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3. Growth impacts in a changing ocean: insights from two coral reef fishes in an extreme environment

Author

D’Agostino, D, Burt, JA, Santinelli, V, Vaughan, GO, Fowler, AM, Reader, T, Taylor, BM, Hoey, AS, Cavalcante, GH, Bauman, AG, and Feary, DA

Subjects
sense organs, humanities, 04 Earth Sciences, 05 Environmental Sciences, 06 Biological Sciences, Marine Biology & Hydrobiology
Abstract

Determining the life-history consequences for fishes living in extreme and variable environments will be vital in predicting the likely impacts of ongoing climate change on reef fish demography. Here, we compare size-at-age and maximum body size of two common reef fish species (Lutjanus ehrenbergii and Pomacanthus maculosus) between the environmentally extreme Arabian/Persian Gulf (‘Arabian Gulf’) and adjacent comparably benign Oman Sea. Additionally, we use otolith increment width profiles to investigate the influence of temperature, salinity and productivity on the individual growth rates. Individuals of both species showed smaller size-at-age and lower maximum size in the Arabian Gulf compared to conspecifics in the less extreme and less variable environment of the Oman Sea, suggesting a life-history trade-off between size and metabolic demands. Salinity was the best environmental predictor of interannual growth across species and regions, with low growth corresponding to more saline conditions. However, salinity had a weaker negative effect on interannual growth of fishes in the Arabian Gulf than in the Oman Sea, indicating Arabian Gulf populations may be better able to acclimate to changing environmental conditions. Temperature had a weak positive effect on the interannual growth of fishes in the Arabian Gulf, suggesting that these populations may still be living within their thermal windows. Our results highlight the potential importance of osmoregulatory cost in impacting growth, and the need to consider the effect of multiple stressors when investigating the consequences of future climate change on fish demography.

Published
2021

4. Brugada syndrome genetics is associated with phenotype severity

Author

Ciconte, G, Monasky, M, Santinelli, V, Micaglio, E, Vicedomini, G, Anastasia, L, Negro, G, Borrelli, V, Giannelli, L, Santini, F, de Innocentiis, C, Rondine, R, Locati, E, Bernardini, A, Mazza, B, Mecarocci, V, Ćalović, Ž, Ghiroldi, A, D'Imperio, S, Benedetti, S, Di Resta, C, Rivolta, I, Casari, G, Petretto, E, Pappone, C, Ciconte, Giuseppe, Monasky, Michelle M, Santinelli, Vincenzo, Micaglio, Emanuele, Vicedomini, Gabriele, Anastasia, Luigi, Negro, Gabriele, Borrelli, Valeria, Giannelli, Luigi, Santini, Francesca, de Innocentiis, Carlo, Rondine, Roberto, Locati, Emanuela T, Bernardini, Andrea, Mazza, Beniamino C, Mecarocci, Valerio, Ćalović, Žarko, Ghiroldi, Andrea, D'Imperio, Sara, Benedetti, Sara, Di Resta, Chiara, Rivolta, Ilaria, Casari, Giorgio, Petretto, Enrico, Pappone, Carlo, Ciconte, G, Monasky, M, Santinelli, V, Micaglio, E, Vicedomini, G, Anastasia, L, Negro, G, Borrelli, V, Giannelli, L, Santini, F, de Innocentiis, C, Rondine, R, Locati, E, Bernardini, A, Mazza, B, Mecarocci, V, Ćalović, Ž, Ghiroldi, A, D'Imperio, S, Benedetti, S, Di Resta, C, Rivolta, I, Casari, G, Petretto, E, Pappone, C, Ciconte, Giuseppe, Monasky, Michelle M, Santinelli, Vincenzo, Micaglio, Emanuele, Vicedomini, Gabriele, Anastasia, Luigi, Negro, Gabriele, Borrelli, Valeria, Giannelli, Luigi, Santini, Francesca, de Innocentiis, Carlo, Rondine, Roberto, Locati, Emanuela T, Bernardini, Andrea, Mazza, Beniamino C, Mecarocci, Valerio, Ćalović, Žarko, Ghiroldi, Andrea, D'Imperio, Sara, Benedetti, Sara, Di Resta, Chiara, Rivolta, Ilaria, Casari, Giorgio, Petretto, Enrico, and Pappone, Carlo

Abstract

Aims : Brugada syndrome (BrS) is associated with an increased risk of sudden cardiac death due to ventricular tachycardia/fibrillation (VT/VF) in young, otherwise healthy individuals. Despite SCN5A being the most commonly known mutated gene to date, the genotype-phenotype relationship is poorly understood and remains uncertain. This study aimed to elucidate the genotype-phenotype correlation in BrS. Methods and results: Brugada syndrome probands deemed at high risk of future arrhythmic events underwent genetic testing and phenotype characterization by the means of epicardial arrhythmogenic substrate (AS) mapping, and were divided into two groups according to the presence or absence of SCN5A mutation. Two-hundred probands (160 males, 80%; mean age 42.6 ± 12.2 years) were included in this study. Patients harbouring SCN5A mutations exhibited a spontaneous type 1 pattern and experienced aborted cardiac arrest or spontaneous VT/VF more frequently than the other subjects. SCN5A-positive patients exhibited a larger epicardial AS area, more prolonged electrograms and more frequently observed non-invasive late potentials. The presence of an SCN5A mutation explained >26% of the variation in the epicardial AS area and was the strongest predictor of a large epicardial area. Conclusion : In BrS, the genetic background is the main determinant for the extent of the electrophysiological abnormalities. SCN5A mutation carriers exhibit more pronounced epicardial electrical abnormalities and a more aggressive clinical presentation. These results contribute to the understanding of the genetic determinants of the BrS phenotypic expression and provide possible explanations for the varying degrees of disease expression.

Published
2021

6. General Anesthesia Attenuates Brugada Syndrome Phenotype Expression: Clinical Implications From a Prospective Clinical Trial

Author

Ciconte G., Santinelli V., Brugada J., Vicedomini G., Conti M., Monasky M. M., Borrelli V., Castracane W., Aloisio T., Giannelli L., Di Dedda U., Pozzi P., Ranucci M., Pappone C., Ciconte, G., Santinelli, V., Brugada, J., Vicedomini, G., Conti, M., Monasky, M. M., Borrelli, V., Castracane, W., Aloisio, T., Giannelli, L., Di Dedda, U., Pozzi, P., Ranucci, M., and Pappone, C.

Subjects
Adult, Male, propofol, Anesthetics, General, Middle Aged, Anesthesia, General, general anesthesia, type 1 Brugada pattern, Electrocardiography, Prospective Studie, Sevoflurane, Phenotype, Brugada syndrome, Female, Human
Abstract

Objectives: This study investigates the electrocardiographic-electrophysiological effects of administration of anesthetic drugs for general anesthesia (GA) in patients with BrS at high risk of sudden cardiac death (SCD). Background: The safety of anesthetic agents in Brugada syndrome (BrS) is under debate. Methods: All consecutive patients with spontaneous type 1 BrS electrocardiographic (ECG) patterns undergoing epicardial ablation of the arrhythmogenic substrate (AS) under GA were enrolled. Anesthesia was induced with single bolus of propofol and maintained with sevofluorane. ECG measurements were collected before, immediately after, and 20 min after induction of GA. Three-dimensional maps during GA and after ajmaline indicated the epicardial AS before ablation. Results: Thirty-six patients with BrS (32 male, 88.9%; mean age 38.8 ± 12.0 years) with a spontaneous type 1 ECG pattern underwent GA. Induction was performed using propofol at mean dose of 1.6 to 2.6 mg/kg (2.1 ± 0.3 mg/kg). Twenty-eight (28 of 36, 77.8%) patients showed a reversion to a nondiagnostic pattern. ST-segment elevation (0.32 ± 0.01 mV vs. 0.19 ± 0.02 mV; p < 0.001) and J-wave amplitude (0.47 ± 0.02 mV vs. 0.31 ± 0.03 mV; p < 0.001) decreased after propofol. The AS area during GA, in the absence of BrS pattern, significantly enlarged after administration of ajmaline (3.6 ± 0.5 cm2 vs. 20.3 ± 0.8 cm2). No patient developed malignant arrhythmias during GA induction and maintenance. Conclusions: This study shows that GA using single-bolus propofol and volatile anesthetics is safe in high-risk patients with BrS, and it may exert a modulating effect by reducing the manifestation of type 1 BrS pattern and AS in the form of epicardial abnormal ECGs. (Epicardial Ablation in Brugada Syndrome: An Extension Study of 200 BrS Patients; NCT03106701)

Published
2018

7. Intermittent alternance of Brugada ECG patterns: Insights from a unique electrophysiological phenomenon

Author

Ciconte G., Conti M., Vicedomini G., Santinelli V., Brugada J., Pappone C., Ciconte, G., Conti, M., Vicedomini, G., Santinelli, V., Brugada, J., and Pappone, C.

Subjects
Adult, Time Factor, ECG, arrhythmic genetic syndrome, sudden death, Predictive Value of Test, intermittent Brugada pattern, Electrocardiography, Heart Conduction System, Heart Rate, Ablation Technique, Brugada syndrome, Action Potential, Human
Published
2017

8. Radiofrequency Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation Meta-Analysis of Quality of Life, Morbidity, and Mortality

Author

Siontis, K C, Ioannidis, J P A, Katritsis, G D, Noseworthy, P A, Packer, D L, Hummel, J D, Jais, P, Krittayaphong, R, Mont, L, Morillo, C A, Nielsen, J C, Oral, H, Pappone, C, Santinelli, V, Weerasooriya, R, Wilber, D J, Gersh, B J, Josephson, M E, Katritsis, D G, Siontis, K C, Ioannidis, J P A, Katritsis, G D, Noseworthy, P A, Packer, D L, Hummel, J D, Jais, P, Krittayaphong, R, Mont, L, Morillo, C A, Nielsen, J C, Oral, H, Pappone, C, Santinelli, V, Weerasooriya, R, Wilber, D J, Gersh, B J, Josephson, M E, and Katritsis, D G

Subjects
atrial fibrillation, radiofrequency ablation, antiarrhythmic drug therapy, meta-analysi
Abstract

Objectives The aim of this study was to perform a collaborative meta-analysis of published and unpublished quality-of-life, morbidity, and mortality data from randomized controlled trial comparisons of radiofrequency ablation (RFA) and antiarrhythmic drug therapy (AAD) in symptomatic atrial fibrillation. Background RFA is superior to AAD in decreasing recurrences of atrial fibrillation, but the effects on other clinical outcomes are not well established. Methods The primary investigators of eligible randomized controlled trials were invited to contribute standardized outcome data. Random-effects summary estimates were calculated as standardized mean differences and risk ratios with 95% confidence intervals for continuous and binary outcomes, respectively. Fixed effects were used in subgroup analyses. Results Twelve randomized controlled trials (n = 1,707 patients) were included. RFA led to greater improvements in 4 36-Item Short Form Health Survey areas and the symptom frequency score from baseline to 3 months. In all quality-of-life metrics, there was a trend toward diminution of the differences between the 2 approaches with follow-up. There were 7 of 866 (5 in a study using phased RFA) and 0 of 704 strokes in the RFA and AAD arms, respectively (p = 0.02, Fisher exact test). Bleeding and mortality events were not significantly different between the 2 arms. There was high heterogeneity for hospitalizations, with decreased hospitalization risk with RFA when it was not first-line therapy (risk ratio: 0.34; 95% confidence interval: 0.24 to 0.46) and increased risk as first-line therapy (risk ratio: 1.22; 95% confidence interval: 1.03 to 1.45). Conclusions RFA demonstrates an early but nonsustained superiority over AAD for the improvement of quality of life. There are no obvious differences in other clinical outcomes, and the periprocedural stroke risk is non-negligible.

Published
2016

9. Multipoint left ventricular pacing in a single coronary sinus branch improves mid-term echocardiographic and clinical response to cardiac resynchronization therapy

Author

Pappone C., Calovic Z., Vicedomini G., Cuko A., McSpadden L. C., Ryu K., Romano E., Baldi M., Saviano M., Pappone A., Ciaccio C., Giannelli L., Ionescu B., Petretta A., Vitale R., Fundaliotis A., Tavazzi L., Santinelli V., Pappone, C., Calovic, Z., Vicedomini, G., Cuko, A., Mcspadden, L. C., Ryu, K., Romano, E., Baldi, M., Saviano, M., Pappone, A., Ciaccio, C., Giannelli, L., Ionescu, B., Petretta, A., Vitale, R., Fundaliotis, A., Tavazzi, L., and Santinelli, V.

Subjects
Male, Pacemaker, Artificial, Time Factor, Cardiac Pacing, Artificial, multipoint pacing, cardiac resynchronization therapy, heart failure, LV modeling, Stroke Volume, Equipment Design, Recovery of Function, Middle Aged, pressure-volume loop, Ventricular Function, Left, Heart Ventricle, Cardiac Resynchronization Therapy Device, Treatment Outcome, Italy, CRT response, Coronary Sinu, Ventricular Pressure, Female, Human, Aged, Ultrasonography
Abstract

Multipoint LV Pacing Improves Mid-Term CRT Response Introduction Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing in a single coronary sinus branch improves acute LV function. We hypothesized that multipoint pacing (MPP) can improve midterm echocardiographic and clinical response compared with conventional CRT. Methods and Results Consecutive patients receiving a CRT implant (Unify Quadra MP™ or Quadra Assura MP™ CRT-D and Quartet™ LV lead, St. Jude Medical, Sylmar, CA, USA) were randomized to receive biventricular (BiV) pacing with either conventional LV pacing (CONV group) or MPP (MPP group). For each patient, an optimal pacing configuration for the assigned pacing mode was programmed based on intraoperative pressure-volume (PV) loop measurements. A clinical evaluation and transthoracic echocardiogram were performed before implant (BASELINE) and at 3 months postimplant and analyzed by a blinded observer. A reduction in end-systolic volume (ESV) of ≥15% relative to BASELINE was prospectively defined as response to CRT. Forty-four patients (NYHA Class III, EF 29 ± 6%, QRS duration 152 ± 17 milliseconds) were enrolled and randomized. One patient in the MPP group was lost to follow-up and excluded from further analysis. After 3 months, 11 of 22 (50%) CONV patients and 16 of 21 (76%) MPP patients were classified as responders. ESV reduction, EF increase, and NYHA class reduction relative to BASELINE were significantly greater in the MPP group than in the CONV group (ESV: -21.0 ± 13.9 vs. -12.6 ± 11.1%, P = 0.03; EF: +9.8 ± 5.1 vs. +2.0 ± 7.8 percentage points, P < 0.001; ΔNYHA: -1.05 ± 0.22 vs. -0.72 ± 0.46 functional classes, P = 0.006). Conclusion PV loop optimized BiV pacing with MPP resulted in an improved rate of response to CRT.

Published
2015

11. Risk of malignant arrhythmias in initially symptomatic patients with Wolff-Parkinson-White syndrome: results of a prospective long-term electrophysiological follow-up study

Author

Pappone C, Vicedomini G, Manguso F, Baldi M, Pappone A, Petretta A, Vitale R, Saviano M, Ciaccio C, Giannelli L, Calovic Z, Tavazzi L, Santinelli V, Pappone, C, Vicedomini, G, Manguso, F, Baldi, M, Pappone, A, Petretta, A, Vitale, R, Saviano, M, Ciaccio, C, Giannelli, L, Calovic, Z, Tavazzi, L, and Santinelli, V

Published
2012

15. Post ablation left atrial tachycardia: Understanding mechanism, prevention and teatment

Author

Pappone C, Santinelli V, Pappone, C, and Santinelli, V

Subjects
Post Ablation Left Atrial Tachycardia, Atrial fibrillation
Abstract

Currently, post-ablation Atrial Tachycardias (ATs) represent a growing clinical problem particularly in patients with persistent AF undergoing a more extensive substrate ablation. Understanding mechanisms and location of potentially widely located arrhythmogenic substrates in the left atrium is crucial for successful ablation. Mapping and ablation are challenging since complex and multiple ATs may frequently develop during the index procedure and before conversion to sinus rhythm. Use of irrigated ablation guided by detailed 3-D electroanatomic activation maps combined with entrainment pacing is effective with excellent acute and long-term success rates, rarely requiring multiple procedures.

Published
2012

20. Atrial Fibrillation

Author

Pappone C, Santinelli V, Pappone, C, and Santinelli, V

Published
2011

29. Magnetic navigation

Author

Pappone C, Santinelli V, Pappone, C, and Santinelli, V

Published
2009

32. Long-term outcome of remote catheter ablation using a magnetic irrigated-tip catheter

Author

Santinelli V, Radinovic A, Vicedomini G, Ciconte G, Mazzone P, Augello G, Gulletta S, Sala S, Paglino G, M Saviano, Sacchi S, Vergara P, Pappone C, Santinelli, V, Radinovic, A, Vicedomini, G, Ciconte, G, Mazzone, P, Augello, G, Gulletta, S, Sala, S, Paglino, G, M, Saviano, Sacchi, S, Vergara, P, and Pappone, C

Published
2009

40. The natural history of ventricular preexcitation in 293 asymptomatic adult subjects

Author

Santinelli V, Radinovic A, Ciconte G, Vicedomini G, Mazzone P, Gulletta S, Paglino G, Sala S, Ciaccio C, Sacchi S, Avitabile M, Saviano M, Augello G, Santagostino A, Vergara P, Pappone C, Santinelli, V, Radinovic, A, Ciconte, G, Vicedomini, G, Mazzone, P, Gulletta, S, Paglino, G, Sala, S, Ciaccio, C, Sacchi, S, Avitabile, M, Saviano, M, Augello, G, Santagostino, A, Vergara, P, and Pappone, C

Published
2009

48. Atrial Fibrillation Progression in Patients With and Without Lone Atrial Fibrillation: A Five-Year Prospective Follow-Up Study

Author

Santinelli V, Radinovic A, Manguso F, Sala S, Vicedomini G, Mazzone P, Ciconte G, Frigoli E, Augello G, Gelera E, Gulletta S, Saviano M, Pappone A, Paglino G, Pappone C, Santinelli, V, Radinovic, A, Manguso, F, Sala, S, Vicedomini, G, Mazzone, P, Ciconte, G, Frigoli, E, Augello, G, Gelera, E, Gulletta, S, Saviano, M, Pappone, A, Paglino, G, and Pappone, C

Published
2008

49. Safety, Efficacy and Follow-Up of Circumferential Pulmonary Vein Ablation in Octogenarians

Author

Santinelli V, Radinovic A, Sala S, Vicedomini G, Mazzone P, Gulletta S, Ciaccio C, Ciconte G, Paglino G Augello G, Gelera E, Frigoli E, Santagostino A, Pappone C, Santinelli, V, Radinovic, A, Sala, S, Vicedomini, G, Mazzone, P, Gulletta, S, Ciaccio, C, Ciconte, G, Paglino, G Augello G, Gelera, E, Frigoli, E, Santagostino, A, and Pappone, C

Published
2008

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