212 results on '"S, Kacet"'
Search Results
2. La télécardiologie en France, état des lieux en 2012 et perspectives de développement
- Author
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L. Guédon-Moreau, S. Kacet, P. Mabo, and J. Clémenty
- Subjects
Health Information Management ,Health Informatics - Abstract
Resume La cardiologie est un domaine ou la telemedecine devrait connaitre un essor rapide. L’application la plus avancee aujourd’hui est le telesuivi des stimulateurs et defibrillateurs cardiaques implantables, permettant de limiter les suivis en face a face au centre d’implantation et d’acceder plus facilement aux donnees memorisees dans la protheses. Apres une phase de validation technologique, des larges etudes prospectives randomisees (TRUST, CONNECT, COMPAS, ECOST, EVATEL) ont demontre la securite d’utilisation du telesuivi sur des criteres durs de morbi-mortalite avec une valeur ajoutee sous la forme d’une reduction du nombre des consultations, d’une detection anticipee des evenements et d’une reduction des therapies inappropriees. Ce nouveau standard de suivi s’integre parfaitement dans la loi francaise sur la telemedecine. Neanmoins, certains obstacles doivent encore etre leves, notamment les aspects financiers de remboursement des actes pour les equipes medicales et de prise en charge d’un service pour les industriels, avant de passer dans la routine. L’acceptation par les patients et la communaute medicale ne devrait pas etre un reel probleme sous reserve de bien definir les objectifs cliniques et les modalites de partage de l’information. D’autres domaines de la cardiologie devraient a moyen terme s’ouvrir a la telemedecine. more...
- Published
- 2012
- Full Text
- View/download PDF
Catalog
3. Le télésuivi des dispositifs implantés
- Author
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L. Guédon-Moreau, L. Finat, and S. Kacet
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2011
- Full Text
- View/download PDF
4. Thérapeutiques actuelles de la fibrillation atriale, rythme et fréquence, réflexion sur un nouveau paradigme de prise en charge
- Author
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S. Kacet
- Subjects
Pediatrics ,medicine.medical_specialty ,Aspirin ,Heart disease ,medicine.drug_class ,business.industry ,medicine.medical_treatment ,Anticoagulant ,Atrial fibrillation ,Antiarrhythmic agent ,medicine.disease ,Dronedarone ,Heart rate ,medicine ,Sinus rhythm ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Over the past 30 years, treatment paradigms for atrial fibrillation (AF) patients have changed dramatically. Before 1989, and the publication of the CAST trial results, the primary objective was to maintain or restore sinus rhythm. In the following 20 years, the management of AF patients has focused on the prevention of thrombo-embolic events (with the confrontation of aspirin and oral anticoagulants), and on the debate between rhythm control and rate control. In 2010, the objectives are to reduce symptoms and improve quality of life, to prevent thrombo-embolic complications, and, if possible, to reduce mortality. New anticoagulants will soon be available. Ablative techniques are becoming current practice in selected patients, and the new antiarrhythmic agent dronedarone has shown remarkable clinical results in the ATHENA trial. Overall, ablative techniques can be used in younger patients with paroxysmal or persistent AF refractory to medical treatment a rate control strategy is appropriate in permanent AF, or as second line treatment in patients with other forms of AF. more...
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- 2010
- Full Text
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5. DAI : quel est le bon nombre d’implantations ?
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S. Kacet, N. Saoudi, and C. Kouakam
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2010
- Full Text
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6. Les enjeux du traitement antithrombotique
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L. Guédon-Moreau and S. Kacet
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Aspirin ,medicine.medical_specialty ,Thienopyridine ,business.industry ,medicine.drug_class ,fungi ,food and beverages ,Low molecular weight heparin ,Atrial fibrillation ,medicine.disease ,Antithrombotic treatment ,Internal medicine ,Antithrombotic ,Cardiology ,Medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,medicine.drug - Abstract
Antithrombotic treatment is a crucial challenge in the management of patients with atrial fibrillation (AF). It is the only treatment which can decrease mortality in relation with AF. It can also prevent the first cause of dependency in elderly: stroke. Vitamin K antagonists are the more potent drugs to reduce the risk of ischemic stroke in patient with AF. Aspirin, unfractioned heparine or low molecular weight heparin and thienopyridine can also play a role in the antithrombotic therapy in special situations. more...
- Published
- 2009
- Full Text
- View/download PDF
7. Traitement antithrombotique et fibrillation atriale
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L. Guédon-Moreau and S. Kacet
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2008
- Full Text
- View/download PDF
8. Atrial Fibrillation Detection and R-Wave Synchronization by Metrix Implantable Atrial Defibrillator
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C.-P. Lau, Harry J.G.M. Crijns, J. S. Sra, N. Edvardsson, S. Kacet, D. G. Wyse, and Hung-Fat Tse
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Fibrillation ,medicine.medical_specialty ,Atrium (architecture) ,Defibrillation ,business.industry ,medicine.medical_treatment ,Atrial fibrillation ,medicine.disease ,QRS complex ,Physiology (medical) ,Internal medicine ,Ventricular fibrillation ,medicine ,Cardiology ,Sinus rhythm ,Electrical conduction system of the heart ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background —The long-term efficacy of atrial fibrillation (AF) detection and R-wave synchronization are critical safety requirements for the development of an implantable atrial defibrillator (IAD) for treatment of AF. Methods and Results —The long-term efficacy of the Metrix IAD for AF detection and R-wave synchronization was tested in 51 patients. The mean duration of follow-up was 259±138 days (72 to 613 days). AF detection tests were performed 2240 times during observed operation with 100% specificity and 92.3% sensitivity for differentiation between sinus rhythm and AF; 2219 episodes and their electrograms stored in the device during AF detection were analyzed. The positive predictive value of the AF detection algorithm was 97.4% (lower 95% confidence limit [CL], 94.5%) in the out-of-hospital setting. A total of 242 435 R waves were analyzed for R-wave synchronization. Of these, 49% were marked for synchronized shock delivery, 82% of sinus rhythm and 36% of AF R waves, respectively. All shock markers were properly synchronized and within the R wave (overall synchronization accuracy, 100%; lower 95% CL, 99.999%). Overall, 3719 shocks have been delivered via the IAD with no instance of unsynchronized shock delivery or any episode of proarrhythmia. The observed proarrhythmic risk was 0%, with an estimated maximum proarrhythmic risk of 0.084% per shock (95% upper CL). Conclusions —The Metrix IAD can appropriately detect AF with a high specificity and sensitivity and reliably synchronize within a suitable R wave for shock delivery to minimize the risk of ventricular proarrhythmia. more...
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- 1999
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9. [Current management of atrial fibrillation: rhythm or rate control and thoughts about a new treatment paradigm]
- Author
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S, Kacet
- Subjects
Heart Rate ,Atrial Fibrillation ,Humans - Abstract
Over the past 30 years, treatment paradigms for atrial fibrillation (AF) patients have changed dramatically. Before 1989, and the publication of the CAST trial results, the primary objective was to maintain or restore sinus rhythm. In the following 20 years, the management of AF patients has focused on the prevention of thrombo-embolic events (with the confrontation of aspirin and oral anticoagulants), and on the debate between rhythm control and rate control. In 2010, the objectives are to reduce symptoms and improve quality of life, to prevent thrombo-embolic complications, and, if possible, to reduce mortality. New anticoagulants will soon be available. Ablative techniques are becoming current practice in selected patients, and the new antiarrhythmic agent dronedarone has shown remarkable clinical results in the ATHENA trial. Overall, ablative techniques can be used in younger patients with paroxysmal or persistent AF refractory to medical treatment a rate control strategy is appropriate in permanent AF, or as second line treatment in patients with other forms of AF. more...
- Published
- 2011
10. [Atrial fibrillation: challenge of antithrombotic treatment]
- Author
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L, Guédon-Moreau and S, Kacet
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Fibrinolytic Agents ,Atrial Fibrillation ,Practice Guidelines as Topic ,Humans - Abstract
Antithrombotic treatment is a crucial challenge in the management of patients with atrial fibrillation (AF). It is the only treatment which can decrease mortality in relation with AF. It can also prevent the first cause of dependency in elderly: stroke. Vitamin K antagonists are the more potent drugs to reduce the risk of ischemic stroke in patient with AF. Aspirin, unfractioned heparine or low molecular weight heparin and thienopyridine can also play a role in the antithrombotic therapy in special situations. more...
- Published
- 2010
11. [Management of atrial fibrillation in France: the observational FACTUEL study]
- Author
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P, Mabo, A, Leenhardt, P, Jaillon, S, Kacet, F, Aubin, I, Denjoy, and J-Y, Le Heuzey
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Male ,Cross-Sectional Studies ,Atrial Fibrillation ,Humans ,Female ,France ,Guideline Adherence ,Practice Patterns, Physicians' ,Aged - Abstract
To describe the management of patients with atrial fibrillation (AF) and to study consistency with guidelines on management of AF.Observational study on a random sample of cardiologists from a French national database. Each cardiologist had to recruit the first five patients meeting inclusion criteria (patients diagnosed with AF between January 2004 and one month before inclusion and accepting the collection of their medical data).Between December 2006 and January 2207, 1789 patients aged 71 on average have been recruited by 481 cardiologists. Fifty-one percent were diagnosed with paroxysmal, 15% with persistent and 33% with permanent AF. Restoration of sinus rhythm was preferred in forms considered as paroxysmal or persistent forms whereas control of the ventricular rate was more frequent in AF considered as permanent. Overall, therapeutic guidelines are applied in practice, despite a frequent use of amiodarone in patients with no associated heart disease. Prevention of thromboembolism was observed in 88% of the patients.FACTUEL is the biggest observational study on AF ever conducted in France. The therapeutic strategies used by the cardiologists are consistent with the objectives of preventing thromboembolism and controlling heart rhythm and/or rate. In most cases, the treatment used is consistent with the therapeutic guidelines. more...
- Published
- 2008
12. [Clinical evolution of patients following investigation of atrial vulnerability after a first cerebral ischaemic accident]
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E, Somody, M, Delay, P H, Rouesnel, D, Galley, P, Cosnay, C, Arquizan, J L, Mas, S, Kacet, and J Y, Le Heuzey
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Adult ,Aged, 80 and over ,Male ,Smoking ,Age Factors ,Middle Aged ,Stroke ,Risk Factors ,Atrial Fibrillation ,Hypertension ,Humans ,Female ,Registries ,Electrophysiologic Techniques, Cardiac ,Aged ,Retrospective Studies - Abstract
Atrial vulnerability reflects the ability of the atrium to fibrillate. ISAV (Ischemic stroke and atrial vulnerability) is a French epidemiological registry whose main goal is to assess the evolution modalities of patients in whom an electrophysiological study of the atrium has been performed. A group of 269 patients with a history of non elucidated ischemic stroke and an electrophysiological study of the atrium performed in a mean delay of 3 months after the stroke has been included. Their mean age at the time of the stroke was 55 +/- 15.8 years. The electrophysiological study has measured the effective refractory period of the atrium, the locoregional right intra-atrial conduction time, the index of latent atrial vulnerability and assessed the inductibility. The mean delay between the date of the stroke and the date of the last news was 4.4 +/- 2.8 years. We observed 12 deaths and 11 patients presented during the follow up a spontaneous atrial arrhythmia and 17 a recurrence of stroke. If we consider the occurrence of the 28 combined events (atrial arrhythmia and/or stroke), it is not correlated with the presence of an atrial septal defect nor with the existence of an atrial vulnerability. On the contrary this occurrence is correlated with tobacco consumption and/or arterial hypertension; 82% of patients have these risk factors versus 54% of patients without events (p = 0.004). This association is not significant in patients younger than 55 years. more...
- Published
- 2006
13. [AFFIRM: what we have learned ... and pending issues]
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J Y, Le Heuzey, E, Aliot, P, Jaillon, S, Kacet, A, Leenhardt, and P, Mabo
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Atrial Fibrillation ,Humans ,Anti-Arrhythmia Agents ,Survival Analysis ,Randomized Controlled Trials as Topic - Abstract
During these last years, several therapeutic strategies trials have been performed in atrial fibrillation: the goal was to compare the rhythm control strategy (restoration and maintenance of sinus rhythm) to the rate control strategy (slowing of heart rate in atrial fibrillation). The most important of these different trials is the AFFIRM study. The main conclusion of this trial is that rate control can be chosen in first intention and not only in case of failure of the rhythm control strategy. These results can not be applied to 2 categories of patients: on one hand patients with heart failure and on the other hand young patients without cardiopathy in whom the strategy of rhythm control and sinus rhythm maintenance, mainly by class I antiarrhythmic drugs, remains the better choice. more...
- Published
- 2005
14. [New concepts of anticoagulant therapy of atrial fibrillation]
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L, Guedon-Moreau, F, Brigadeau, and S, Kacet
- Subjects
Vitamin K ,Atrial Fibrillation ,Anticoagulants ,Humans ,Thrombosis - Abstract
The news concerning anticoagulant therapy is very rich. It was also keenly awaited in view of the real imperfection of antivitamin K drugs on which the present strategy of prevention of thromboembolic risk related to atrial fibrillation is based. The new anticoagulants have differing targets identified from the physiological mechanism of coagulation and the physiopathology of thrombosis. more...
- Published
- 2004
15. [Complications of permanent cardiac pacing]
- Author
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D, Klug, C, Marquié, D, Lacroix, and S, Kacet
- Subjects
Pacemaker, Artificial ,Prosthesis-Related Infections ,Cardiovascular Diseases ,Humans ,Equipment Failure ,Equipment Design - Abstract
The implantation of a pacemaker is an everyday medical procedure. New indications are under evaluation. However, it should be recalled that this is a surgical intervention with implantation of a prosthesis with possible complications. This should, therefore, be a considered decision. There are early complications which occur in the first 6 weeks after implantation. Their incidence is underestimated (up to 7%) as is their seriousness. There are late complications. Some are responsible for pacemaker dysfunction, the risk of which is proportional to the dependence of the patient on permanent cardiac pacing. The migration of a pacing catheter or the fracture of an Accufix catheter expose the patient to much greater risk. Venous complications are overlooked as they are usually asymptomatic. The superior vena cava syndrome is, however, a serious complication of cardiac pacing. Two recent studies (MOST and DAVID) underline the deleterious haemodynamic effects of unnecessary right ventricular pacing. This right ventricular pacing may have a pro-arrhythmic effect on the ventricles and be responsible for sudden death. It may also cause atrial arrhythmia even if atrio-ventricular synchronisation is preserved. Infectious complications are also under-reported, partially because of the difficulty of diagnosis. They may be life-threatening and require extraction of the implanted material. In conclusion, it is wrong to think that even if a patient does not benefit from his implanted device this cannot have deleterious consequences. Pacemakers should be adjusted especially to avoid inappropriate right ventricular stimulation. more...
- Published
- 2004
16. [Infections secondary to the implantation of a pacemaker: update]
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M, Dheedene, D, Klug, M, Jarwé, C, Kouakam, C, Marquie, and S, Kacet
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Pacemaker, Artificial ,Prosthesis-Related Infections ,Decision Trees ,Humans ,Prognosis - Abstract
Pacemaker lead infection is a major complication of endovascular permanent pacing. The incidence is less than 1% but it is a frequent disease due to the high number of pacemaker implanted. The diagnosis is difficult due to the insidious symptoms. Pacemaker infection must be systematically considered in patients with a pacemaker and symptoms of infection. Several investigations are useful for the diagnosis particularly the transesophageal echocardiography, but all investigations have a low negative predictive value. All of the implanted material must be completely removed. more...
- Published
- 2003
17. [Use of semi-automatic defibrillators outside the hospital]
- Author
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S, Kacet, N, Zghal, C, Kouakam, N, Benameur, and P, Goldstein
- Subjects
Automation ,Patient Education as Topic ,Survival ,Ventricular Fibrillation ,Electric Countershock ,Humans ,Prognosis - Abstract
With an annual incidence of 1 to 2@1000 and a rate of survival without complication of 2%, sudden death outside hospital constitutes a serious public health problem in France. Ventricular fibrillation (VF) is responsible for more than three quarters of these deaths. The rate of survival is inversely proportional to the duration of VF making early defibrillation a strong link in the chain of survival. The chances of survival are much greater if the cardio-respiratory arrest occurs with a witness, basic first aid is started rapidly, diagnosis of VF is made quickly and the first shock is delivered as soon as possible. These last two criteria are being met more often since the advent of the semi-automatic defibrillator (SAD) and its availability to first line rescuers. The SAD is a light and compact defibrillator capable of automatic analysis of the electrocardiographic trace, charging if it detects ventricular tachycardia (VT) or VF. By analysing the QRS amplitude, its slope, its morphology, its spectral density and the duration of the isoelectric line, the SAD is capable of recognising VF with a sensibility of 98% and a specificity of 93%. The shock, however, is only delivered with a manoeuvre from the operator. The SAD memorizes both the rhythmic event treated and certain parameters relating to its use. During the last decade, the SAD has benefited from the technological evolutions of the implantable automatic defibrillator, with the introduction of a biphasic shock. The use of a biphasic shock allows reduction in the minimal defibrillation charge and thus lightens the apparatus and increases the number of shocks which the SAD can deliver on a charged battery. In authorizing paramedics by statute to use the SAD, it has been possible to reduce the interval from alert to first delivered shock to 8 minutes although it would be 10 minutes if the medical team was awaited, and to obtain a survival rate without complication of 6.3%. The progress achieved by the use of the SAD in the chain of survival cannot be denied. However, to surpass automatic defibrillation and widen the use of defibrillators to an informed and motivated public would certainly bring our results closer to those obtained in America where the survival rate reaches 30% in the best cases; subject to widespread first aid training for the population. more...
- Published
- 2002
18. [Contribution of the implantable ECG monitor in the etiologic diagnosis of syncope and unexplained recurrent syncopal attacks. Initial experience with 32 patients]
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R, Chettaoui, C, Kouakam, D, Klug, C, Marquie, D, Lacroix, and S, Kacet
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Adult ,Male ,Adolescent ,Electrocardiography, Ambulatory ,Humans ,Female ,Prostheses and Implants ,Middle Aged ,Child ,Syncope ,Aged ,Follow-Up Studies - Abstract
Following an exhaustive aetiological investigation, 10 to 26% of syncopal attacks remain unexplained. In these cases the correlation between symptoms and rhythm is a deciding step for the aetiological diagnosis. We report our initial experience using an implantable electrocardiographic monitor, a new diagnostic tool in patients suffering from syncope and recurrent unexplained syncopal attacks.The study included 32 patients (average age 55 +/- 22 years; 23 males) suffering from syncope and/or recurrent syncopal attacks remaining unexplained following an exhaustive aetiological investigation. The average follow up was 10.2 +/- 2.5 months. No case of sudden death was registered, and the device was removed in only one patient due to poor tolerance. During follow up, 21 recordings were memorized and analysed in 15 patients (45%), giving an average of 1.4 recordings per patient. The average interval for recurrence of symptoms after implantation was from 84 +/- 104 days, 75% of the episodes coming in the first 2 months following implantation. An arrhythmia was detected on 10 occasions: a malignant ventricular arrhythmia in 2 patients, a non-sustained ventricular tachycardia in 1 patient, a junctional tachycardia in 1 patient, entry into paroxysmal atrial fibrillation in 4 patients, a sinus bradycardia in 1 patient, and a sinus pause for 19 seconds in 1 patient. In one patient ST segment depression was documented following anterior chest pain. The tracing was normal with sinus rhythm recorded on 10 occasions, representing the only documented information in 4 patients. In total, an aetiology was found in 11 of the 32 patients evaluated (34%). Once the aetiological diagnosis was established and a specific treatment initiated, all the patients became asymptomatic.Our preliminary results underline the significance of the implantable ECG monitor in the diagnostic approach to recurrent unexplained syncopal attacks. The exact place of this tool in the decisional algorithm for syncope remains to be defined with further studies. more...
- Published
- 2002
19. Impact of remote monitoring in the reduction of inappropriate shocks related to implantable cardioverter-defibrillators lead fractures: A real life observational study
- Author
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S. Kacet, S. Boulé, L Guédon-Moreau, Z. Souissi, C. Marquié, Dominique Lacroix, D. Klug, C. Kouakam, S. Mouton, L. Finat, and François Brigadeau
- Subjects
medicine.medical_specialty ,Inappropriate shock ,Ventricular lead ,business.industry ,medicine.medical_treatment ,Icd lead ,Health Informatics ,Electronic records ,Health Information Management ,medicine ,Observational study ,In patient ,Intensive care medicine ,business ,Lead (electronics) ,Reduction (orthopedic surgery) - Abstract
Background Lead fractures in implantable cardioverter-defibrillator (ICD) patients may cause inappropriate shocks. An early diagnosis is essential to prevent adverse clinical events. ICD remote monitoring permits prompt detection of lead fracture. Limited data define the impact of remote monitoring on inappropriate shocks related to lead fracture. Aims To compare the number of inappropriate shocks related to lead fracture in patients with and without remote monitoring follow-up. Methods We checked the registry of our institution and collected, between July 2007 and June 2014, 115 cases of right ventricular lead fractures. All relevant data were documented from patients’ files, device interrogations printouts and electronic records, and remote transmissions databases when applicable. We assessed the inappropriate shocks that were related to lead fracture. The first study endpoint was the number of inappropriate shocks per shocked patient. Results Among the 82 patients with conventional follow-up and the 33 patients with remote monitoring, a first inappropriate shock occurred in 32.9% ( n = 27) and 30.3% ( n = 10, P = 0.83) of the patients respectively. Shocked patients in the remote monitoring group underwent significantly lesser inappropriate shocks with a median of 3.5 [1.8 to 8.3] shocks per patient than those in the conventional follow-up group with a median of 10.0 [5.0 to 22.0] shocks per patient ( P = 0.03). Conclusion Remote monitoring helps to reduce the number of inappropriate shocks in symptomatic ICD lead fractures. more...
- Published
- 2014
- Full Text
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20. ICD remote monitoring: A validated organizational model of transmission management
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S. Boulé, C. Marquié, D. Klug, S. Kacet, François Brigadeau, L. Finat, C. Kouakam, Dominique Lacroix, L Guédon-Moreau, and B. Mondesert
- Subjects
business.industry ,Organizational model ,Healthcare quality improvement ,Decision tree ,Health Informatics ,medicine.disease ,computer.software_genre ,Sudden cardiac death ,Health Information Management ,Health care ,medicine ,Observational study ,Medical emergency ,Data mining ,business ,Standard therapy ,computer - Abstract
Background Implantable cardioverter-defibrillators (ICD) are a standard therapy to prevent sudden cardiac death (SCD). Remote monitoring (RM) of ICD patients provides healthcare quality improvement and resource savings compared with standard in-hospital visits. Only limited data exist about RM organizations. Objectives We aimed to evaluate and validate our institutional optimized RM organization model for ICD patients. Methods This observational study compared two RM models with an iterative qualitative and quantitative approach in 562 ICD patients: RM1 with device diagnostics evaluation by nurses and cardiologists, and RM2 with a selected approach with decision trees for actions. The main endpoints were in-hospital professional actions and times related to RM alerts. Results During RM1, 1134 alerts occurred in 427 patients (286 patient-years) of which 376 (33%) were submitted to cardiologist review whereas during RM2, 1522 alerts occurred in 562 patients (458 patient-years) of which 273 (18%) were submitted to cardiologist review (P Conclusion In ICD patients, optimized RM strategy based on automatic alerts and decision trees allows to focus on clinically relevant events and to reduce healthcare resources without compromising quality. more...
- Published
- 2014
- Full Text
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21. [Value of an implantable EKG monitor for the diagnosis of arrhythmic syncope in children]
- Author
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D, Satsou, C, Kouakam, G, Vaksmann, D, Klug, S, Kacet, and C, Rey
- Subjects
Diagnosis, Differential ,Male ,Electrocardiography ,Humans ,Arrhythmias, Cardiac ,Prostheses and Implants ,Child ,Syncope - Abstract
The value of an implantable ECG monitor (Reveal TM Plus) is reported in a 12 year old child with unexplained syncopal episodes despite extensive investigations. Twenty-seven days after the implantation, ventricular tachycardia at 450/min was recorded at the first recurrence. This case shows that this type of monitoring can be particularly useful when an arrhythmia is thought to be the cause of syncope in a child and the initial investigation is negative. more...
- Published
- 2001
22. [The ilio-femoral approach: an alternative for implanting permanent cardiac pacemakers. Three case reports]
- Author
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O, Roux, D, Klug, M, Jarwe, and S, Kacet
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Adult ,Male ,Pacemaker, Artificial ,Postoperative Complications ,Cardiovascular Surgical Procedures ,Humans ,Femoral Vein ,Iliac Vein ,Aged - Abstract
Permanent endocavitary cardiac pacing is a widely used therapeutic method. The implantation of pacing catheters is usually performed by the supracardiac veins, the epicardial approach being the classical alternative. The ilio-femoral approach is a third possibility. The authors report three cases in which this approach was used. The implantations were performed under general anaesthesia with an abdominal pacemaker. In two cases, atrial and ventricular catheters were implanted. After an average of 19 months' follow-up, no short or long-term complications were observed: displacement or fracture of the pacing catheter, infection, venous thrombosis, threshold elevation. These results show that this is a safe and feasible alternative to implantation by the traditional or epicardial techniques when these approaches cannot be used. more...
- Published
- 2001
23. [Determinants of survival after implantation of an automatic defibrillator. Report of 127 patients]
- Author
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A, Gay, D, Lacroix, D, Klug, P, Le Franc, P, Delfaut, C, Kouakam, N, Zghal, M, Jarwé, and S, Kacet
- Subjects
Adult ,Male ,Middle Aged ,Prognosis ,Survival Analysis ,Ventricular Function, Left ,Defibrillators, Implantable ,Death, Sudden, Cardiac ,Postoperative Complications ,Risk Factors ,Atrial Fibrillation ,Tachycardia, Ventricular ,Humans ,Longitudinal Studies ,Aged ,Retrospective Studies - Abstract
The authors present a retrospective and longitudinal study of the predictive factors of mortality in patients having an implanted automatic defibrillator. The population comprised 127 patients implanted between September 1988 and September 1997. There were 107 men with a mean age of 57.7 +/- 13 years. The left ventricular ejection fraction was 39.3%. The proportion of coronary patients was 68%; 20% of patients had atrial fibrillation and 5% were in Class III of the NYHA classification. The indications were: resuscitated cardiac arrest (N = 56) and poorly tolerated ventricular tachycardia (N = 71). The follow-up period was 30 +/- 25 months. There were 23 early and 10 late complications. Seventy-two patients had received an electric shock; 57 had an appropriate shock. There were 23 arrhythmic storms (ventricular arrhythmia requiring at least 2 shocks in less than 24 hours) in 17 patients. The operative mortality was 1.1%; at 1 year, the global survival was 93.9 +/- 2.2%; cardiac survival was 94.7 +/- 2.1%; survival without sudden death was 98.3 +/- 1.2%. Multivariate analysis isolated predictive factors for mortality; atrial fibrillation was predictive for global mortality; an ejection fraction30% and the fact of having received an appropriate shock were predictive of cardiac mortality; and an arrhythmic storm was predictive of sudden death. more...
- Published
- 2001
24. Optimization of pacemakers programmation
- Author
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V. Alexandre, S. Khemis, S. Kacet, and M. Jarwé
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medicine.medical_specialty ,business.industry ,Physiology (medical) ,medicine ,Medical physics ,Cardiology and Cardiovascular Medicine ,business - Published
- 2001
- Full Text
- View/download PDF
25. [Mapping and radiofrequency ablation in different forms of right peri-atriotomy flutter]
- Author
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N, Zghal, D, Lacroix, D, Klug, N, Elbaz, G H, Mairesse, C, Kouakam, G, Vaksmann, C, Rey, and S, Kacet
- Subjects
Adult ,Male ,Electrocardiography ,Postoperative Complications ,Atrial Flutter ,Catheter Ablation ,Humans ,Female ,Heart Atria ,Middle Aged ,Aged - Abstract
Peri-atriotomy flutter is a possible complication of surgical atriotomy. This tachycardia in an indication for radiofrequency ablation. The aim of this study was to determine the mechanism of the flutter, evaluate the possibility of mapping and the role of radiofrequency ablation in its treatment. Eleven patients with a mean age of 45 years (26-70) were referred for ablation of atrial flutter observed on average 15 years after surgical atriotomy. In 7 patients (Group I), the ECG appearances before the procedure were that of a rare flutter. Endocavitary mapping showed a circuit limited to the free wall of the right atrium with a posterior caudo-cranial and an anterior cranio-caudal front. A series of radiofrequency applications joining the atriotomy scar to the inferior vena cava interrupted the flutter in all patients and created a bidirectional block around the atriotomy. In 4 patient (Group II), the ECG appearances were that of a common flutter. A series of radiofrequency ablations in the cavo-tricuspid isthmus led to sudden change in polarity of the F wave in all patients. Repeat mapping then showed a peri-atriotomy circuit identical to that described in Group I. The whole was interpreted as a figure-of-eight circuit. The primary success rate was 100%. There were no complications but the early recurrence rate remained high. This preliminary experience confirms the value of radiofrequency ablation in the treatment of peri-atriotomy flutter and shows ECG polymorphism related to a figure-of-eight reentry circuit. more...
- Published
- 1999
26. [Implantable defibrillators. Good cost-effectiveness or supplementary expense to our hospitals?]
- Author
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S, Lévy, E, Aliot, J, Clémenty, S, Kacet, and P, Coumel
- Subjects
Cost-Benefit Analysis ,Humans ,France ,Hospital Costs ,Defibrillators, Implantable - Published
- 1999
27. Biventricular pacing in patients with congestive heart failure: two prospective randomized trials. The VIGOR CHF and VENTAK CHF Investigators
- Author
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L A, Saxon, J P, Boehmer, J, Hummel, S, Kacet, T, De Marco, G, Naccarelli, and E, Daoud
- Subjects
Adult ,Cardiomyopathy, Dilated ,Heart Failure ,Male ,Pacemaker, Artificial ,Cross-Over Studies ,Middle Aged ,Combined Modality Therapy ,Defibrillators, Implantable ,Survival Rate ,Treatment Outcome ,Tachycardia, Ventricular ,Humans ,Multicenter Studies as Topic ,Female ,Prospective Studies ,Aged ,Randomized Controlled Trials as Topic - Abstract
Epidemiologic studies suggest that 20-30% of patients diagnosed with symptomatic congestive heart failure (CHF) have intraventricular conduction disorders characterized by a discoordinate contraction pattern and wide QRS. Biventricular pacing is an emerging therapy allowing simultaneous electrical stimulation of the right and left ventricles with the use of an implantable pacing system. The aim of this article is to describe 2 prospective randomized multicenter trials examining the effects of biventricular pacing on functional capacity, quality of life, and hemodynamic status in patients with dilated cardiomyopathy and intraventricular delay. The VIGOR CHF Trial is designed to assess functional and symptomatic improvement in heart failure patients with biventricular pacing and without a concomitant indication for conventional bradycardia pacemaker therapy. To assess for potential placebo effects, patients are randomized to receive either biventricular pacemaker therapy or no pacing therapy for the first 6 weeks, after which both groups receive pacing therapy. The VENTAK CHF trial uses an implantable cardioverter defibrillator system (ICD) designed to provide chronic biventricular pacing therapy in addition to treating ventricular tachyarrhythmias. All patients receive conventional ICD and CHF therapy throughout the study and are randomized in a 2-period crossover design to receive either no pacing or biventricular pacing for 3-month intervals. Patient enrollment in both studies is ongoing, with a closed analysis. The unique designs of these trials provide the opportunity to study this therapy in high-risk patients who have been optimally treated for heart failure. more...
- Published
- 1999
28. Atrial fibrillation detection and R-wave synchronization by Metrix implantable atrial defibrillator: implications for long-term efficacy and safety. The Metrix Investigators
- Author
-
H F, Tse, C P, Lau, J S, Sra, H J, Crijns, N, Edvardsson, S, Kacet, and D G, Wyse
- Subjects
Male ,Risk ,Equipment Design ,Middle Aged ,Sensitivity and Specificity ,Defibrillators, Implantable ,Cohort Studies ,Heart Conduction System ,Atrial Fibrillation ,Ventricular Fibrillation ,Humans ,Female ,Safety ,Algorithms ,Aged - Abstract
The long-term efficacy of atrial fibrillation (AF) detection and R-wave synchronization are critical safety requirements for the development of an implantable atrial defibrillator (IAD) for treatment of AF.The long-term efficacy of the Metrix IAD for AF detection and R-wave synchronization was tested in 51 patients. The mean duration of follow-up was 259+/-138 days (72 to 613 days). AF detection tests were performed 2240 times during observed operation with 100% specificity and 92.3% sensitivity for differentiation between sinus rhythm and AF; 2219 episodes and their electrograms stored in the device during AF detection were analyzed. The positive predictive value of the AF detection algorithm was 97.4% (lower 95% confidence limit [CL], 94.5%) in the out-of-hospital setting. A total of 242 435 R waves were analyzed for R-wave synchronization. Of these, 49% were marked for synchronized shock delivery, 82% of sinus rhythm and 36% of AF R waves, respectively. All shock markers were properly synchronized and within the R wave (overall synchronization accuracy, 100%; lower 95% CL, 99.999%). Overall, 3719 shocks have been delivered via the IAD with no instance of unsynchronized shock delivery or any episode of proarrhythmia. The observed proarrhythmic risk was 0%, with an estimated maximum proarrhythmic risk of 0.084% per shock (95% upper CL).The Metrix IAD can appropriately detect AF with a high specificity and sensitivity and reliably synchronize within a suitable R wave for shock delivery to minimize the risk of ventricular proarrhythmia. more...
- Published
- 1999
29. [Complete atrioventricular block during temporal lobe epilepsy. Apropos of a case]
- Author
-
C, Kouakam, C, Daems-Monpeurt, P, Le Franc, P, Derambure, E, Josien, and S, Kacet
- Subjects
Adult ,Hallucinations ,Videotape Recording ,Electroencephalography ,Syncope ,Heart Arrest ,Diagnosis, Differential ,Heart Block ,Epilepsy, Temporal Lobe ,Tilt-Table Test ,Auditory Perception ,Syncope, Vasovagal ,Humans ,Epilepsy, Generalized ,Female - Abstract
The authors report the case of a 37 years old woman with no previous medical history, admitted to hospital for investigation of unexplained syncope, sometimes associated with generalised fits. After standard non-invasive cardiovascular investigations, no diagnosis could be made. The tilt test induced a minor syncopal episode without reproducing the clinical symptoms. In view of the discordance between the induced and spontaneous symptoms, a neurological opinion was requested. During the recording of an electroencephalogram, syncopal atrioventricular block was observed, preceded by auditory hallucinations, reproducing exactly the clinical symptoms. Analysis of the sequence of events showed the conduction defect to arise after the onset of the epileptic fit, indicating a diagnosis of syncopal complete atrioventricular block complicating cryptogenic temporal epilepsy, and requiring specific treatment. This case illustrates the importance of close collaboration between cardiologists and neurologists in the management of cases of unexplained syncope. more...
- Published
- 1999
30. [Is programmed ventricular stimulation still up to date in the medicinal evaluation of ventricular tachycardia?]
- Author
-
C, Kouakam, L, Guédon-Moreau, and S, Kacet
- Subjects
Tachycardia, Ventricular ,Humans ,Anti-Arrhythmia Agents ,Electric Stimulation ,Defibrillators, Implantable - Abstract
Despite considerable advances in the understanding of cardiac arrhythmia mechanisms, death in relation to ventricular tachyarrhythmias remains an important public health problem, and management of ventricular arrhythmias remains a perpetual challenge in clinical cardiology. In the last decade, the development and refinement of implantable cardioverter defibrillators and the progress in techniques of radiofrequency electrode catheter ablation and antiarrhythmic surgery have been revolutionary in the management of ventricular tachycardia. On the other hand, there have been major changes in the use of drug therapy since the publication of the results of the CAST study. Inclusion of mortality as an endpoint in clinical trials highlights the fact that some antiarrhythmic drugs may have the proclivity to exert fatal proarrhythmic reactions while also having the potential to control recurrences of ventricular tachycardia. All these changes that now need to be integrated into global approaches for ventricular arrhythmia control led us to wonder whether serial testing is still up to date in the management of ventricular tachycardia. After more than 20 years of clinical use, there is much concern about the use of serial drug testing to guide antiarrhythmic drug therapy for the management of life-threatening sustained ventricular tachyarrhythmias in light of recent advances in the management of cardiac arrhythmias. The purpose of this article is to discuss, within a relatively brief compass, the cumulative data from different lines of investigations, results of randomized clinical trials, recently acquired beliefs and meta-analytic findings concerning the present place of serial electrophysiologic drug testing in the management of ventricular tachycardia. more...
- Published
- 1999
31. [Ventricular tachycardia revealing viral myocarditis]
- Author
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I, Mahé, D, Lacroix, C, Kouakam, and S, Kacet
- Subjects
Male ,Myocarditis ,Echocardiography ,Adrenergic beta-Antagonists ,Tachycardia, Ventricular ,Coxsackievirus Infections ,Humans ,Middle Aged ,Radionuclide Imaging - Abstract
The first diagnostic hypothesis in a middle-aged patient presenting with inaugural ventricular tachycardia would be coronary artery disease. If the work-up lacks arguments for this etiology, other cardiac conditions may be involved (dilated cardiopathy, hypertrophic cardiopathy, valve disease arrhythmogenic dysplasia, long QT...).A 52-year-old male patient was referred for inaugural ventricular tachycardia. The initial work-up including echocardiography, coronography and the electrophysiologic study provided no explanation. The ventricular tachycardia was later attributed to viral myocarditis.Viral myocarditis should always be entertained in patients with unexplained ventricular tachycardia, particular if a viral context is present. In such cases, antibody-labeled scintigraphy is the choice exploration. This noninvasive technique provides determining diagnostic information and helps orient patient management. more...
- Published
- 1999
32. Single radiofrequency application to cure atrioventricular nodal reentry: arguments for the slow pathway origin of the high-low frequency slow potentials
- Author
-
D, Klug, D, Lacroix, P, Le Franc, Y, Ben Ameur, C, Kouakam, S, Kacet, and J, Lekieffre
- Subjects
Male ,Time Factors ,Refractory Period, Electrophysiological ,Action Potentials ,Middle Aged ,Coronary Vessels ,Electrocardiography ,Heart Rate ,Atrioventricular Node ,Catheter Ablation ,Humans ,Tachycardia, Atrioventricular Nodal Reentry ,Female ,Prospective Studies ,Tricuspid Valve ,Follow-Up Studies - Abstract
High-low frequency slow potentials are thought to be related to the slow AV pathway conduction. Their use was proposed to guide radiofrequency (RF) ablation of atrioventricular nodal reentrant tachycardia (AVNRT). The present study was designed to determine the prospective value of these high-low frequency slow potentials to guide AVNRT ablation using a single RF application. Single RF application could indeed reduce the size of the lesion created in the viciny of the specialized AV conduction system and shorten the radiation exposure and the overall duration of the procedure.Forty-one patients (14 men, 27 women, 45 +/- 16 years old) with AVNRT underwent slow pathway RF ablation guided by high-low frequency slow potentials. High-low frequency slow potentials were found in all patients along the tricuspid annulus and above the coronary sinus. Ablation was always performed in the posterior part of Koch's triangle. The mean A/V amplitude ratio of the successful site was 0.43 +/- 0.59. In 32 patients (78%) AVNRT was no longer inducible after a single RF application. Procedure and radiation times were 35 +/- 31 and 13 +/- 12 min respectively. Five patients required 2, 3 patients 3, and 1 patient 6 RF applications. The mean number of RF applications was 1.4 +/- 0.9 (median = 1). In the 32 patients who required only one RF application, 24 (75%) had an obvious dual AV nodal pathways with a jump before ablation, which completely disappeared in 18 of them (75%) after ablation. In the 6 remaining patients, who still had a jump after 1 RF application, there was no significant change in either conduction times or refractory periods concerning both the anterograde and retrograde AV conduction. No patient had PR interval purlongation. After a mean follow up of 11 +/- 5 months, recurrence was observed in a single patient who received 2 discontinued RF applications.Catheter-mediated ablation of AVNRT using high-low frequency slow potentials to localize the slow AV pathway is feasible and safe. Using this technique, a single RF application was successfull in 78% of patients, and slow pathway characteristics were completely eliminated in 75% of patients. The radiation time and the procedure duration were short. This suggest that, in patients with AVNRT, the choice of an appropriate RF target can reduce procedural duration. more...
- Published
- 1998
33. [Epidemiology of paroxysmal auricular fibrillation]
- Author
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L, Guédon-Moreau, C, Kouakam, and S, Kacet
- Subjects
Adult ,Male ,Incidence ,Atrial Fibrillation ,Chronic Disease ,Prevalence ,Humans ,Female ,France ,Middle Aged ,Tachycardia, Paroxysmal ,Aged - Abstract
The epidemiology of paroxysmal atrial fibrillation (PAF) is poorly known because of the difficulties in setting up trials to study this condition. Its biannual incidence is about 2 per thousand. Its prevalence is 1 to 2% in a population of over 65 years of age. Paroxysmal atrial fibrillation is often asymptomatic. An initial episode of atrial fibrillation may remain a single event in a number of cases. Isolated paroxysmal atrial fibrillation progresses to permanent atrial fibrillation in about 20% of cases, usually if there is underlying cardiac disease. Rheumatic valve disease, cardiac failure, hypertension, previous myocardial infarction and cerebrovascular accidents are often associated with paroxysmal atrial fibrillation. Embolic complications are rare if paroxysmal atrial fibrillation is isolated. more...
- Published
- 1998
34. [Dual-chamber implantable automatic defibrillators. Experiences apropos of 16 cases]
- Author
-
P, Le Franc, D, Klug, D, Lacroix, C, Kouakam, M, Jarwé, and S, Kacet
- Subjects
Cardiomyopathy, Dilated ,Heart Failure ,Male ,Pacemaker, Artificial ,Heart Ventricles ,Resuscitation ,Cardiac Pacing, Artificial ,Hemodynamics ,Arrhythmias, Cardiac ,Equipment Design ,Middle Aged ,Catheterization ,Defibrillators, Implantable ,Heart Arrest ,Bradycardia ,Tachycardia, Supraventricular ,Tachycardia, Ventricular ,Humans ,Equipment Failure ,Female ,Heart Atria ,Algorithms ,Follow-Up Studies - Abstract
In view of the large number of inappropriate shocks observed in patients with implanted defibrillators, improved detection of ventricular arrhythmias has become a major objective. The addition of an atrial catheter has been proposed to improve discrimination between ventricular and non-ventricular arrhythmias. Besides this function, the additional catheter could be used for DDD pacing without risk of interaction between the pacemaker and defibrillator. The authors report their initial experience in 16 patients implanted with a DDD pacemaker. The indication was resuscitated sudden death (N = 5) or ventricular tachycardia (N = 11). The choice of a DDD defibrillator was justified by a bradycardia (N = 9), haemodynamic factors (N = 4) or supraventricular tachycardia (N = 3). The devices used were the Defender 9001 (ELA Medical SA, France, N = 3), the Ventak AV 1810 and the Ventak AV II DR 1821 (Guidant/CPI, Inc. USA, N = 11 and N = 2 respectively). There were three immediate complications. After 2 to 29 months' follow-up, 5 patients had received appropriate treatment by their devices. Five patients had inappropriate shocks : one patient received a shock triggered by electrical interference, two others had no active sensing algorithme when the shocks were delivered, and the other two had an activated algorithme with 1/1 conduction of a supraventricular arrhythmia. No recurrences were recorded after reprogramming the device. DDD or VDD pacing was permanent in 9 patients and intermittent in 3 others. Seven patients had dilated cardiomyopathy and severe cardiac failure and were clinically improved by dual chamber pacing. In many patients, candidates for a defibrillator, this new generation of devices has improved specificity of arrhythmia detection and cardiac pacing without risk of interaction. The authors propose a classification of the indications for a DDD defibrillator. more...
- Published
- 1998
35. [VDD mode single electrode cardiac stimulation: indications, results and limitations of the method]
- Author
-
Y, Ben Ameur, E, Martin, M, Jarwe, C, Kouakam, D, Klug, D, Lacroix, P, Lefranc, C, De Gheldere, and S, Kacet
- Subjects
Adult ,Aged, 80 and over ,Pacemaker, Artificial ,Heart Block ,Adolescent ,Evaluation Studies as Topic ,Cardiac Pacing, Artificial ,Humans ,Middle Aged ,Aged ,Follow-Up Studies ,Retrospective Studies - Abstract
Several authors have reported the single atrioventricular (AV) electrode, comprising an atrial dipole floating in the right atrium, to be a system capable of providing results which are just as satisfactory as those of conventional systems (DDD). Between August 1992 and March 1995, a VDD single electrode pacemaker was implanted in 65 patients (mean age: 73 years +/- 17.2). The indication for implantation was isolated high degree AVB with no apparent sinus dysfunction. Four pacemakers were used: Vitatron (n = 24), Intermedics (n = 23), Medico (n = 13), Biotronik (n = 5). Intraoperative atrial endocavitary recording was 1.8 mV +/- 0.74. 17 patients died from a cause unrelated to pacemaker dysfunction. 4 patients were lost to follow-up. The remaining 44 patients were reviewed in our centre with a mean follow-up of 14.5 months +/- 7 months. Seven pacemakers (16%) were reprogrammed in VVI or VVI (R) mode, because of permanent atrial fibrillation in 3 cases, complete loss of atrial reception in 2 cases and late onset sinus dysfunction in 1 case. In the 41 patients in sinus atrial rhythm, the atrioventricular synchronization rate was greater than 90% in 88% of patients, equal to 76.3% in 2.4% of patients and atrioventricular synchronization was impossible in 9.6% of cases.The overall results of our preliminary experience of VDD mode single electrode pacemaker are moderate. The poor results essentially concerned patients with paroxysmal atrial arrhythmias prior to pacing. more...
- Published
- 1998
36. [Value of the tilt-table test in the management of unexplained syncope in children and adolescents]
- Author
-
C, Kouakam, G, Vaksmann, D, Lacroix, F, Godart, S, Kacet, and C, Rey
- Subjects
Male ,Pacemaker, Artificial ,Adolescent ,Adrenergic beta-Antagonists ,Vagus Nerve ,Psychophysiologic Disorders ,Syncope ,Diagnosis, Differential ,Predictive Value of Tests ,Recurrence ,Tilt-Table Test ,Bradycardia ,Humans ,Female ,Hypotension ,Child ,Follow-Up Studies - Abstract
The value of the tilt test in assessing unexplained syncope in children and adolescents was investigated in 79 patients (41 girls and 38 boys, 12.3 +/- 2.9 years). The test was performed with a tilt of 60 degrees for 45 minutes. A pharmacological provocation with isoprenaline was carried out in negative passive test. The tilt test was considered to be positive in cases of symptomatic falls of the systolic blood pressure with or without bradycardia. Asystole was defined as a ventricular pauseor = 5 seconds. During the investigation, 52 patients (66%) reproduced symptoms related to vasovagal syncope in 45 patients (57%) or panic attack in 7 others (9%). Of the 45 presenting vasovagal syncope, 7 had a cardio-inhibitory reaction with asystole of 11.2 +/- 3.3 seconds. The other responses were vasodepressive in 17 patients and mixed in 21 patients. A comparative study did not reveal any significant difference between patients with a positive or negative test including those with panic attacks. Seventy-five patients were followed up for an average of 32 +/- 22.3 months. Preventive therapy was prescribed in 34 patients because of the frequency or severity of their symptoms. At the end, 10 patients (13%) had at least one recurrence of syncope, 3 in the group with panic attacks, 5 in non-treated patients (irrespective of the result of the tilt test) and only 1 in the group of 23 patients treated with beta-blockers. The authors conclude that with a diagnostic return of 66% in this series, the tilt test seems to be the non-invasive investigation of choice in unexplained syncope in children and adolescents. In addition, true vasovagal syncope can be differentiated from psychogenic. more...
- Published
- 1997
37. [Determinants of malignant vasovagal syncopes with asystole disclosed by the tilting test and therapeutic implications]
- Author
-
C, Kouakam, D, Lacroix, D, Klug, Y, Ben Ameur, L, Guédon-Moreau, S, Kacet, and J, Lekieffre
- Subjects
Adult ,Male ,Time Factors ,Seizures ,Tilt-Table Test ,Adrenergic beta-Antagonists ,Cardiac Pacing, Artificial ,Syncope, Vasovagal ,Humans ,Female ,Prognosis ,Sensitivity and Specificity ,Heart Arrest - Abstract
In order to evaluate the determinants of malignant vasovagal syncope with asystole revealed by the tilting test and to determine the possible therapeutic implications, 179 patients (91 women and 88 men, mean age 36.6 +/- 20.1 years) referred for the assessment of unexplained a were studied. The test was performed with a tilt of 60 degrees for 45 minutes. A bolus of isoprenaline (0.02 to 0.08 microgram/kg.min) was injected in the case of a negative passive test. Asystole was defined as a ventricular pause lastingor = 5 seconds.Ten (13%) of the 77 patients with a positive tilting test experienced a cardio-inhibitory reaction with prolonged asystole lasting an average of 11.9 +/- 4.9 seconds. Compared to the other 67 patients with a positive test, those with asystole were younger (23/9 +/- 14.8 years vs 32.9 +/- 18.5 years, NS) and had a more frequent history of convulsions (6/10 vs 9/67, p = 0.05) during spontaneous episodes and trauma (9/10 vs 27/67, p = 0.005). Implantation of a pacemaker was chosen first-line treatment for the first 6 patients. Their follow-up tilting tests remained positive (pre S = 4, S = 1) despite DDD stimulation of 45 bpm. Five of these patients and the following 4 patients were retested under beta-blockers. In six patients treated with beta-blockers, the clinical symptoms resolved completely (n = 3) or improved (n = 3), in contrast with 3 other patients in whom the tilting test remained positive with recurrence of asystole. The mean follow-up for the 169 patients is 22.7 +/- 11 months and the ten patients with asystole remained totally asymptomatic.An asystolic response during the tilting test is characteristic of vasovagal syncope described as malignant. The syndrome essentially affects young patients, with a more frequent history of trauma and convulsions. Beta-blockers appear to be at least as effective as permanent pacemaker to prevent symptoms in this specific subgroup. more...
- Published
- 1997
38. [Ventricular fibrillation after radiofrequency ablation of the atrioventricular node]
- Author
-
C, Kouakam, Y, Ben Ameur, D, Klug, D, Lacroix, P, Le Franc, and S, Kacet
- Subjects
Male ,Electrocardiography ,Pacemaker, Artificial ,Treatment Outcome ,Atrial Fibrillation ,Ventricular Fibrillation ,Atrioventricular Node ,Catheter Ablation ,Humans ,Aged ,Follow-Up Studies - Abstract
The authors report the case of a 77 year old patient who underwent radiofrequency ablation of the atrioventricular node for chronic. Invalidating atrial fibrillation, refractory to pharmacological therapy. A single chamber ventricular pacemaker was implanted one week before interruption of AV conduction. Eleven applications (7 on the right and 4 on the left side of the interventricular septum) were required for successful ablation. Four hours later, the patient developed episodes of non-sustained polymorphic ventricular tachycardia and torsades de pointe. These arrhythmias were initiated by long cycle-short cycle sequences and preceded by changes of ventricular repolarisation (prolongation of the spontaneous and paced QTc and JTc intervals). Eight days after ablation, the patient had an episode of ventricular fibrillation reduced by external DC shock. This arrhythmia was also preceded by changes in ventricular repolarisation. This case demonstrates the potential proarrhythmogenic effect of radiofrequency ablation of the AV node with changes in ventricular repolarisation which induces malignant ventricular arrhythmias. The authors suggest an appropriate preventive attitude. The progression in two distinct phases (immediate and late) imposes prolonged arrhythmia monitoring. more...
- Published
- 1997
39. [Anxiety disorders and unexplained syncopes of presumed vaso-vagal origin]
- Author
-
C, Kouakam, D, Lacroix, P, Baux, L, Guédon-Moreau, D, Klug, G, Vaksmann, D, Dutoit, S, Kacet, and J, Lekieffre
- Subjects
Adult ,Male ,Pacemaker, Artificial ,Adolescent ,Adrenergic beta-Antagonists ,Decision Trees ,Vagus Nerve ,Middle Aged ,Anxiety Disorders ,Syncope ,Recurrence ,Tilt-Table Test ,Humans ,Female ,Stress, Psychological ,Follow-Up Studies - Abstract
The impact of anxiety neurosis on the diagnosis and treatment of patients with unexplained syncope (S) was assessed in 178 patients (91 women and 87 men) with an average age of 36.5 +/- 20 years, presenting with 10.7 +/- 24 episodes of S). None had evidence of underlying cardiac disease apart from 7 patients with mild hypertension. All patients underwent a tilt test (TT) at 60 degrees for 45 minutes. A bolus of isoproterenol was injected intravenously in subjects with negative TT. After the test, the patients were classified according to the presence (n = 38) or absence (n = 140) of anxiety neurosis based on the DSM III-R diagnostic. The TT was positive in 76 patients, 9 of whom had a cardioinhibitory reaction with prolonged asystole. Patients with anxiety had more episodes of S (24 +/- 43 versus 7 +/- 13; p = 0.001), a shorter interval between S (11.5 +/- 23 months versus 12.5 +/- 20 months, p = 0.02) but more negative TT (27/38 versus 75/140; p = 0.05). One hundred and sixty-eight patients were followed up : 10 were lost to follow-up. Preventive treatment was undertaken in 59 patients who were representative of the whole group with respect to age (30 +/- 18 years 39 +/- 21 years : p = 0.004). After an average follow-up of 24.5 +/- 15 months, 26 patients (15%) experienced a recurrence of S. The recurrence rate was identical in patients with positive and negative TT and in treated and untreated cases. On the other hand, recurrence was higher in those with anxiety (12/25 versus 14/117; p = 0.001) who also had less improvement of symptoms (12/15 versus 74/120; p = 0.001). The "anxiety" variable was therefore identified as being the only predictive factor for recurrence of syncope. The authors conclude that in patients referred for investigation of unexplained syncope, some suffer from anxiety neurosis, in whom the TT is usually negative, and have a higher risk of recurrence. They justify a specific therapeutic management. more...
- Published
- 1996
40. [Prognostic factors after sustained ventricular fibrillation or tachycardia. A multivariate study apropos of 160 cases]
- Author
-
E, Fleurant, D, Lacroix, D, Klug, H, Warembourg, S, Kacet, and J, Lekieffre
- Subjects
Adult ,Heart Failure ,Male ,Adrenergic beta-Antagonists ,Age Factors ,Cardiac Pacing, Artificial ,Amiodarone ,Middle Aged ,Prognosis ,Ventricular Function, Left ,Death, Sudden, Cardiac ,Actuarial Analysis ,Ventricular Fibrillation ,Tachycardia, Ventricular ,Humans ,Female ,Aged ,Follow-Up Studies ,Retrospective Studies - Abstract
The authors analysed survival of 160 patients (121 men and 31 women; average age 57.2 +/- 12.5 years; follow-up 29 +/- 20 months) treated for malignant ventricular arrhythmias (sustained ventricular tachycardia, ventricular fibrillation, syncope with inducible ventricular tachycardia). The therapeutic evaluation was frequently invasive (145 patients underwent at least programmed ventricular stimulation, 108 patients underwent full endocavitary electrophysiological studies) and non-pharmacological therapy was widely used (defibrillator n = 44; antiarrhythmic surgery n = 28; ablative procedures n = 19; transplantation n = 7). The following underlying pathologies were observed: ischaemic heart disease n = 120; non-ischaemic left heart disease n = 19; right heart cardiac disease n = 4; and apparently normal hearts n = 17). The average ejection fraction was 40.5 +/- 15.5% and 29 patients were in the NYHA functional classes III or IV. Fifty-five patients had life-threatening arrhythmias whilst receiving amiodarone. At 2 years, the actuarial sudden death rate was 5.9 +/- 2.1% and the actuarial total cardiac mortality rate was 13.1 +/- 2.9%. Univariate analysis showed age, the presence of underlying cardiac disease, the presence of dilated cardiomyopathy, the absence of an invasive approach, the need for basal pacing in electrical cardioversion, the absence of betablocker therapy, a decreased left ventricular ejection fraction and a high NYHA functional class, to be predictive of sudden death. In multivariate analysis, age, the NYHA class for total cardiac mortality and the NYHA class for sudden death, were the only independent predictive factors. The authors conclude that in the era of invasive methods of evaluation and widespread use of non-pharmacological therapeutic methods, the symptomatology of cardiac failure assessed by the NYHA classification remains the most powerful independent prognostic factor after an episode of malignant ventricular arrhythmia. more...
- Published
- 1996
41. [Automatic implantable defibrillator and antiarrhythmic surgery in ischemic cardiopathies. Apropos of 53 cases]
- Author
-
E, Fleurant, D, Lacroix, D, Klug, R, Logier, M, Al Koussa, H, Warembourg, S, Kacet, and J, Lekieffre
- Subjects
Male ,Myocardial Ischemia ,Arrhythmias, Cardiac ,Middle Aged ,Prognosis ,Defibrillators, Implantable ,Death, Sudden, Cardiac ,Treatment Outcome ,Catheter Ablation ,Humans ,Female ,Aged ,Follow-Up Studies ,Retrospective Studies - Abstract
The automatic implantable defibrillator (AID) and antiarrhythmic surgery are the two therapeutic options after failure of catheter ablation and/or antiarrhythmic therapy for sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients with coronary artery disease. The authors undertook retrospective study of the characteristics of two groups of patients treated between November 31st 1987 et December 31st 1993 either by AID (28 men and 4 women with an average age of: 56.1 +/- 11.2 years) or by surgery (19 men and 2 women with an average age of: 60.6 +/- 6.8 years). The "surgical" patients differed from "defibrillator" patients in the fewer number of cardiac arrests, a higher proportion of sustained monomorphic VT, better tolerated sustained monomorphic VT (rarely syncopal), fewer early post-infarction arrythmias (or = 8 weeks), more anterior wall infarction and a higher proportion of aneuvrysms. The perioperative mortality was 6.2% in the "defibrillator" group and nil in the "surgical" group (p = NS). At 2 years, the sudden death rate in the "defibrillator" and "surgical" groups was 7.5% and 0% respectively and total cardiac mortality was 17% and 20% respectively (p = NS). The authors conclude that perioperative mortality and the sudden death rate at 2 years are relatively low in the two groups. However, the total cardiac mortality remains high, largely related to perioperative death and secondary cardiac failure. Nevertheless, compared with defibrillator patients and with identical average ejection fractions, there was no extra mortality due to cardiac failure after antiarrhythmic surgery. more...
- Published
- 1995
42. Determination of left ventricular mass in systemic hypertension: comparison of standard and signal averaged electrocardiography
- Author
-
S. Kacet, Didier Klug, M. A. Nader, Christine Savoye, R. Logier, Jean Lekieffre, and D. Lacroix
- Subjects
Male ,medicine.medical_specialty ,Heart Ventricles ,Left ventricular hypertrophy ,Left ventricular mass ,QRS complex ,Electrocardiography ,Internal medicine ,Medicine ,Humans ,cardiovascular diseases ,Prospective Studies ,Prospective cohort study ,Bundle branch block ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Signal-averaged electrocardiography ,Hypertension ,Cardiology ,Female ,Hypertrophy, Left Ventricular ,Cardiology and Cardiovascular Medicine ,business ,Research Article - Abstract
OBJECTIVE--To investigate the quantitative relationship, if any, between signal averaged electrocardiographic variables and echocardiographically determined left ventricular mass in hypertensive subjects. DESIGN--Cohort analytic prospective study. SETTING--University hospital. SUBJECTS--50 hypertensive subjects selected consecutively from inpatients. Patients older than 75 years, with underlying cardiac disease, with inconclusive echocardiograms with bundle branch block, or in atrial fibrillation were excluded. INTERVENTIONS--Antihypertensive therapy involving 41 patients was continued. MAIN OUTCOME MEASURES--Left ventricular mass calculated in accordance with the standards of the Penn convention. Thirteen criteria derived from combinations of signal averaged electrocardiographic X, Y, and Z Frank orthogonal leads, including voltage criteria, duration, and time-voltage integrals of the QRS complex. Four widely used standard electrocardiographic criteria for detection of left ventricular hypertrophy. RESULTS--There was no difference in the values for any of the electrocardiographic variables between patients with (n = 29) and without left ventricular hypertrophy (n = 21). The time-voltage integral of QRS in the horizontal plane was the best signal averaged variable related to left ventricular mass (r = 0.33, P = 0.019); however, the correlation with Rodstein voltage was stronger (r = 0.46, P = 0.0009). A positive correlation was also found between left ventricular indexed mass and Rodstein voltage (r = 0.43, P = 0.0019). Stepwise regression analysis revealed Rodstein voltage as the only predictor of indexed mass (P = 0.0019), and Rodstein voltage (P = 0.0022) and body weight (P = 0.011) as the only independent correlates of left ventricular mass. CONCLUSIONS--The relation between electrocardiographic variables and left ventricular mass or indexed mass is of limited value; signal averaged orthogonal leads do not improve this assessment compared with standard electrocardiographic leads. more...
- Published
- 1995
43. [Automatic implantable defibrillators. Clinical experience apropos of 45 patients]
- Author
-
D, Lacroix, P, Le Franc, D, Klug, M, al Koussa, S, Kacet, H, Warembourg, and J, Lekieffre
- Subjects
Adult ,Male ,Ventricular Fibrillation ,Tachycardia, Ventricular ,Feasibility Studies ,Humans ,Female ,Middle Aged ,Aged ,Defibrillators, Implantable ,Follow-Up Studies - Abstract
The aim of this study was to analyse the efficacy and survival after implantation of an automatic cardioverter-defibrillator.. Forty-five patients including 37 men were followed up for 0 to 51 months. The indications were ventricular fibrillation with no curable cause (n = 27) and sustained resistant or poorly tolerated ventricular tachycardia (n = 17) when programmed ventricular pacing with antiarrhythmic therapy was not applicable or gave poor results. One patient was implanted with this device for torsades de pointes. The underlying cardiac disease was ischaemic in 34 cases, non-ischaemic in 8 cases, and 3 patients had no apparent cardiac disease. Twenty patients were implanted with an epicardial system (group I) and 25 patients with endocardial system (group II). In group II, there was one complete failure of implantation requiring the use of an epicardial system and 2 partial failures requiring an additional epicardial patch electrode. The perioperative mortality was 2/45 (4.4%), both cases being due to permanent arrhythmias. In 5 patients, the minimal effective energy of defibrillation was over 25 Joules at implantation, without any untoward consequences on the clinical outcome. Ten non-fatal complications were observed including two major problems (haemopericardium); there were two cases of late increase of the minimal effective energy of defibrillation requiring the addition of a subcutaneous patch. Twenty-four patient (53%) received at least one appropriate therapy; 14 patients (36%) had at least one inappropriate shock during follow-up. During follow-up, 7 patients died, 6 of a cardiac cause and 3 of an arrhythmic problem.(ABSTRACT TRUNCATED AT 250 WORDS) more...
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- 1995
44. [Thromboembolic complications of arrhythmia due to atrial fibrillation]
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J, Lekieffre, D, Lacroix, D, Klug, and S, Kacet
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Adult ,Aged, 80 and over ,Male ,Incidence ,Anticoagulants ,Intracranial Embolism and Thrombosis ,Middle Aged ,Double-Blind Method ,Risk Factors ,Thromboembolism ,Atrial Fibrillation ,Humans ,Female ,Platelet Aggregation Inhibitors ,Aged - Abstract
Fifteen per cent of cerebrovascular accidents have a cardiac origin, two thirds of which are due to atrial fibrillation (AF). The Framingham study showed the risk of an ischaemic cerebral event to be increased by 5.6 in AF unrelated to rheumatic heart disease and by 17.5 when AF is associated with valvular heart disease. The risk of embolism is higher in elderly subjects and in those with underlying cardiac disease. Other high risk conditions include hypertension, diabetes, hyperthyroidism and cases with echocardiographic changes: left atrial dilatation, pre-thrombotic state or intra-atrial thrombus, atheroma of the ascending aorta. This stratification of risk should be taken into account when deciding on treatment. Conscious of the importance of the risk of embolism in AF, several authors have undertaken, over the last few years, randomised studies of the prevention of thromboembolic complications of AF: the AFASAK, BAATAF, SPAF and SPINAF trials. All showed the unquestionable efficacy of warfarin, even at low doses, at the price of a haemorrhagic risk of less than 2% per year for severe haemorrhages. A more recent study (SPAF II) confirmed the value of aspirin at the dosage of 325 mg/day which would seem to be a good alternative to anticoagulant therapy when this is contraindicated, although aspirin is less effective. The indications for anticoagulant therapy have become clearer since the publication of these results. Anticoagulant therapy is essential in permanent AF whether or not associated with rheumatic heart disease.(ABSTRACT TRUNCATED AT 250 WORDS) more...
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- 1994
45. Poster Session 2
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T. Andersson, A. Magnusson, I.- L. Bryngelsson, O. Frobert, K. M. Henriksson, N. Edvardsson, D. Poci, M. Polovina, T. Potpara, M. Licina, N. Mujovic, A. Kocijancic, D. Simic, M. C. Ostojic, R. A. Providencia, A. Botelho, J. Trigo, J. Nascimento, N. Quintal, P. Mota, A. M. Leitao-Marques, R. F. Bosch, W. Kirch, L. Rosin, S. N. Willich, D. Pittrow, H. Bonnemeier, M. C. Valenza, L. Martin, T. Munoz Casaubon, G. Valenza, M. Botella, M. Serrano, B. Valenza, I. Cabrera, K. Anderson, B. S. Benzaquen, N. Koziolova, J. Nikonova, Y. Shilova, D. Scherr, S. Narayan, M. Wright, D. Krummen, A. Jadidi, P. Jais, M. Haissaguerre, M. Hocini, R. Hunter, Y. Liu, Y. Lu, W. Wang, R. J. Schilling, S. Bernstein, B. Wong, R. Rooke, C. Vasquez, R. Shah, S. Rosenberg, L. Chinitz, G. Morley, M. Bashir Choudhary, F. Holmqvist, J. Carlson, H.- J. Nilsson, P. G. Platonov, A. S. Jadidi, H. Cochet, S. Miyazaki, A. J. Shah, N. Marrouche, N. Calvo, M. Nadal, D. Andreu, D. Tamborero, F. E. Diaz, A. Berruezo, J. Brugada, L. Mont, S. Fichtner, G. Hessling, H. L. Estner, C. Jilek, T. Reents, S. Ammar, J. Wu, I. Deisenhofer, H. Nakanishi, K. Kashiwase, A. Hirata, M. Wada, Y. Ueda, J. Skoda, P. Neuzil, J. Popelova, J. Petru, L. Sediva, V. Y. Reddy, L. Uldry, A. Forclaz, N. Virag, J.- M. Vesin, L. Kappenberger, R. Sehra, C. Briggs, W.- J. Rappel, M. Janotka, M. Chovanec, K. Yamashiro, K. Takami, Y. Sakamoto, K. Satoh, T. Suzuki, H. Nakagawa, A. Romanov, E. Pokushalov, S. Artemenko, V. Shabanov, I. Stenin, D. Elesin, A. Turov, A. Yakubov, M. Hioki, S. Matsuo, K. Ito, R. Narui, S. Yamashita, K. Sugimoto, M. Yoshimura, T. Yamane, L. Di Biase, J. D. Gallinghouse, K. Rajappan, J. Kautzner, A. Dello Russo, C. Tondo, F. Lorgat, A. Natale, O. Balta, K. Buenz, M. Paessler, H. Anders, M. Horlitz, T. Deneke, L. Lickfett, I. Liberman, M. Linhart, R. Andrie, E. Mittmann-Braun, F. Stockigt, G. Nickenig, J. Schrickel, R. Tilz, A. Rillig, B. Feige, A. Metzner, A. Fuernkranz, A. Burchard, E. Wissner, F. Ouyang, T. R. Betts, M. A. Jones, K. C. K. Wong, N. Qureshi, Y. Bashir, G. Corbucci, D. Losik, V. Selina, M. A. Crandall, C. Daniels, E. Daoud, S. Kalbfleisch, H. Yamaji, T. Murakami, H. Kawamura, M. Murakami, K. Hina, S. Kusachi, G. Dakos, V. Vassilikos, S. Paraskevaidis, A. Mantziari, S. Theophylogiannakos, I. Chouvarda, I. Chatzizisis, I. Styliadis, T. Kimura, K. Fukumoto, N. Nishiyama, Y. Aizawa, Y. Fukuda, T. Sato, S. Miyoshi, S. Takatsuki, A. J. Navarrete Casas, I. Ali, F. C. Conte, M. Moran, B. G. Graham, O. Kalejs, R. Lacis, P. Stradins, A. Koris, I. Putnins, M. Vikmane, A. Lejnieks, A. Erglis, A. Estrada, A. Perez Silva, S. Castrejon, D. Doiny, J. L. Merino, A. Baranchuk, I. Greiss, C. S. Simpson, H. Abdollah, D. P. Redfearn, M. Buys-Topart, R. Nitzsche, B. Thibault, S. Kathan, C. Kolb, S. Reif, S. Schade, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, M. Schmidt, O. Cano Perez, F. Buendia, B. Igual, J. M. Osca, J. M. Sanchez, M. J. Sancho-Tello, J. M. Olague, A. Salvador, J. M. Tolosana, J. Fernandez-Armenta, M. Matas, M. C. Barbarin, M. Habibovic, K. C. Van Den Broek, D. A. M. J. Theuns, L. Jordaens, M. Alings, P. H. Van Der Voort, S. S. Pedersen, G. Pupita, S. Molini, M. Brambatti, A. Capucci, S. Molodykh, E. M. Idov, O. V. Belyaev, L. Segreti, E. Soldati, G. Zucchelli, A. Di Cori, S. Viani, L. Paperini, R. De Lucia, M. G. Bongiorni, L. Binner, M. Taborsky, D. Bello, H. Heuer, B. Ramza, I. Jenniskens, W. B. Johnson, M. S. Silvetti, L. Rava', M. S. Russo, C. Di Mambro, A. Ammirati, G. Gimigliano, M. Prosperi, F. Drago, A. R. Santos, B. Picarra, P. Semedo, P. Dionisio, R. Matos, M. Leitao, A. Jacinto, M. Trinca, P. Mazzone, G. Ciconte, A. Marzi, G. Paglino, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, P. Koppitz, A. Fach, S. Hobbiesiefken, E. Fiehn, R. Hambrecht, J. Sperzel, M. Jung, J. Schmitt, D. Pajitnev, H. Burger, G. Goebel, W. Ehrlich, T. Walther, T. Ziegelhoeffer, V. Vancura, D. Wichterle, V. Melenovsky, M. Glikson, G. Goldenberg, A. Segev, D. Dvir, J. Kuzniec, A. Finkelstein, I. Hay, V. Guetta, W. K. Choo, S. Gupta, R. Kirkfeldt, J. Johansen, E. Nohr, M. Moller, P. Arnsbo, J. Nielsen, M. Banha, P. Stojanov, S. Raspopovic, D. Vasic, D. Savic, G. Nikcevic, V. Jovanovic, P. Defaye, B. Mondesert, A. Mbaye, R. Cassagneau, V. Gagniere, J. Jacon, V. Sanfins, H. R. Reis, J. N. Nobre, V. M. Martins, L. D. Duarte, C. M. Morais, J. C. Conceicao, M. Hero, J. L. Rey, A. Ducharme, C. Simpson, C. Stuglin, L. Blier, M. Senaratne, Y. Khaykin, A. Pinter, A. Mlynarska, R. Mlynarski, M. Sosnowski, J. Wilczek, C. Iorgulescu, S. Bogdan, D. Constantinescu, C. Caldararu, M. Dorobantu, A. Radu, R.- G. Vatasescu, S. Yusu, T. Ikeda, H. Mera, Y. Miwa, A. Abe, M. Miyakoshi, T. Tsukada, H. Yoshino, V. Nayar, P. Cantelon, A. Rawling, M. R. D. Belham, P. J. Pugh, J. Osca Asensi, O. Cano, D. Tejada, B. Munoz, M. Rodriguez, J. Olague, L. Wecke, A. Van Hunnik, T. Thompson, L. Di Carlo, M. Zdeblick, A. Auricchio, F. Prinzen, A. Doltra Magarolas, B. Bijnens, E. Silva, D. Penela, M. Sitges, P. Ofman, L. Navaravong, J. Leng, A. Peralta, P. Hoffmeister, R. Levine, J. Cook, M. Stoenescu, M. E. Tettamanti, A. Revilla Orodea, J. Lopez Diaz, L. De La Fuente Galan, R. Arnold, E. Garcia Moran, J. A. San Roman Calvar, I. Gomez Salvador, K. Nakamura, M. Takami, T. Keida, A. Mesato, S. Higa, M. Shimabukuro, H. Masuzaki, R. Proietti, A. Sagone, G. Domenichini, H. Burri, C. Valzania, M. Biffi, H. Sunthorn, G. Gavaruzzi, H. Foulkes, G. Boriani, S. Koh, W. Hou, J. Snell, J. Poore, N. Dalal, G. Bornzin, A. Kloppe, D. Mijic, H. Bogossian, I. Ninios, M. Zarse, B. Lemke, L. Guedon-Moreau, C. Kouakam, D. Klug, C. Marquie, F. Ziglio, S. Kacet, H. Mohamed Fereig Hamed, A. M. A. L. Hamdy, A. H. M. E. D. Abd El Aziz, M. R. V. A. T. Nabih, R. E. H. A. B. Hamdy, A. Yaminisaharif, G. H. Davoudi, A. Kasemisaeid, S. Sadeghian, A. Vasheghani Farahani, P. Yazdanifard, A. Shafiee, C. Alonso, C. Grimard, G. Jauvert, A. Lazarus, L. L. Mont, J. Ortiz-Perez, T. Caralt, J. Escudero, F. Perez, K. M. Griffith, R. Ferreyra, P. Urena, M. Demas, C. Muratore, H. Mazzetti, J. Guardado, M. Fernandes, V. H. Pereira, F. Canario-Almeida, F. Ferreira, B. Rodrigues, J. Almeida, A. Sokal, E. Jedrzejczyk, R. Lenarczyk, S. Pluta, O. Kowalski, P. Pruszkowska, A. Swiatkowski, Z. Kalarus, M. Heinke, B. Ismer, H. Kuehnert, T. Heinke, R. Surber, N. Osypka, D. Prochnau, H. R. Figulla, S. Iacopino, M. Landolina, A. Proclemer, L. Padeletti, V. Calvi, A. Pierantozzi, P. Di Stefano, A. Bauer, F. Bode, F. Le Gal, J. C. Deharo, M. Delay, J. Clementy, M. Kawamura, Y. Munetsugu, K. Tanno, Y. Kobayashi, D. Cannom, J. Hosoda, T. Ishikawa, K. Andoh, M. Nobuyoshi, S. Fujii, S. Shizuta, T. Isshiki, M. A. Castel, F. Perez-Villa, B. Vidal, P. Pruszkowska-Skrzep, M. Szulik, T. Kukulski, L. Gianfranchi, K. Bettiol, F. Pacchioni, P. Alboni, R. Abu Sham'a, J. Buber, E. Nof, R. Kuperstein, M. Feinberg, D. Luria, M. Eldar, K. Parks, J. R. Stone, J. P. Singh, E. Hatzinikolaou-Kotsakou, M. Kotsakou, T. H. Beleveslis, G. Moschos, E. Reppas, P. Latsios, K. Tsakiridis, A. Kazemisaeid, G. Davoodi, A. Yamini Sharif, M. Sheikhvatan, M. Toniolo, G. Zanotto, A. Rossi, L. Tomasi, C. Vassanelli, H. Versteeg, P. M. C. Mommersteeg, G. Vergara, J. Blauer, R. Ranjan, S. Vijayakumar, E. Kholmovski, N. Volland, R. Macleod, L. E. Aguinaga Arrascue, A. Bravo, P. Garcia Freire, P. Gallardo, E. Hasbani, J. Dantur, R. Quintana, P. P. Adragao, D. Cavaco, L. Parreira, K. Reis Santos, P. Carmo, R. Miranda, S. Marcelino, D. Cabrita, P. Sommer, T. Gaspar, S. Rolf, A. Arya, C. Piorkowski, G. Hindricks, E. Valles Gras, V. Bazan, L. Portillo, F. Suarez, J. Bruguera, J. Marti, Y. Huo, S. Richter, R. Schoenbauer, N. Rivas, J. Casaldaliga, I. Roca, L. Dos, J. Perez-Rodon, A. Pijuan, D. Garcia-Dorado, A. Moya, H. B. Carter, A. Garg, J. Hegrenes, H. J. Sih, L. R. Teplitsky, K. Kuroki, H. Tada, Y. Seo, T. Ishizu, M. Igawa, Y. Sekiguchi, K. Kuga, K. Aonuma, C. Rodriguez A, J. Mejias, P. Hidalgo, J. A. Hidalgo L, M. Orczykowski, P. Derejko, F. Walczak, E. Szufladowicz, P. Urbanek, R. Bodalski, K. Bieganowska, L. Szumowski, P. Peichl, R. Cihak, I. Skalsky, P. Kubus, P. Vit, L. Zaoral, R. A. Gebauer, M. Fiala, J. Janousek, K. Hiroshima, M. Goya, M. Ohe, K. Hayashi, Y. Makihara, M. Nagashima, Y. An, M. Schloesser, T. Lawrenz, D. Meyer Zu Vilsendorf, C. Strunk-Mueller, C. Stellbrink, J. Papagiannis, D. Avramidis, C. Kokkinakis, G. Kirvassilis, G. Eidelman, A. Arenal, T. Datino, F. Atienza, E. Gonzalez Torrecilla, A. Miracle, J. Hernandez, F. Fernandez Aviles, E. Ene, P. Insulander, H. Bastani, F. Braunschweig, N. Drca, G. Kenneback, J. Schwieler, J. Tapanainen, M. Jensen-Urstad, B. Andrea, E. M. A. Andrea, W. M. Maciel, L. S. Siqueira, R. C. Cosenza, F. M. Mittidieri, S. F. Farah, J. A. Atie, E. Kanoupakis, E. Kallergis, H. Mavrakis, C. Goudis, I. Saloustros, N. Malliaraki, G. Chlouverakis, P. Vardas, J. L. Bonnes, J. Jaspers Focks, S. W. Westra, M. A. Brouwer, J. L. R. M. Smeets, G. Inama, C. Pedrinazzi, F. Oliva, M. Senni, M. Zoni Berisso, S. Mostov, M. Haim, R. Nevzorov, D. Hasadi, B. Starsberg, A. Porter, J. Kuschyk, A. Schoene, F. Streitner, C. G. Veltmann, R. Schimpf, M. Borggrefe, U. Luesebrink, A. Gardiwal, H. Oswald, T. Koenig, D. Duncker, G. Klein, R. Bastiaenen, V. Batchvarov, O. Atty, J. H. Cheng, E. R. Behr, M. M. Gallagher, A. H. Starrenburg, K. Kraaier, M. F. Scholten, J. Van Der Palen, S. Adhya, L. A. Smith, T. Zhao, C. Bannister, R. H. Kamdar, M. Martinelli, S. Siqueira, R. Greco, S. A. D. Nishioka, A. A. A. Pedrosa, R. Alkmim-Teixeira, G. L. Peixoto, R. Costa, J. C. Nielsen, P. T. Mortensen, J. B. Johansen, W. Kwasniewski, A. Filipecki, D. Urbanczyk-Swic, W. Orszulak, M. Trusz - Gluza, J. Jimenez-Candil, J. Morinigo, C. Ledesma, C. Martin-Luengo, T. Vogtmann, M. Gomer, S. Stiller, V. Kuehlkamp, G. Zach, S. Loescher, S. Kespohl, G. Baumann, J. D. Snell, N. Korsun, J. R. Snell, B. Morley, R. Bharmi, Y. Nabutovsky, M. Mollerus, L. Naslund, A. Meyer, M. Lipinski, B. Libey, K. Dornfeld, A. Martin, M. Gallego, M. K. De Bie, J. B. Van Rees, C. J. Borleffs, J. Thijssen, J. W. Jukema, M. J. Schalij, L. Van Erven, E. T. Van Der Velde, T. A. Witteman, H. Foeken, T. Szili-Torok, F. Akca, K. Caliskan, F. Ten Cate, M. Michels, D. C. Cozma, L. Petrescu, C. Mornos, S. I. Dragulescu, J. A. Groeneweg, B. K. Velthuis, M. G. P. J. Cox, P. Loh, D. Dooijes, M. J. Cramer, J. M. T. De Bakker, R. N. W. Hauer, S. D. Park, S. H. Shin, S. I. Woo, J. Kwan, K. S. Park, D. H. Kim, A. Iorio, L. Vitali Serdoz, F. Brun, E. Daleffe, M. Zecchin, M. Dal Ferro, S. Santangelo, G. F. Sinagra, S. Ouali, R. Hammemi, S. Hammas, S. Kacem, R. Gribaa, E. Neffeti, F. Remedi, E. Boughzela, P. Korantzopoulos, K. Letsas, Z. Christogiannis, K. Kalantzi, A. Ntorkos, J. Goudevenos, P. W. X. Foley, L. Yung, E. Barnes, M. Kikuchi, H. Ito, F. Miyoshi, R. Pecini, J. M. Marott, G. B. Jensen, J. Theilade, T. Mine, T. Kodani, T. Masuyama, I. M. Mozos, C. Serban, C. Costea, L. Susan, P. Barthel, A. Mueller, M. Malik, G. Schmidt, O. Karakurt, H. Kilic, D. R. Munevver Sari, D. Mroczek-Czernecka, A. Z. Pietrucha, A. Borowiec, M. Wnuk, I. Bzukala, O. Kruszelnicka, E. Konduracka, J. Nessler, Y. Kikuchi, A. Meireles, C. Gomes, D. Anjo, C. Roque, A. Pinheiro Vieira, V. Lagarto, A. Hipolito Reis, S. Torres, L. Miller, G. Vedrenne, E. Bruguiere, A. Redheuil, T. Lavergne, J. Y. Le Heuzey, E. Mousseaux, A. Hersi, K. Alhabib, H. Alfaleh, K. Sulaiman, W. Almahmeed, J. Alsuwidi, H. Amin, A. Almotarreb, H. W. K. Pang, K. Michael, E. J. Pereira, P. W. Munt, M. F. Fitzpatrick, A. S. Revishvili, G. Simonyan, T. Dzhordzhikiya, O. Sopov, V. Kalinin, E. T. Locati, A. M. Vecchi, G. Cattafi, A. Sachero, M. Lunati, S. Sayah, A. Alizadeh, N. Nazari, M. Hekmat, M. Moradi, M. Zeighami, H. Ghanji, K. Suzuki, M. Takagi, K. Maeda, H. Tatsumi, P. Vieira, H. Reis, A. Toth, H. Vago, P. Takacs, E. Edes, A. Marki, G. Y. Balazs, K. Huttl, B. Merkely, F. Lainis, M. M. Buckley, E. J. Johns, C. M. Seifer, L. Daba, K. Liebrecht, W. Piwowarska, J. Toquero Ramos, E. Perez Pereira, C. Mitroi, V. Castro Urda, J. M. Fernandez Villanueva, A. Corona Figueroa, L. Hernandez Reina, I. Fernandez Lozano, A. Bartoletti, P. Bocconcelli, S. Giuli, R. Massa, C. Svetlich, G. Tarsi, F. Tronconi, E. Vitale, P. Stryjewski, M. Wegrzynowska, A. Lousinha, J. Labandeiro, E. Antunes, S. Silva, S. Alves, A. Timoteo, M. Oliveira, R. Cruz Ferreira, and J. Jedrzejczyk-Spaho more...
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medicine.medical_specialty ,Voltage-dependent calcium channel ,business.industry ,medicine.drug_class ,Umbilical artery ,030204 cardiovascular system & hematology ,Cyclase ,3. Good health ,Low testosterone levels ,03 medical and health sciences ,0302 clinical medicine ,Bkca channel ,Endocrinology ,Physiology (medical) ,Internal medicine ,medicine.artery ,Natriuretic peptide ,Medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Ionic Channels - Abstract
Inthelastdecadesseveralinvestigatorshavesuggestedtheassociationofandrogenswithhypertension. Recently, some studies have shown that the incidence of cardiovascular diseases is increased in men with low testosterone levels, suggesting a protective role of androgens. Hypertension is one of the mostcommonproblemsinpregnancythatcomplicates5-10 %ofpregnancies.Anincreaseofmorbidity wasobservedinbabiesfrompregnantwomenwithhypertension.However,thepathogenesisremains unclearandthislimitstheabilitytopreventandtreatthispathology.Thebeneficialeffectsofandrogens for vascular system are associated with their ability to cause vasorelaxation. Inhuman vessels, this non genomiceffectofandrogensappeartobeduetoactivationoflargeconductancecalcium-activatedpotassiumchannels(BKCa)andvoltagegatedpotassiumchannels(KV)whichisinducedbycGMPincrease andaconsequentactivationofcGMP-dependentproteinkinase(PKG).Ontheotherhand,thegenomic effects of androgens concerning ionic channels are almost unknown. Our previous studies suggested that androgens increase the expression of BKCa channels and decrease expression of L-type calcium channels (LTCC). The aim of this work was to analyze the genomic effects of androgens on theexpressionofotherproteinsinvolvedintheregulationofvascularcontractility,suchassolubleguanylate cyclase (sGC), the natriuretic peptide receptor-A (NPRA) and PKG. This study also aimed to compare the expression levels of these proteins in human umbilical artery (HUA) from normotensive andhypertensivepregnantwomen.ToachievethesegoalsrealtimePCRwasperformedusingsmooth more...
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- 2011
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46. Poster Session 3
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G. M. T. Fabbri, S. Baldasseroni, D. Panuccio, M. Zoni Berisso, M. Scherillo, D. Lucci, G. Di Pasquale, G. Mathieu, I. Burazor, M. Burazor, Z. Perisic, V. Atanaskovic, V. Erakovic, A. Stojkovic, T. Vogtmann, C. Schoebel, S. Sogorski, M. Sebert, J. Schaarschmidt, I. Fietze, G. Baumann, T. Penzel, C. Mornos, A. Ionac, D. Cozma, D. Dragulescu, A. Mornos, L. Petrescu, L. Pescariu, B. Brembilla-Perrot, H. Khachab, F. Lamberti, C. Bellini, R. Remoli, T. Cogliandro, R. Nardo, F. Bellusci, V. Mazzuca, A. Gaspardone, L. E. Aguinaga Arrascue, A. Bravo, P. Garcia Freire, P. Gallardo, E. Hasbani, R. Quintana, J. Dantur, K. Inoue, A. Ueoka, Y. Tsubakimoto, T. Sakatani, A. Matsuo, H. Fujita, M. Kitamura, M. Wegrzynowska, E. Konduracka, A. Z. Pietrucha, D. Mroczek-Czernecka, A. Paradowski, I. Bzukala, J. Nessler, O. Igawa, M. Adachi, H. Atarashi, Y. Kusama, E. Kodani, R. Okazaki, A. Nakagomi, Y. Endoh, J. L. Baez-Escudero, A. S. Dave, C. M. Sasaridis, M. Valderrabano, R. Tilz, R. Bai, L. Di Biase, G. J. Gallinghouse, D. Gibson, A. Pisapia, O. Wazni, A. Natale, A. Arujuna, R. Karim, A. Rinaldi, M. Cooklin, K. Rhode, R. Razavi, M. O'neill, J. Gill, S. Kusa, Y. Komatsu, K. Kakita, K. Takayama, H. Taniguchi, K. Otomo, Y. Iesaka, S. Ammar, T. Reents, S. Fichtner, J. Wu, P. Zhu, C. Kolb, G. Hessling, I. Deisenhofer, G. Gilbert, P. Mohanty, J. Cunningham, T. Metz, R. Horton, S. Tao, Y. Yamauchi, H. Okada, S. Maeda, T. Obayashi, M. Isobe, J. Chan, S. Johar, T. Wong, V. Markides, W. Hussain, M. Konstantinidou, E. Wissner, A. Fuernkranz, Y. Yoshiga, A. Metzner, K.- H. Kuck, F. Ouyang, K. Kettering, F. Gramley, H. Mollnau, C. Weiss, S. Bardeleben, L. Biasco, M. Scaglione, D. Caponi, P. Di Donna, D. Sergi, N. Cerrato, A. Blandino, F. Gaita, M. Fiala, D. Wichterle, L. Sknouril, V. Bulkova, J. Chovancik, R. Nevralova, J. Pindor, J. Januska, J. I. Choi, J. E. Ban, N. Yasutsugu, J. S. Park, J. S. Jung, H. E. Lim, S. W. Park, Y. H. Kim, M. Kuhne, T. Reichlin, P. Ammann, B. Schaer, S. Osswald, C. Sticherling, M. Ohe, M. Goya, K. Hiroshima, K. Hayashi, Y. Makihara, M. Nagashima, M. Fukunaga, Y. An, U. Dorwarth, M. Schmidt, M. Wankerl, J. Krieg, F. Straube, E. Hoffmann, S. Kathan, P. Defaye, A. Mbaye, R. Cassagneau, V. Gagniere, P. Jacon, E. Pokushalov, A. Romanov, S. Artemenko, V. Shabanov, D. Elesin, I. Stenin, A. Turov, D. Losik, K. Kondo, J. Miake, A. Yano, K. Ogura, M. Kato, C. Shigemasa, Y. Sekiguchi, H. Tada, K. Yoshida, Y. Naruse, H. Yamasaki, M. Igarashi, T. Machino, K. Aonuma, S. Chen, S. Liu, G. Chen, W. Meng, F. Zhang, Y. Yan, L. Sciarra, S. Dottori, C. Lanzillo, E. De Ruvo, L. De Luca, M. Minati, E. Lioy, L. Calo', J. Lin, Z. Nie, M. Zhu, X. Wang, J. Zhao, W. Hu, H. Tao, J. Ge, B. Johansson, B. Houltz, N. Edvardsson, H. Schersten, T. Karlsson, B. Wandt, E. Berglin, R. H. Hoyt, B. P. Jenson, S. A. I. P. Trines, J. Braun, A. Tjon Joek Tjien, K. Zeppenfeld, G. Tavilla, R. J. M. Klautz, M. J. Schalij, R. Krausova, R. Cihak, P. Peichl, J. Kautzner, J. Pirk, I. Skalsky, J. Maly, K. Imai, T. Sueda, K. Orihashi, B. C. Picarra, A. R. Santos, P. Dionisio, P. Semedo, R. Matos, M. Leitao, M. Banha, M. Trinca, D. H. J. Elder, J. George, R. Jain, C. C. Lang, A. M. Choy, M. Konert, S. Loescher, A. Hartmann, E. Aversa, R. Chirife, E. Sztyglic, H. Mazzetti, O. Mascheroni, M. C. Tentori, R. M. Pop, A. D. Margulescu, R. Dulgheru, O. Enescu, C. Siliste, D. Vinereanu, A. Menezes Junior, A. R. Castro Carneiro, B. L. De Oliveira, A. N. Shah, B. Kantharia, R. De Lucia, E. Soldati, L. Segreti, A. Di Cori, G. Zucchelli, S. Viani, L. Paperini, M. G. Bongiorni, A. Kutarski, M. Czajkowski, R. Pietura, B. Malecka, J. Heintze, L. Eckardt, A. Bauer, M. Meine, L. Van Erven, P. E. Bloch Thomsen, M. P. Lopez Chicharro, O. Merhi, Y. Soga, K. Andou, M. Nobuyoshi, A. Gonzalez-Mansilla, R. Martin-Asenjo, L. Unzue, J. Torres, E. Garralda, R. R. Coma, J. E. Rodriguez Garcia, T. Yaegashi, H. Furusho, T. Kato, A. Chikata, S. Takashima, S. Usui, M. Takamura, S. Kaneko, M. Chudzik, P. Mitkowski, A. Przybylski, J. Lewek, T. Smukowski, A. Maciag, S. Castrejon Castrejon, A. Perez-Silva, A. Estrada, D. Doiny, M. Ortega, J. L. Lopez-Sendon, J. L. Merino, C. O'mahony, C. Coats, M. Cardona, A. Garcia, M. Calcagnino, R. Lachmann, D. Hughes, P. M. Elliott, S. Conti, G. P. Pruiti, E. Puzzangara, S. A. Romano, A. Di Grazia, G. P. Ussia, C. Tamburino, V. Calvi, A. Radinovic, S. Sala, A. Latib, M. Mussardo, S. Sora, G. Paglino, M. Gullace, A. Colombo, M.- A. G. Ohlow, B. Lauer, A. Wagner, M. Schreiber, B. Buchter, A. Farah, J. T. Fuhrmann, J. C. Geller, R. M. Nascimento Cardoso, L. A. Batista Sa, L. F. C. Campos Filho, S. V. Rodrigues, M. V. F. Dutra, T. R. S. A. Borges, D. R. Portilho, T. Deering, A. Bernardes, A. Veiga, O. Gartenlaub, A. Goncalves, A. Jimenez, A. Rousseauplasse, J. C. Deharo, H. Striekwold, G. Gosselin, H. Sitbon, V. Martins, G. Molon, F. Ayala-Paredes, M. J. Sancho-Tello, I. A. Fazal, S. Brady, J. Cronin, S. Mcnally, M. Tynan, C. J. Plummer, J. M. Mccomb, J. E. Val-Mejias, R. M. Oliveira, R. Costa, M. Martinelli Filho, K. R. Silva, L. M. Menezes, W. T. Tamaki, W. Mathias, N. A. G. Stolf, T. Misawa, I. Ohta, T. Shishido, T. Miyasita, T. Miyamoto, J. Nitobe, T. Watanabe, I. Kubota, B. Thibault, A. Ducharme, C. Simpson, C. Stuglin, C. E. Gagne, R. Williams, S. Mcnicoll, M. S. Silvetti, F. Drago, D. Penela, B. Bijnens, A. Doltra, E. Silva, A. Berruezo, L. Mont, M. Sitges, R. Mcintosh, O. Baumann, P. Raju, S. Gurunathan, S. Furniss, N. Patel, N. Sulke, G. Lloyd, M. Mor, S. Dror, Y. Tsadok, N. Bachner-Hinenzon, A. Katz, N. Liel-Cohen, Y. Etzion, R. Mlynarski, A. Mlynarska, J. Wilczek, M. Sosnowski, A. M. Sinha, D. Sinha, G. Noelker, J. Brachmann, F. Weidemann, G. Ertl, M. Jones, N. Searle, M. Cocker, E. Ilsley, P. Foley, R. Khiani, K. E. Nelson, A. J. Turley, W. A. Owens, S. A. James, N. J. Linker, V. Velagic, M. Cikes, B. Pezo Nikolic, D. Puljevic, J. Separovic-Hanzevacki, M. Lovric-Bencic, B. Biocina, D. Milicic, H. Kawata, L. Chen, H. Phan, K. Anand, G. Feld, U. Birgesdotter-Green, I. Fernandez Lozano, C. Mitroi, J. Toquero Ramos, V. Castro Urda, V. Monivas Palomero, A. Corona Figueroa, L. Hernandez Reina, L. Alonso Pulpon, A. Gate-Martinet, A. Da Costa, P. Rouffiange, A. Cerisier, L. Bisch, C. Romeyer-Bouchard, K. Isaaz, M.- A. Morales, E. Bianchini, U. Startari, F. Faita, T. Bombardini, V. Gemignani, M. Piacenti, S. Adhya, R. H. Kamdar, L. M. Millar, C. Burchardt, F. D. Murgatroyd, D. Klug, C. Kouakam, L. Guedon-Moreau, C. Marquie, S. Benard, S. Kacet, N. Cortez-Dias, P. Carrilho-Ferreira, D. Silva, S. Goncalves, M. Valente, P. Marques, L. Carpinteiro, J. Sousa, T. Keida, T. Nishikido, M. Fujita, T. Chinen, T. Kikuchi, K. Nakamura, H. Ohira, M. Takami, D. Anjo, A. Meireles, C. Gomes, C. Roque, A. Pinheiro Vieira, V. Lagarto, H. Reis, S. Torres, D. F. Ortega, L. D. Barja, J. P. Montes, E. Logarzo, P. Bonomini, N. Mangani, C. Paladino, T. Chwyczko, E. Smolis-Bak, M. Sterlinski, M. Pytkowski, B. Firek, A. Jankowska, H. Szwed, I. Nakajima, T. Noda, H. Okamura, K. Satomi, T. Aiba, W. Shimizu, N. Aihara, S. Kamakura, W. Brzozowski, A. Tomaszewski, A. Wysokinski, E. G. Bertoldi, L. E. Rohde, L. I. Zimerman, M. Pimentel, C. A. Polanczyk, G. Boriani, M. Lunati, M. Gasparini, M. Landolina, G. Lonardi, D. Pecora, M. Santini, S. Valsecchi, B. J. Rubinstein, D. Y. Wang, S. E. Cabreriza, M. E. Richmond, A. Rusanov, T. A. Quinn, B. Cheng, H. M. Spotnitz, H. M. Kristiansen, G. Vollan, T. Hovstad, H. Keilegavlen, S. Faerestrand, U. Brigesdotter-Green, A. M. R. Nawar, D. A. L. I. A. Ragab, R. A. N. I. A. Eluhsseiny, A. H. M. E. D. Abdelaziz, E. Nof, R. Abu Shama, J. Buber, R. Kuperstein, M. S. Feinberg, D. Barlev, M. Eldar, M. Glikson, H. Badran, R. Samir, M. Tawfik, M. Amin, H. Eldamnhoury, S. Khaled, J. M. Tolosana, A. M. Martin, A. Hernandez-Madrid, A. Macias, I. Fernandez-Lozano, J. Osca, A. Quesada, L. Padeletti, G. L. Botto, T. De Santo, A. Szwed, J. G. Martinez, B. Degand, G. Q. Villani, C. Leclercq, P. Ritter, I. Watanabe, K. Nagashima, Y. Okumura, M. Kofune, K. Ohkubo, T. Nakai, A. Hirayama, E. Mikhaylov, M. Vander, D. Lebedev, M. Zarse, H. Suleimann, H. Bogossian, J. Stegelmeyer, I. Ninios, Z. Karosienne, A. Kloppe, B. Lemke, S. John, T. Gaspar, S. Rolf, P. Sommer, G. Hindricks, C. Piorkowski, J. Fernandez-Armenta, L. L. Mont, H. Zeljko, D. Andreu, C. Herzcku, T. Boussy, J. Brugada, T. Obayahi, J. Hegrenes, E. Lim, V. Mediratta, R. Bautista, L. Teplitsky, C. F. B. Van Huls Van Taxis, A. P. Wijnmaalen, M. Gawrysiak, J. D. Schuijf, J. J. Bax, Y. Huo, S. Richter, A. Arya, A. Bollmann, F. Akca, T. Bauernfeind, B. Schwagten, N. M. S. De Groot, L. Jordaens, T. Szili-Torok, S. Miller, G. Kastner, P. Maury, P. Della Bella, E. Delacretaz, F. Sacher, G. Maccabelli, R. Brenner, A. Rollin, P. Jais, P. Vergara, N. Trevisi, A. Ricco, F. Petracca, C. Bisceglia, F. Baratto, R. Salguero Bodes, A. Fontenla Cerezuela, M. De Riva Silva, M. Lopez Gil, E. Mejia Martinez, A. Jurado Roman, M. Montero Alvarez, F. Arribas Ynsaurriaga, A. Baszko, K. Krzyzanowski, W. Bobkowski, R. Surmacz, E. Zinka, A. Siwinska, A. Szyszka, A. Perez Silva, A. Estrada Mucci, M. Ortega Molina, J. L. Lopez Sendon, J. L. Merino Llorens, K. Kaitani, K. Hanazawa, C. Izumi, Y. Nakagawa, I. Yamanaka, T. Hirahara, Y. Sugawara, C. Suga, J. Ako, S. Momomura, N. Galizio, J. Gonzalez, F. Robles, A. Palazzo, L. Favaloro, M. Diez, E. Guevara, A. Fernandez, S. Greenberg, A. Epstein, D. S. Goldman, C. Sangli, J. A. Keeney, K. Lee, S. R. D. Piers, J. B. Van Rees, J. Thijssen, C. J. W. Borleffs, E. T. Van Der Velde, C. H. Leclercq, M. Hero, M. Mizobuchi, Y. Enjoji, Y. Yazaki, K. Shibata, A. Funatsu, T. Kobayashi, S. Nakamura, G. Amit, B. Pertzov, D. Zahger, L. Medesani, R. Rana, F. Albano, H. Fraguas, S. S. Pedersen, M. T. Hoogwegt, D. A. M. J. Theuns, K. C. Van Den Broek, F. B. Tekle, M. Habibovic, M. Alings, P. Van Der Voort, J. Denollet, H. Vrazic, C. Jilek, H. Lesevic, S. Tzeis, V. Semmler, M. R. Gold, M. C. Burke, G. H. Bardy, N. Varma, B. Pavri, B. Stambler, J. Michalski, T. R. U. S. T. Investigators, E. Safak, D. Schmitz, T. Konorza, C. Wende, A. Schirdewan, J. Neuzner, T. Simmers, A. Erglis, R. Gradaus, J. Goetzke, L. Coutrot, K. Goehl, V. Bazan Gelizo, N. Grau, E. Valles, M. Felez, C. Sanjuas, J. Bruguera, J. Marti-Almor, S. Y. Chu, P. W. Li, W. H. Ding, C. Schukro, L. Leitner, J. Siebermair, G. Stix, T. Pezawas, J. Kastner, M. Wolzt, H. Schmidinger, N. A. T. H. A. L. I. E. Behar, G. Kervio, B. Petit, P. Maison-Balnche, S. Bodi, P. Mabo, P. W. X. Foley, E. Mutch, J. Brashaw-Smith, L. Ball, F. Leyva, D. H. Kim, M. J. Lee, W. S. Lee, S. D. Park, S. H. Shin, S. I. Woo, J. Kwan, K. S. Park, Y. Munetsugu, K. Tanno, M. Kikuchi, H. Ito, F. Miyoshi, M. Kawamura, Y. Kobayashi, S. Man, A. M. Algra, C. A. Schreurs, E. E. Van Der Wall, S. C. Cannegieter, C. A. Swenne, K. Iitsuka, T. Kondo, K. Goebbert, Z. Karossiene, D. Goldman, B. Kallen, E. Kerpi, J. Sardo, P. Arsenos, K. Gatzoulis, G. Manis, P. Dilaveris, D. Tsiachris, D. Mytas, S. Asimakopoulos, C. Stefanadis, S. Sideris, E. Kartsagoulis, O. Barbosa, M. Marocolo Junior, R. Silva Cortes, R. A. Moraes Brandolis, L. F. Oliveira, L. A. Pertili Rodrigues De Resende, M. A. Vieira Da Silva, V. J. Dias Da Silva, R. A. Hegazy, I. A. Sharaf, F. Fadel, H. Bazaraa, R. Esam, M. S. Deshko, V. A. Snezhitsky, T. P. Stempen, K. Kuroki, M. Igawa, K. Kuga, L. Ferreira Santos, T. Dionisio, L. Nunes, J. Machado, S. Castedo, C. Henriques, A. Matos, J. Oliveira Santos, K. Kraaier, M. A. G. M. Olimulder, M. A. Galjee, P. F. H. M. Van Dessel, J. Van Der Palen, A. A. M. Wilde, M. F. Scholten, F. Chouchou, L. Poupard, C. Philippe, I. Court-Fortune, J.- C. Barthelemy, F. Roche, T. S. Dolgoshey, G. A. Madekina, S. Sugiura, E. Fujii, M. Senga, K. Dohi, E. Sugiura, M. Nakamura, M. Ito, C. Eitel, J. Mendell, K. Lasseter, M. Shi, L. Urban, R. Hatala, P. Hlivak, M. De Melis, C. Garutti, G. Corbucci, H. Mlcochova, R. Maxian, E. Arbelo, A. Dogac, C. Luepkes, M. Ploessnig, C. Chronaki, L. Hinterbuchner, A. Guillen, S. S. Bun, D. G. Latcu, F. Franceschi, S. Prevot, L. Koutbi, P. Ricard, N. Saoudi, N. Nazari, A. Alizadeh, S. Sayah, M. Hekmat, M. Assadian, A. Ahmadzadeh, M. Wnuk, J. Jedrzejczyk-Spaho, O. Kruszelnicka, W. Piwowarska, A. Fedorowski, P. Burri, S. Juul-Moller, O. Melander, P. Mitro, P. Murin, P. Kirsch, V. Habalova, E. Slaba, E. Matyasova, M. A. Barlow, R. J. Blake, P. Rostoff, E. Wojewodka Zak, L. Froidevaux, F. P. Sarasin, M. Louis-Simonet, O. Hugli, B. Yersin, J. Schlaepfer, C. Mischler, E. Pruvot, E. Occhetta, F. Frascarelli, A. Burali, and E. Dovellini more...
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Oncology ,medicine.medical_specialty ,business.industry ,nutritional and metabolic diseases ,medicine.disease ,Logistic regression ,Breast cancer ,Physiology (medical) ,Internal medicine ,medicine ,lipids (amino acids, peptides, and proteins) ,skin and connective tissue diseases ,Cardiology and Cardiovascular Medicine ,business - Abstract
Results: Out of 664159 women there were 22938 patients with hyperlipidaemia (3.5%) and 9312 patients with breast cancer. Out of the hyperlipidaemia patients, 530 patients developed breast cancer (2.3%) compared with 8782 patients developing breast cancer without hyperlipidaemia (1.4%). A logistic regression model accounting for time from first presentation to development of breast cancer showed that the presence of hyperlipidaemia increases the outcome of breast cancer by 1.64 times (95% C.I. 1.50-1.79). Conclusions: Whilst we appreciate numerous limitations of our methods, coupled with the main findings of the recent basic science research, our analysis further augments the case for the role of cholesterol in the development of breast cancer. Our data from a large clinical relevant sample further strengthens the argument to prospectively trial statins in the management of breast cancer. more...
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- 2011
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- View/download PDF
47. [Efficacy and tolerability of sustained-release disopyramide in the treatment of cardiac arrhythmia. Results of a study with 593 patients]
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J, Lekieffre, L, Vaur, S, Kacet, and D, Lacroix
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Adult ,Aged, 80 and over ,Electrocardiography ,Delayed-Action Preparations ,Drug Evaluation ,Humans ,Arrhythmias, Cardiac ,Middle Aged ,Disopyramide ,Aged - Abstract
In the context of an open multicentre study, 593 patients participated in the evaluation of sustained release disopyramide (*) in the treatment of cardiac arrhythmias. One hundred and seventy one (29%) had a ventricular arrhythmia, 382 (64%) a supraventricular arrhythmia and 40 (7%) an atrial and ventricular arrhythmia. Two hundred and seventy patients (46%) had underlying cardiac disease. Disopyramide was administered at the mean daily dose of 462 +/- 95 mg. The effectiveness of treatment was assessed after 3 and 6 months by Holter in the group treated for ventricular arrhythmias, the responder rate was 52.6% at three months and 58.1% at 6 months. It was significantly (p0.001) greater in the group treated for supraventricular arrhythmias (71.3% at 3 months and 82.1% at 6 months). The Holter responder rate in patients aged over 65 (70.5% at 6 months) was high and general and cardiac acceptability similar to that in younger patients. Adverse events led to the interruption of treatment in 8.2% of patients. Thus the effectiveness/acceptability ratio of SR disopyramide makes it entirely appropriate for the treatment of cardiac arrhythmias, even in the elderly. more...
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- 1993
48. [Interference between cardiac pacemaker and electromagnetic anti-theft devices in stores]
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D, Beaugeard, S, Kacet, M, Bricout, and J, Camblin
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Pacemaker, Artificial ,Electromagnetic Fields ,Humans ,Theft ,Electromagnetic Phenomena ,Signal Transduction - Abstract
Electromagnetic anti-theft devices in shops comprise large diameter magnetic induction coils between which the shoppers pass. This study was undertaken with a simulator to assess the behaviour of different models of single and double-chamber pacemakers when exposed to 6 stereotyped and repetitive situations of 4 different electromagnetic anti-theft devices. Of the 35 pacemakers tested, 25 developed serious dysfunctions: 14 long-lasting inhibitions (over 3 seconds), 2 stimulations at maximal frequency, 2 electrical bradycardias and 2 permanent reprogramming. These dysfunctions due to electromagnetic interference are observed in old or modern, monopolar or bipolar pacemakers, and seem to be influenced by the amplitude and complexity of the signals emitted by the detectors. These observations justify a clear signalization warning pacemaker patients of a potential danger. more...
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- 1992
49. [Influence of age and body surface on the signal averaged high amplification ECG after complete repair of tetralogy of Fallot]
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G, Vaksmann, M, el Kohen, J M, Schleich, S, Kacet, C, Rey, and C, Dupuis
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Adult ,Electrocardiography ,Postoperative Complications ,Adolescent ,Body Surface Area ,Risk Factors ,Child, Preschool ,Bundle-Branch Block ,Age Factors ,Tetralogy of Fallot ,Humans ,Arrhythmias, Cardiac ,Child - Abstract
The aim of this study was to assess the influence of age and body surface area on the signal averaged ECG after complete repair of Tetralogy of Fallot. Fifty eight patients operated for Tetralogy of Fallot in whom the postoperative ECG showed right bundle branch block without any significant arrhythmia on Holter monitoring or exercise stress testing underwent signal averaged electrocardiography. A very significant relationship was observed between age and body surface area and the duration of the filtered QRS (r = 0.45, p = 0.0004 and r = 0.49, p = 0.00009 respectively) or the average voltage of the last 40 milliseconds (r = -0.49, p less than 0.03 and r = -0.31, p less than 0.02 respectively). Therefore, signal averaged ECG in patients operated for Tetralogy of Fallot varies with age and morphology. An adjustment of the parameters of the signal averaged ECG with respect to clinical characteristics is necessary before assessing the value of this technique for identifying patients at risk of developing ventricular arrhythmias. more...
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- 1992
50. [Holter monitoring, exercise test and atropine test in isolated congenital atrioventricular block in children]
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E, Chammas, G, Vaksmann, S, Kacet, C, Rey, G M, Brevière, M, el Kohen, and C, Dupuis
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Atropine ,Pacemaker, Artificial ,Heart Block ,Adolescent ,Child, Preschool ,Bradycardia ,Electrocardiography, Ambulatory ,Exercise Test ,Humans ,Child ,Prognosis - Abstract
Twenty-four patients with isolated congenital heart block were investigated by 24-hour Holter monitoring at an average age of 9.3 +/- 5.5 years. Six patients were symptomatic and 18 were asymptomatic. Eight asymptomatic patients underwent exercise stress tests and an atropine test was performed in 10 asymptomatic patients to evaluate the capacity to accelerate the heart rate. The symptomatic patients were older than the asymptomatic patients. None of the parameters which analyse ventricular rate were significantly different in the two groups of patients. Significant ventricular arrhythmias (Lown Grade 2 or over) were recorded in 1 symptomatic and 3 asymptomatic patients. The incidence of these ventricular arrhythmias increased with age and degree of bradycardia. The percentage increase in ventricular rate after atropine correlated with what was observed on effort (r = 0.95, p = 0.01) but there was no relationship between the ventricular rates during these two tests and those recorded on Holter monitoring. The results of this series of children with isolated congenital heart block show the Holter parameters cannot distinguish symptomatic from asymptomatic patients. The exercise stress and atropine tests gave very similar results but their prognostic value has not yet been established. more...
- Published
- 1991
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