risk of AF recurrence at 12 months (OR = 0.76, 95%CI 0.60-0.97, p = 0.046).This study suggests that the presence of an LCO or a RAPV is not associated with a higher rate of AF recurrence at 12 months after radiofrequency PVI using contact force-sensing catheters in PAF patients.
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- 2022
10. Cardiac stereotactic ablative radiotherapy for refractory ventricular arrhythmias: A radical alternative? A narrative review of rationale and cardiological aspects
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Karim Benali, Antoine Da Costa, Louis Rigal, Renaud de Crevoisier, Vincent Galand, Raphaël P. Martins, Nefissa Hammache, Antoine Simon, N. Jaksic, J. Bellec, Pierre Caille, CHU Saint-Etienne, Centre Eugène Marquis (CRLCC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), CRLCC Eugène Marquis (CRLCC), CHU Pontchaillou [Rennes], Jonchère, Laurent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
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medicine.medical_specialty ,cardiac radioablation ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Radiosurgery ,03 medical and health sciences ,cardiac SBRT ,0302 clinical medicine ,Refractory ,Ablative case ,catheter ablation ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,cardiovascular diseases ,Cardiac disorders ,Intensive care medicine ,[SDV.IB] Life Sciences [q-bio]/Bioengineering ,Radiological and Ultrasound Technology ,business.industry ,ventricular arrhythmias ,Arrhythmias, Cardiac ,Heart ,refractory ventricular tachycardia ,3. Good health ,Radiation therapy ,cardiovascular system ,Narrative review ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,business ,cardiac sterteotactic radiotherapy - Abstract
International audience; Ventricular arrhythmias are serious life-threatening cardiac disorders. Despite many technological improvements, a non-negligible number of patients present refractory ventricular tachycardias, resistant to a catheter ablation procedure, placing these patients in a therapeutic impasse. Recently, a cardiac stereotactic radioablative technique has been developed to treat patients with refractory ventricular arrhythmias, as a bail out strategy. This new therapeutic option historically brings together two fields of expertise unknown to each other, pointing out the necessity of an optimal partnership between cardiologists and radiation oncologists. As described in this narrative review, the understanding of cardiological aspects of the technique for radiation oncologists and treatment technical aspects comprehension for cardiologists represent a major challenge for the application and the future development of this promising treatment.
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- 2021
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11. Running after Activated Clotting Time Values in Patients Receiving Direct Oral Anticoagulants: A Potentially Dangerous Race. Results from a Prospective Study in Atrial Fibrillation Catheter Ablation Procedures
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Charles Guenancia, Julien Verain, Christian de Chillou, Karim Benali, I. Magnin-Poull, Jean-Marc Sellal, Nefissa Hammache, Darren A. Hooks, and Marie Toussaint-Hacquard
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vitamin K antagonist ,anti-Xa activity ,medicine.drug_class ,medicine.medical_treatment ,Activated clotting time ,Catheter ablation ,activated clotting time ,heparin ,direct oral anticoagulants ,Article ,Dabigatran ,catheter ablation ,Medicine ,atrial fibrillation ,anticoagulation ,Rivaroxaban ,medicine.diagnostic_test ,business.industry ,Anticoagulant ,Atrial fibrillation ,General Medicine ,Vitamin K antagonist ,medicine.disease ,Anesthesia ,Apixaban ,business ,medicine.drug - Abstract
Background: Activated Clotting Time (ACT) guided heparinization is the gold standard for titrating unfractionated heparin (UFH) administration during atrial fibrillation (AF) ablation procedures. The current ACT target (300 s) is based on studies in patients receiving a vitamin K antagonist (VKA). Several studies have shown that in patients receiving Direct Oral Anticoagulants (DOACs), the correlation between ACT values and UFH delivered dose is weak. Objective: To assess the relationship between ACT and real heparin anticoagulant effect measured by anti-Xa activity in patients receiving different anticoagulant treatments. Methods: Patients referred for AF catheter ablation in our centre were prospectively included depending on their anticoagulant type. Results: 113 patients were included, receiving rivaroxaban (n = 30), apixaban (n = 30), dabigatran (n = 30), and VKA (n = 23). To meet target ACT, a higher UFH dose was required in DOAC than VKA patients (14,077.8 IU vs. 9565.2 IU, p <, 0.001), leading to a longer time to achieve target ACT (46.5 min vs. 27.3 min, p = 0.001). The correlation of ACT and anti-Xa activity was tighter in the VKA group (Spearman correlation ρ = 0.53), compared to the DOAC group (ρ = 0.19). Despite lower ACT values in the DOAC group, this group demonstrated a higher mean anti-Xa activity compared to the VKA group (1.56 ± 0.39 vs. 1.14 ± 0.36, p = 0.002). Conclusion: Use of a conventional ACT threshold at 300 s during AF ablation procedures leads to a significant increase in UFH administration in patients treated with DOACs. This increase corresponds more likely to an overdosing than a real increase in UFH requirement.
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- 2021
12. A Paced-ECG Detector and Delineator for Automatic Multi-Parametric Catheter Mapping of Ventricular Tachycardia
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Freddy Odille, Julien Oster, Alberto Battaglia, Philip Hoyland, Jacques Felblinger, Nefissa Hammache, Christian de Chillou, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biosense Webster France, Johnson & Johnson, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Odille, Freddy, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
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General Computer Science ,Computer science ,medicine.medical_treatment ,electrocardiography ,0206 medical engineering ,radiofrequency catheter ablation ,02 engineering and technology ,030204 cardiovascular system & hematology ,Ventricular tachycardia ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Wavelet ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine ,General Materials Science ,Sinus rhythm ,cardiovascular diseases ,Parametric statistics ,[SDV.IB] Life Sciences [q-bio]/Bioengineering ,medicine.diagnostic_test ,business.industry ,General Engineering ,Pattern recognition ,Ablation ,medicine.disease ,020601 biomedical engineering ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Catheter ,cardiac interventional electrophysiology ,medicine.anatomical_structure ,Ventricle ,cardiovascular system ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Artificial intelligence ,lcsh:Electrical engineering. Electronics. Nuclear engineering ,business ,Electrocardiography ,lcsh:TK1-9971 ,Arrhythmia - Abstract
International audience; Ventricular tachycardia (VT) is a life-threatening arrhythmia, which can be treated by catheter intervention. Accurate identification of the underlying reentrant circuit is often challenging, yet it is key to successful ablation of the VT. In practice, the cardiologist often uses electrocardiography (ECG) data provided by various catheter mapping techniques, including parameters acquired during sinus rhythm (voltage maps, presence of fragmented/late potentials) and during controlled pacing from different sites of the ventricle, so-called pace-mapping. A novel method is presented here to automatically extract the key information from pace-mapping data with automated detection of paced heartbeats from the surface ECG signals, using wavelet detection of pacing spikes and combined time/energy criteria, and automated delineation of paced beats, QRS peak, and QRS onset. This allows the generation of correlation gradient maps (indicating QRS morphology changes as the catheter is moved) and stimulus-to-QRS maps (sQRS, indicating the delay between pacing and activation of the healthy myocardium). The delineator is shown to be in good agreement with manual annotations from experts in a retrospective study of 18 VT ablation procedures. Paced-QRS detection had 95.2% sensitivity and 98.4% positive predictive value. Resulting sQRS maps had a mean absolute error of 11.1 ms, which was in the same range as the inter-observer errors (9.7 ms). The automatic processing drastically reduces the need for manual annotations. Therefore it makes it feasible to process and visualize, during the procedure, all the relevant parametric maps, which can be analyzed jointly to identify VT circuits and corresponding ablation targets.
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- 2020
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13. Distance between the descending aorta and the left inferior pulmonary vein as a determinant of biophysical parameters during paroxysmal atrial fibrillation cryoablation
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Jean Baptiste Guichard, Antoine Da Costa, Karim Benali, Dominique Pavin, Laurent Macle, Cécile Romeyer, Christophe Leclercq, Raphaël P. Martins, Vincent Galand, Nefissa Hammache, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Montreal Heart Institute - Institut de Cardiologie de Montréal, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,cryoballoon ,Aorta, Thoracic ,030204 cardiovascular system & hematology ,Cryosurgery ,aortic imprint ,03 medical and health sciences ,0302 clinical medicine ,cryolesion ,Recurrence ,Physiology (medical) ,medicine.artery ,Internal medicine ,medicine ,Left inferior pulmonary vein ,Humans ,blood flow ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Aorta ,business.industry ,left inferior pulmonary vein ,temperature ,Cryoablation ,Atrial fibrillation ,Blood flow ,Middle Aged ,medicine.disease ,Ablation ,Ostium ,aorta ,Treatment Outcome ,Pulmonary Veins ,cryoablation ,Descending aorta ,Catheter Ablation ,cardiovascular system ,Cardiology ,Female ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Cardiology and Cardiovascular Medicine ,business - Abstract
International audience; INTRODUCTION: The distance from the descending aorta (DA) to the posterior wall of the left atrium (LA) is variable. We aimed to determine whether the proximity between the DA and the left inferior pulmonary vein (LIPV) ostium has an impact on biophysical parameters and cryoballoon (CB) ablation efficacy during LIPV freezing. METHODS: Patients referred for CB-ablation of atrial fibrillation (AF) in two high-volume centers were included. Cryoablation data were collected prospectively for each patient. The anatomical relationships between the LIPV and the DA (distance LIPV ostium-DA, presence of an aortic imprint on the posterior aspect of the LIPV) were then retrospectively analysed on the LA computed tomography (CT) scans realized before AF ablation. RESULTS: 350 patients were included (70% men, 59.7±11.5 yo). The decrease in the Ostium-DA distance was significantly correlated to the increase in the Time-To-Isolation (TTI) (r=-0.31; p=0.036), with less negative temperature (r=-0.11; p=0.045). Similarly, the presence of an aortic imprint on the LIPV was associated with a longer TTI (p
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- 2021
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14. Is There an Association between Epicardial Adipose Tissue and Outcomes after Paroxysmal Atrial Fibrillation Catheter Ablation?
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Damien Minois, Mathieu Echivard, Hugo Pegorer-Sfes, Christian de Chillou, Jean Marc Sellal, Nefissa Hammache, Nicolas Sadoul, Isabelle Magnin Poull, Arnaud Olivier, Karim Benali, Damien Mandry, and Nathalie Pace
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medicine.medical_specialty ,Paroxysmal atrial fibrillation ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Article ,Pulmonary vein ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,catheter ablation ,medicine ,Sinus rhythm ,030212 general & internal medicine ,paroxysmal atrial fibrillation ,business.industry ,Retrospective cohort study ,General Medicine ,Ablation ,epicardial adipose tissue ,Pathophysiology ,Epicardial adipose tissue ,Cardiology ,Medicine ,business - Abstract
Background: In patients undergoing paroxysmal atrial fibrillation (PAF) ablation, pulmonary vein isolation (PVI) alone fails in maintaining sinus rhythm in up to one third of patients after a first catheter ablation. Epicardial adipose tissue (EAT), as an endocrine-active organ, could play a role in the recurrence of AF after catheter ablation. Objective: To evaluate the predictive value of clinical, echocardiographic, biological parameters and epicardial fat density measured by computed tomography scan (CT-scan) on AF recurrence in PAF patients who underwent a first pulmonary vein isolation procedure using radiofrequency (RF). Methods: This monocentric retrospective study included all patients undergoing first-time RF PAF ablation at the Nancy University Hospital between March 2015 and December 2018 with one-year follow-up. Results: 389 patients were included, of whom 128 (32.9%) had AF recurrence at one-year follow-up. Neither total-EAT volume (88.6 ± 37.2 cm3 vs. 91.4 ± 40.5 cm3, p = 0.519), nor total-EAT radiodensity (−98.8 ± 4.1 HU vs. −98.8 ± 3.8 HU, p = 0.892) and left atrium-EAT radiodensity (−93.7 ± 4.3 HU vs. −93.4 ± 6.0 HU, p = 0.556) were significantly associated with AF recurrence after PAF ablation. In multivariate analysis, previous cavo-tricuspid isthmus (CTI) ablation, ablation procedure duration, BNP and triglyceride levels remained independently associated with AF recurrence after catheter ablation at 12-months follow-up. Conclusion: Contrary to persistent AF, EAT parameters are not associated with AF recurrence after paroxysmal AF ablation. Thus, the role of the metabolic atrial substrate in PAF pathophysiology appears less obvious than in persistent AF.
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- 2021
15. Impact of Midregional N‐Terminal Pro–Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study
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Marie-France Seronde, Guillaume Serzian, Fiona Ecarnot, Marc Badoz, Alexandre Mebazaa, Baptiste Favoulet, Gabriel Laurent, Nefissa Hammache, Jean-Marc Sellal, Francois Schiele, Nicolas Meneveau, Christian de Chillou, and Karine Bardonnet
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Male ,medicine.medical_specialty ,Time Factors ,medicine.drug_class ,medicine.medical_treatment ,Biorhythm ,Catheter ablation ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,Predictive Value of Tests ,Recurrence ,Risk Factors ,Internal medicine ,catheter ablation ,Atrial Fibrillation ,medicine ,Natriuretic peptide ,Humans ,In patient ,Arrhythmia and Electrophysiology ,030212 general & internal medicine ,Heart Atria ,Prospective Studies ,Original Research ,Aged ,sST2 ,business.industry ,MRproANP ,biomarkers ,Atrial fibrillation ,Plasma levels ,Middle Aged ,medicine.disease ,Interleukin-1 Receptor-Like 1 Protein ,Up-Regulation ,Heart Rhythm ,Treatment Outcome ,Pro atrial natriuretic peptide ,Cardiology ,Female ,France ,Cardiology and Cardiovascular Medicine ,business ,Catheter Ablation and Implantable Cardioverter-Defibrillator ,Atrial Natriuretic Factor - Abstract
Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P P =0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03351816.
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- 2021
16. New Perspective in Atrial Fibrillation
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Nefissa Hammache, Audrey Sagnard, Charles Guenancia, Jean-Marc Sellal, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and SELLAL, Jean-Marc
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medicine.medical_specialty ,education ,MEDLINE ,lcsh:Medicine ,macromolecular substances ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,0502 economics and business ,medicine ,Intensive care medicine ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,business.industry ,lcsh:R ,05 social sciences ,Perspective (graphical) ,Subject (documents) ,Atrial fibrillation ,General Medicine ,medicine.disease ,3. Good health ,n/a ,Editorial ,050211 marketing ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Despite a large number of publications on this subject, the pathophysiological mechanisms involved in atrial fibrillation (AF) onset and recurrence are uncertain [...]
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- 2020
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17. Is cardiac magnetic resonance imaging a game changer in re-ablation of atrial fibrillation?
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Jean-Marc Sellal, Christian de Chillou, Charles Guenancia, Nefissa Hammache, Service de Cardiologie [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Ablation of atrial fibrillation ,Heart ,030204 cardiovascular system & hematology ,Magnetic Resonance Imaging ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Cardiac magnetic resonance imaging ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,Catheter Ablation ,medicine ,Cardiology ,Humans ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
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- 2021
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18. Low versus standard-blood-flow reperfusion strategy in a pig model of refractory cardiac arrest resuscitated with Extra Corporeal Membrane Oxygenation
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Yun Luo, Nguyen Tran, Bruno Levy, Eliane Albuisson, Nefissa Hammache, Antoine Kimmoun, Daniel Grandmougin, Sophie Orlowski, and Caroline Fritz
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Male ,Mean arterial pressure ,medicine.medical_specialty ,Resuscitation ,Swine ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Emergency Nursing ,Statistics, Nonparametric ,Microcirculation ,03 medical and health sciences ,Random Allocation ,0302 clinical medicine ,Extracorporeal Membrane Oxygenation ,Internal medicine ,Extracorporeal membrane oxygenation ,medicine ,Animals ,Humans ,Arterial Pressure ,business.industry ,030208 emergency & critical care medicine ,Blood flow ,Oxygenation ,Heart Arrest ,Disease Models, Animal ,medicine.anatomical_structure ,Cerebral blood flow ,Cerebrovascular Circulation ,Reperfusion ,Emergency Medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Objective This study was designed to assess the effect of two veno-arterial ExtraCorporeal Membrane Oxygenation (ECMO) blood-flow strategies in an experimental model of Extracorporeal Cardio-Pulmonary Resuscitation (ECPR) on macrocirculatory, metabolic and microcirculatory parameters in the first six hours of ECMO initiation. Methods Cardiac arrest was induced in 18 pigs by surgical ligature of the left descending coronary artery followed by a low-flow time of 40 min using internal cardiac massage. ECPR was initiated in normothermia with an ECMO blood flow of 30–35 ml.kg−1. min−1 (low-blood-flow group, LBF) or 65–70 ml.kg−1. min-1 (standard-blood-flow group, SBF), with the same mean arterial pressure target of 65 mmHg adjusted with norepinephrine. Macrocirculatory and metabolic parameters were assessed by lactate clearance and carotid blood flow. Microcirculatory parameters were assessed by sublingual microcirculation with Sidestream Dark Field (SDF) imaging and peripheral Near-InfraRed Spectrometry (NIRS). Inflammatory cytokine levels were measured with a multicomplexed ELISA-based array platform. Results There were no between-group differences at baseline and at ECMO initiation (H0). Lactate clearance at H6 was lower in LBF compared to SBF (6.67[-10.43-18.78] vs. 47.41[19.54–70.69] %, p = 0.04). Carotid blood flow was significantly lower (p Conclusion In an experimental porcine model of refractory cardiac arrest treated by ECMO, a low-blood-flow strategy during the first six hours of resuscitation was associated with lower lactate clearance and lower cerebral blood flow with no benefits on ischemia-reperfusion parameters.
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- 2018
19. Impact of Global and Segmental Hypertrophy on Two-Dimensional Strain Derived from Three-Dimensional Echocardiography in Hypertrophic Cardiomyopathy: Comparison with Healthy Subjects
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Christine Selton-Suty, Etienne Aliot, Laura Filippetti, Thibaud Vaugrenard, Yves Juillière, Olivier Huttin, Nicolas Sadoul, Damien Voilliot, and Nefissa Hammache
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Male ,medicine.medical_specialty ,3d strain ,Heart Ventricles ,Echocardiography, Three-Dimensional ,Ventricular Function, Left ,Muscle hypertrophy ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Myocardial mass ,Retrospective Studies ,Ejection fraction ,Strain (chemistry) ,business.industry ,Hypertrophic cardiomyopathy ,Reproducibility of Results ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,Myocardial Contraction ,Healthy Volunteers ,Cardiology ,Female ,Deformation (engineering) ,Cardiology and Cardiovascular Medicine ,business ,Radial stress ,Follow-Up Studies - Abstract
Patients with hypertrophic cardiomyopathy (HCM) present unusual myocardial mechanics. The aim of this study was to assess the impact of hypertrophy on global and regional two-dimensional (2D) strain derived from both tomographic images (2D/2D) and volumetric image acquisition (2D/three-dimensional [3D]) in patients with HCM compared with control subjects.Comprehensive resting 2D and 3D echocardiography was performed in 40 patients with HCM and in 53 control subjects, with comparable distributions of age, gender, and left ventricular (LV) ejection fraction. LV global and segmental measurements of all 2D/2D and 2D/3D peak strain components (global and segmental longitudinal strain, global and segmental circumferential strain, global and segmental radial strain, and global and segmental area strain) and 3D indexed LV end-diastolic myocardial mass were obtained from all patients. LV wall thickness was assessed in short-axis views and classified in four quartiles (10.5, 10.5-13.0, 13.0-16.5, and16.5 mm).The reproducibility of 2D/3D strain was similar or greater and more consistent for all components compared with 2D/2D strain analysis. There was a significant correlation between 3D LV end-diastolic mass and all 2D/3D strain components (P .05). Two-dimensional/3D global circumferential strain had the strongest association with 3D LV ejection fraction (r = 0.50, P = .001). For segmental deformation, patients with HCM had lower longitudinal deformation whatever the LV wall thickness, whereas circumferential function was increased in nonhypertrophied and poorly hypertrophied segments compared with control subjects.Two-dimensional/3D strain is a reliable technique to assess myocardial deformation. Myocardial mass is related to 2D/3D strain components in patients with HCM. Circumferential deformation, compared with longitudinal deformation, seems to be the main component of the maintenance of systolic function in HCM.
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- 2014
20. 8 Impact of global and segmental hypertrophy on 2D and 3D strain in hypertrophic cardiomyopathy: comparison with healthy subjects
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Thibaud Vaugrenard, Nicolas Sadoul, Yves Juillière, Laura Filippetti, Christine Selton-Suty, Etienne Aliot, Damien Voilliot, Olivier Huttin, and Nefissa Hammache
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medicine.medical_specialty ,3d strain ,business.industry ,Internal medicine ,medicine ,Cardiology ,Hypertrophic cardiomyopathy ,Healthy subjects ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Muscle hypertrophy - Published
- 2015
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21. Impact of Midregional N‐Terminal Pro–Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study
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Marc Badoz, Guillaume Serzian, Baptiste Favoulet, Jean‐Marc Sellal, Christian De Chillou, Néfissa Hammache, Gabriel Laurent, Alexandre Mebazaa, Fiona Ecarnot, Karine Bardonnet, Marie‐France Seronde, François Schiele, and Nicolas Meneveau
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atrial fibrillation ,biomarkers ,catheter ablation ,MRproANP ,sST2 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03351816.
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- 2021
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