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1. Association between pulmonary artery pulsatility and mortality after implantation of left ventricular assist device

Author

Ali Akamkam, Vincent Galand, Marie Jungling, Clément Delmas, Camille Dambrin, Mathieu Pernot, Michel Kindo, Philippe Gaudard, Philippe Rouviere, Thomas Senage, Olivier Chavanon, Marylou Para, Vlad Gariboldi, Matteo Pozzi, Pierre‐Yves Litzler, Gerard Babatasi, Olivier Bouchot, Costin Radu, Thierry Bourguignon, Nicolas D'Ostrevy, Ramzi Abi Akar, Fabrice Vanhuyse, Maïra Gaillard, Gilles Chatelier, Audrey Fels, Erwan Flecher, and Julien Guihaire

Subjects
Left ventricular assist device, Haemodynamics, Circulatory assist devices, Ventricle, right, Heart failure, Database, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Aims Right ventricular failure after left ventricular assist device (LVAD) implantation is a major concern that remains challenging to predict. We sought to investigate the relationship between preoperative pulmonary artery pulsatility index (PAPi) and mortality after LVAD implantation. Methods and results A retrospective analysis of the ASSIST‐ICD multicentre registry allowed the assessment of PAPi before LVAD according to the formula [(systolic pulmonary artery pressure − diastolic pulmonary artery pressure)/central venous pressure]. The primary endpoint was survival at 3 months, according to the threshold value of PAPi determined by the receiver operating characteristic (ROC) curve. A multivariate analysis including demographic, echographic, haemodynamic, and biological variables was performed to identify predictive factors for 2 year mortality. One hundred seventeen patients were included from 2007 to 2021. The mean age was 58.45 years (±13.16), with 15.4% of women (sex ratio 5.5). A total of 53.4% were implanted as bridge to transplant and 43.1% as destination therapy. Post‐operative right ventricular failure was observed in 57 patients (48.7%), with no significant difference between survivors and non‐survivors at 1 month (odds ratio 1.59, P = 0.30). The median PAPi for the whole study population was 2.83 [interquartile range 1.63–4.69]. The threshold value of PAPi determined by the ROC curve was 2.84. Patients with PAPi ≥ 2.84 had a higher survival rate at 3 months [PAPi

Published
2024
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2. Ablation of multifocal premature ventricular contractions using automated pace-mapping software

Author

Raphaël P. Martins, Karim Benali, Vincent Galand, Nathalie Behar, Jean-Claude Daubert, Philippe Mabo, Christophe Leclercq, and Dominique Pavin

Subjects
Extrassístole ventricular, Ablação por cateter, Eletrofisiologia, Pace-mapping, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Introduction and Objectives: Ablation of multifocal premature ventricular complexes (PVCs) is challenging. Activation mapping can be performed for the predominant morphology, but may be useless for other less prevalent ones. We aimed to describe the efficacy of an automated pace-mapping software-based ablation strategy for ablating the site of origin of multiple PVC locations. Methods: Consecutive patients referred for ablation of multifocal PVCs were prospectively enrolled. Spontaneous PVC templates were recorded and a detailed pace-mapping map was generated to spot the site of origin of PVCs. Results: A total of 47 PVCs were targeted in 21 patients (five and 16 patients with three or two PVCs morphologies each, respectively). Detailed pace-mapping comprising 73.5±41.6 different pacing locations was performed (best matching 97.2% [IQR 95.9-98.3%] similar to the clinical PVC). Activation points were acquired if possible, although ablation was only based on pace-mapping in 13 (27.6%) foci. Complete acute procedural success was obtained in 14 (66.7%) patients, while one PVC morphology was deliberately not ablated in five patients (23.8%). After 12.3±9.4 months of follow-up, PVC burden decreased from 24.4±10.4% to 5.6±5.0% (p

Published
2022
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3. The saga of dyssynchrony imaging: Are we getting to the point

Author

Elena Galli, Vincent Galand, Virginie Le Rolle, Marion Taconne, Adrien Al Wazzan, Alfredo Hernandez, Christophe Leclercq, and Erwan Donal

Subjects
cardiac imaging, cardiac resynchronization therapy, left ventricular dyssynchrony, heart failure, left ventricular remodelling, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Cardiac resynchronisation therapy (CRT) has an established role in the management of patients with heart failure, reduced left ventricular ejection fraction (LVEF 130 msec). Despite the complex pathophysiology of left ventricular (LV) dyssynchrony and the increasing evidence supporting the identification of specific electromechanical substrates that are associated with a higher probability of CRT response, the assessment of LVEF is the only imaging-derived parameter used for the selection of CRT candidates.This review aims to (1) provide an overview of the evolution of cardiac imaging for the assessment of LV dyssynchrony and its role in the selection of patients undergoing CRT; (2) highlight the main pitfalls and advantages of the application of cardiac imaging for the assessment of LV dyssynchrony; (3) provide some perspectives for clinical application and future research in this field.Conclusionthe road for a more individualized approach to resynchronization therapy delivery is open and imaging might provide important input beyond the assessment of LVEF.

Published
2023
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4. Characteristics and outcome of ambulatory heart failure patients receiving a left ventricular assist device

Author

Guillaume Baudry, Nicolas Nesseler, Erwan Flecher, André Vincentelli, Céline Goeminne, Clément Delmas, Jean Porterie, Karine Nubret, Mathieu Pernot, Michel Kindo, Tam Hoang Minh, Philippe Rouvière, Philippe Gaudard, Magali Michel, Thomas Senage, Aude Boignard, Olivier Chavanon, Marylou Para, Constance Verdonk, Edeline Pelcé, Vlad Gariboldi, Frederic Anselme, Pierre‐Yves Litzler, Katrien Blanchart, Gerard Babatasi, Marie Bielefeld, Olivier Bouchot, David Hamon, Nicolas Lellouche, Xavier Bailleul, Thibaud Genet, Romain Eschalier, Nicolas d'Ostrevy, Marie‐Cécile Bories, Ramzi Abi Akar, Hugues Blangy, Fabrice Vanhuyse, Jean François Obadia, Vincent Galand, and Matteo Pozzi

Subjects
Advanced heart failure, Heart failure medications, Mechanical circulatory support, Left ventricular assist device, Outcome measures, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Aims Despite regularly updated guidelines, there is still a delay in referral of advanced heart failure patients to mechanical circulatory support and transplant centres. We aimed to analyse characteristics and outcome of non‐inotrope‐dependent patients implanted with a left ventricular assist device (LVAD). Methods and results The ASSIST‐ICD registry collected LVAD data in 19 centres in France between February 2006 and December 2016. We used data of patients in Interagency Registry for Mechanically Assisted Circulatory Support Classes 4–7. The primary endpoint was survival analysis. Predictors of mortality were searched with multivariable analyses. A total of 303 patients (mean age 61.0 ± 9.9 years, male sex 86.8%) were included in the present analysis. Ischaemic cardiomyopathy was the leading heart failure aetiology (64%), and bridge to transplantation was the main implantation strategy (56.1%). The overall likelihood of being alive while on LVAD support or having a transplant at 1, 2, 3, and 5 years was 66%, 61.7%, 58.7%, and 55.1%, respectively. Age [hazard ratio (HR) 1.03, 95% confidence interval (CI) 1.00–1.05; P = 0.02], a concomitant procedure (HR 2.32, 95% CI 1.52–3.53; P

Published
2021
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5. Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID‐19: Insight From a French Multicenter Cohort Study

Author

Richard Chocron, Vincent Galand, Joffrey Cellier, Nicolas Gendron, Thibaut Pommier, Olivier Bory, Lina Khider, Antonin Trimaille, Guillaume Goudot, Orianne Weizman, Jean Marc Alsac, Laura Geneste, Armand Schmeltz, Vassili Panagides, Aurélien Philippe, Wassima Marsou, Iannis Ben Abdallah, Antoine Deney, Salma El Batti, Sabir Attou, Philippe Juvin, Thomas Delmotte, Emmanuel Messas, Théo Pezel, Benjamin Planquette, Baptiste Duceau, Pascale Gaussem, Willy Sutter, Olivier Sanchez, Victor Waldman, Jean‐Luc Diehl, Tristan Mirault, Guillaume Bonnet, Ariel Cohen, and David M. Smadja

Subjects
anticoagulant, coagulopathy, COVID‐19, mortality, SARS‐CoV‐2, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Coronavirus disease 2019 (COVID‐19) is a respiratory disease associated with thrombotic outcomes with coagulation and endothelial disorders. Based on that, several anticoagulation guidelines have been proposed. We aimed to determine whether anticoagulation therapy modifies the risk of developing severe COVID‐19. Methods and Results Patients with COVID‐19 initially admitted in medical wards of 24 French hospitals were included prospectively from February 26 to April 20, 2020. We used a Poisson regression model, Cox proportional hazard model, and matched propensity score to assess the effect of anticoagulation on outcomes (intensive care unit admission or in‐hospital mortality). The study enrolled 2878 patients with COVID‐19, among whom 382 (13.2%) were treated with oral anticoagulation therapy before hospitalization. After adjustment, anticoagulation therapy before hospitalization was associated with a better prognosis with an adjusted hazard ratio of 0.70 (95% CI, 0.55–0.88). Analyses performed using propensity score matching confirmed that anticoagulation therapy before hospitalization was associated with a better prognosis, with an adjusted hazard ratio of 0.43 (95% CI, 0.29–0.63) for intensive care unit admission and adjusted hazard ratio of 0.76 (95% CI, 0.61–0.98) for composite criteria intensive care unit admission or death. In contrast, therapeutic or prophylactic low‐ or high‐dose anticoagulation started during hospitalization were not associated with any of the outcomes. Conclusions Anticoagulation therapy used before hospitalization in medical wards was associated with a better prognosis in contrast with anticoagulation initiated during hospitalization. Anticoagulation therapy introduced in early disease could better prevent COVID‐19–associated coagulopathy and endotheliopathy, and lead to a better prognosis.

Published
2021
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7. Atrioventricular nodal reentrant tachycardia ablation and inferior vena cava agenesis

Author

Vincent Galand, Dominique Pavin, Nathalie Behar, Philippe Mabo, and Raphaël P. Martins

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Congenital anomalies of the inferior vena cava (IVC) are rare and very often diagnosed in asymptomatic patients during computed tomography performed for other purposes. These anomalies can have significant clinical implications, for example if electrophysiology procedures are needed. Diagnostic and ablation procedures are difficult since catheter manipulation and positioning are more complex. We present here a case of successful atrioventricular nodal reentrant tachycardia ablation in a patient with unexpected IVC agenesis, using an azygos route. Resumo: As anomalias congénitas da veia cava inferior são raras e são, muitas vezes, diagnosticadas em pacientes assintomáticos como achados de tomografia computorizada realizada com outros objetivos. Estas anomalias podem ter implicações clínicas importantes, nomeadamente quando estão programados estudos eletrofisiológicos. Os procedimentos de diagnóstico e de ablação são difíceis, uma vez que o manuseamento e posicionamento do cateter é mais complexo. Apresentamos o caso bem-sucedido de uma ablação de taquicardia por reentrada nodal auriculoventricular num doente com agenesia da veia cava inferior, utilizando uma via trans-ázigos. Keywords: Supraventricular tachycardia, Ablation, Inferior vena cava agenesis, Palavras-chave: Taquicardia supraventricular, Ablação, Agenesia de veia cava inferior

Published
2016
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8. Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study

Author

Karim Benali, Valentin Barré, Alexis Hermida, Vincent Galand, Antoine Milhem, Séverine Philibert, Serge Boveda, Clément Bars, Frédéric Anselme, Baptiste Maille, Clémentine André, Albin Behaghel, Ghassan Moubarak, Nicolas Clémenty, Antoine Da Costa, Marine Arnaud, Sandrine Venier, Frédéric Sebag, Laurence Jésel-Morel, Audrey Sagnard, Laure Champ-Rigot, Duc Dang, Benoit Guy-Moyat, Selim Abbey, Rodrigue Garcia, Olivier Césari, Nicolas Badenco, Antoine Lepillier, Sandro Ninni, Stéphane Boulé, Philippe Maury, Vincent Algalarrondo, Babé Bakouboula, Jacques Mansourati, François Lesaffre, Philippe Lagrange, Abdeslam Bouzeman, Lucian Muresan, Raoul Bacquelin, Agustin Bortone, Sok-Sithikun Bun, Dominique Pavin, Laurent Macle, Raphaël P. Martins, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], CHU Amiens-Picardie, HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666 (HEMATIM), and Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
pulmonary vein, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), atrial fibrillation, freedom, [SDV.IB]Life Sciences [q-bio]/Bioengineering, dilatation, Cardiology and Cardiovascular Medicine, ablation
Abstract

Background: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown. We analyzed the impact of current ablation strategies in a large multicenter study. Methods: Patients undergoing a redo ablation for AF and presenting durable PVI were included. The freedom from atrial arrhythmia after pulmonary vein-based, linear-based, electrogram-based, and trigger-based ablation strategies were compared. Results: Between 2010 and 2020, 367 patients (67% men, 63±10 years, 44% paroxysmal) underwent a redo ablation for AF recurrences despite durable PVI at 39 centers. After durable PVI was confirmed, linear-based ablation was performed in 219 (60%) patients, electrogram-based ablation in 168 (45%) patients, trigger-based ablation in 101 (27%) patients, and pulmonary vein-based ablation in 56 (15%) patients. Seven patients (2%) did not undergo any additional ablation during the redo procedure. After 22±19 months of follow-up, 122 (33%) and 159 (43%) patients had a recurrence of atrial arrhythmia at 12 and 24 months, respectively. No significant difference in arrhythmia-free survival was observed between the different ablation strategies. Left atrial dilatation was the only independent factor associated with arrhythmia-free survival (HR, 1.59 [95% CI, 1.13–2.23]; P =0.006). Conclusions: In patients with recurrent AF despite durable PVI, no ablation strategy used alone or in combination during the redo procedure appears to be superior in improving arrhythmia-free survival. Left atrial size is a significant predictor of ablation outcome in this population.

Published
2023

9. Taquicardias supraventriculares en adultos (a excepción de la fibrilación auricular)

Author

Vincent Galand, Philippe Mabo, Raphaël P. Martins, and K. Benali

Subjects
Ocean Engineering, Safety, Risk, Reliability and Quality
Abstract

Resumen Las taquicardias supraventriculares (TSV) son un grupo de patologias ritmicas frecuentes en la practica clinica y que se originan en las auriculas o en la union auriculoventricular (AV). Por definicion, se contraponen a las taquicardias de origen ventricular con las que no comparten el riesgo hemodinamico y de muerte subita. Las principales arritmias agrupadas bajo este termino son la fibrilacion auricular, los cuadros de flutter auricular, las taquicardias auriculares, las taquicardias de la union y las taquicardias sinusales. El mecanismo fisiopatologico, la prevalencia y la asociacion con la cardiopatia subyacente difieren mucho entre estas distintas TSV. Sin embargo, estos diferentes aspectos deben estar bien integrados ya que condicionaran las respectivas modalidades de tratamiento de cada una de estas patologias. Su diagnostico suele ser electrocardiografico, pero puede requerir investigaciones mas complejas como la exploracion electrofisiologica. Su tratamiento puede basarse unicamente en la vigilancia, en la introduccion de tratamientos farmacologicos antiarritmicos o en la aplicacion de procedimientos de ablacion, dependiendo del tipo de trastorno del ritmo presente y de su tolerabilidad.

Published
2021

10. Tachicardie sopraventricolari dell’adulto (esclusa la fibrillazione atriale)

Author

Raphaël P. Martins, Vincent Galand, K. Benali, and Philippe Mabo

Subjects
media_common.quotation_subject, General Medicine, Art, Humanities, media_common
Abstract

Riassunto Le tachicardie sopraventricolari (TSV) corrispondono ad un gruppo di patologie ritmiche frequentemente riscontrate nella pratica clinica e originate negli atri o alla giunzione atrioventricolare (AV). Per definizione, sono opposte alle tachicardie di origine ventricolare, con le quali non condividono il rischio emodinamico e di morte improvvisa. Le principali aritmie raggruppate sotto questo termine sono la fibrillazione atriale, i flutter atriali, le tachicardie atriali, le tachicardie giunzionali e le tachicardie sinusali. Il meccanismo fisiopatologico, la prevalenza e l’associazione con una cardiopatia sottostante differiscono notevolmente tra queste diverse TSV. Tuttavia, questi diversi aspetti devono essere ben integrati poiche condizioneranno le rispettive modalita di gestione per ciascuna di queste patologie. La loro diagnosi e spesso elettrocardiografica, ma puo richiedere indagini piu complesse come l’esplorazione elettrofisiologica. Il loro trattamento puo basarsi sul solo monitoraggio, sull’introduzione di trattamenti farmacologici antiaritmici o sull’attuazione di procedure di ablazione a seconda del tipo di aritmia presente e della sua tolleranza.

Published
2021

11. Electrical storm due to Epstein-Barr virus-induced lymphoma of a transplanted heart: a case report

Author

Etienne Charbonneau, Vincent Galand, and Erwan Flécher

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Background Cancers, and specifically lymphomas, are one of the main causes of morbidity and mortality after heart transplantation. Sixteen percent of heart transplant recipients develop cancer within 5 years and lymphomas represent 10% of these patients. Case summary We report the case of an Epstein–Barr Virus–induced primary cardiac lymphoma on the graft. The patient initially present an electrical storm quickly controlled under medical treatment. The multimodal exploration led us to the diagnosis of lymphoma. The lymphoma has spread quickly in spite of the numerous treatments we have tried and has resulted in arrhythmia complications. Discussion This case report highlights the challenging management of heart transplant lymphoma and its treatment. Primary cardiac lymphoma on the graft is highly rare with poor prognosis and arrhythmia complications.

Published
2022

12. Burden of rare variants in arrhythmogenic cardiomyopathy with right dominant form-associated genes provides new insights for molecular diagnosis and clinical management

Author

Adeline Goudal, Matilde Karakachoff, Pierre Lindenbaum, Estelle Baron, Stéphanie Bonnaud, Florence Kyndt, Marine Arnaud, Damien Minois, Emmanuelle Bourcereau, Aurélie Thollet, Jean‐François Deleuze, Emmanuelle Genin, François Wiart, Jean‐Luc Pasquié, Vincent Galand, Frédéric Sacher, Christian Dina, Richard Redon, Stéphane Bezieau, Jean‐Jacques Schott, Vincent Probst, Julien Barc, Centre hospitalier universitaire de Nantes (CHU Nantes), Institut du Thorax [Nantes], Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Santé - François Bonamy, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche en Santé de l'Université de Nantes (IRS-UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre National de Recherche en Génomique Humaine (CNRGH), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB), EFS-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], and Julien Barc is supported by the CRITERIA project funded by the French Federation of Cardiology. Julien Barc is supported by the research program Etoiles montantes des Pays de la Loire REGIOCARD RPH081-U1087-REG-PDL Fondation de l'Avenir et la Ligue Nationale de Basket. Grant Number: RAK20104NNA

Subjects
Heterozygote, burden tests, Desmosomes, arrhythmogenic cardiomyopathy, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, molecular diagnosis, Genetics, Humans, next-generation sequencing, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Plakophilins, Genetics (clinical), Arrhythmogenic Right Ventricular Dysplasia, Genetic Association Studies
Abstract

International audience; Arrhythmogenic cardiomyopathy with right dominant form (ACR) is a rare heritable cardiac cardiomyopathy disorder associated with sudden cardiac death. Pathogenic variants (PVs) in desmosomal genes have been causally related to ACR in 40% of cases. Other genes encoding nondesmosomal proteins have been described in ACR, but their contribution in this pathology is still debated. A panel of 71 genes associated with inherited cardiopathies was screened in an ACR population of 172 probands and 856 individuals from the general population. PVs and uncertain significance variants (VUS) have been identified in 36% and 18.6% of patients, respectively. Among the cardiopathy-associated genes, burden tests show a significant enrichment in PV and VUS only for desmosomal genes PKP2 (plakophilin-2), DSP (desmoplakin), DSC2 (desmocollin-2), and DSG2 (desmoglein-2). Importantly, VUS may account for 15% of ACR cases and should then be considered for molecular diagnosis. Among the other genes, no evidence of enrichment was detected, suggesting an extreme caution in the interpretation of these genetic variations without associated functional or segregation data. Genotype-phenotype correlation points to (1) a more severe and earlier onset of the disease in PV and VUS carriers, underlying the importance to carry out presymptomatic diagnosis in relatives and (2) to a more prevalent left ventricular dysfunction in DSP variant carriers.

Published
2022

13. Pacing for long PR: who, why, and how?

Author

Vincent Galand, Raphael M Martins, Claude Daubert, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
[SDV.IB] Life Sciences [q-bio]/Bioengineering, Pacemaker, Artificial, Cardiac Pacing, Artificial, Hemodynamics, Heart failure, Heart, 030204 cardiovascular system & hematology, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), First degree atrioventricular block, Humans, p-r interval, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Ventricule pacing, Heart ventricle, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2022

14. Septuagenarian population has similar survival and outcomes to younger patients after left ventricular assist device implantation

Author

Jean-François Obadia, Constance Verdonk, Olivier Chavanon, Camille Dambrin, Thomas Senage, Marie-Cécile Bories, Frédéric Anselme, Jean Marc Frapier, Edeline Pelcé, David Hamon, Fabrice Vanhuyse, Gerard Babatasi, Costin Radu, Magali Michel, Eloi Marijon, Erwan Flecher, Marylou Para, Thierry Bourguignon, Vlad Gariboldi, Céline Goéminne, Karine Nubret, Mathieu Pernot, Clément Delmas, Pierre Yves Litlzer, Philippe Gaudard, Aude Boignard, Marie Bielefeld, Anne Flore Plane, André Vincentelli, Romain Eschalier, Christophe Leclercq, Michel Kindo, Bernard Lelong, Céline Chabanne, Thibaud Genet, Raphaël P. Martins, Matteo Pozzi, Fabien Garnier, Nicolas D'Ostrevy, Vincent Galand, Tam Hoang Minh, and Hugues Blangy

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Population, 030204 cardiovascular system & hematology, Ventricular Function, Left, Prosthesis Implantation, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Interquartile range, Intensive care, medicine, Humans, 030212 general & internal medicine, education, Stroke, Aged, Heart Failure, Heart transplantation, education.field_of_study, business.industry, Age Factors, Recovery of Function, General Medicine, Middle Aged, equipment and supplies, medicine.disease, 3. Good health, Surgery, Treatment Outcome, Heart failure, Ventricular assist device, Female, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business, Destination therapy
Abstract

Left ventricular assist device (LVAD) implantation may be an attractive alternative therapeutic option for elderly patients with heart failure who are ineligible for heart transplantation.We aimed to describe the characteristics and outcomes of elderly patients (i.e. aged≥70 years) receiving an LVAD.This observational study was conducted in 19 centres between 2006 and 2016. Patients were divided into two groups-younger (aged70 years) and elderly (aged≥70 years), based on age at time of LVAD implantation.A total of 652 patients were included in the final analysis, and 74 patients (11.3%) were aged≥70 years at the time of LVAD implantation (maximal age 77.6 years). The proportion of elderly patients receiving an LVAD each year was constant, with a median of 10.6% (interquartile range 8.0-15.4%) per year, and all were implanted as destination therapy. Elderly and younger patients had similar durations of hospitalization in intensive care units and total lengths of hospital stays. Both age groups experienced similar rates of LVAD-related complications (i.e. stroke, bleeding, driveline infection and LVAD exchange), and the occurrence of LVAD complications did not impact survival in the elderly group compared with the younger group. Lastly, when compared with younger patients implanted as destination therapy, the elderly group also exhibited similar mid-term survival.This work strongly suggests that selected elderly adults can be scheduled for LVAD implantation.

Published
2020

15. Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator

Author

Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessiere, Fabien Labombarda, Christelle Marquié, Jean Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Frédéric Anselme, Anouk Asselin, Caroline Audinet, Yvette Bernard, Serge Boveda, Paul Bru, Sok Sithikun Bun, Gael Clerici, Antoine Da Costa, Maxime de Guillebon, Pascal Defaye, Nathalie Elbaz, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Franck Halimi, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Anne Messali, Kumar Narayanan, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Penelope Pujadas, Frédéric Sacher, Pascal Sagnol, Ardalan Sharifzadehgan, Camille Walton, Pierre Winum, Cyril Zakine, Laurent Fauchier, Raphael Martins, Jean Luc Pasquié, Jean Benoit Thambo, Xavier Jouven, Nicolas Combes, Eloi Marijon, Fabien Squara, Guillaume Theodore, Didier Scarlatti, Jérome Hourdain, Jean-Claude Deharo, Pierre Ollitrault, Paul Milliez, Laure Champ-Rigot, Hugues Bader, Cécile Duplantier, Antoine Milhem, Audrey Sagnard, Géraldine Bertaux, Gabriel Laurent, Marc Badoz, Agustin Bortone, Guillaume Laborie, Anne Rollin, Quentin Voglimacci Stephanopoli, Franck Mandel, Alexandre Duparc, Guillaume Domain, Jean-Paul Albenque, Christèle Cardin, Stéphane Combes, Nikita Tanese, Karim Hasni, Christophe Leclercq, Vincent Galand, Dominique Pavin, Philippe Mabo, Nathalie Behar, Nicolas Clementy, Christophe Loose, Akli Otmani, Sandrine Venier, Adrien Carabelli, Peggy Jacon, Mouna Ben Kilani, Jean Bapstist Guichard, Cécile Romeyer-Bouchard, Laurianne Le Gloan, Vincent Probst, Luc Freysz, Hugues Blangy, Christian De Chillou, Nicolas Sadoul, Pierre Khattar, Charlotte Potelle, Frederic Jean, Paul Puie, Ziad Khoueiry, Philippe Chevallier, Arnaud Dulac, Sylvie Di Filippo, Kevin Gardey, Pierre Frey, Chrystelle Akret, Antoine Dompnier, Carole Maupain, Xavier Waintraub, Françoise Hidden-Lucet, Thomas Chastre, Estelle Gandjbakhch, Nicolas Badenco, Fabrice Extramiana, Antoine Leenhardt, Amir Zouaghi, Vincent Algalarrondo, Denis Amet, Emilie Varlet, Tej Chalbia, Séverine Philibert, Jacky Ollitrault, Thomas Lavergne, Pierre Baudinaud, Adrian Mirolo, Arnaud Savouré, Bénédicte Godin, Cathy Bertrand, Pierre Fiorello, Nicolas Johnson, Pierre-Marc Lallemand, Alexis Herminda, Jean-Sylvain Hermida, Bruno Degand, Rim El Bouazzaou, Stéphane Mourot, Samuel Goussot, Gaël Jauvert, Arnaud Lazarus, Caroline Grimard, Christine Alonso, Alexandre Zhao, Olivier Thomas, Bruno Cauchemez, Ghassan Moubarak, Nicolas Lellouche, David Hamon, Bogdan Enache, Gabriel Lactu, Françoise Wiart, Olivier Geoffroy, Damien Poindron, Alice Maltret, Cristine Raimondo, Damien Bonnet, Sébastien Hascoët, Nicolas Derval, Michel Haïssaguerre, Mélèze Hocini, and Clinical sciences

Subjects
Adult, Male, medicine.medical_specialty, Long term follow up, Cyanotic congenital heart disease, medicine.medical_treatment, 030204 cardiovascular system & hematology, Sudden death, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Humans, Defibrillators, Implantable/trends, Registries, 030212 general & internal medicine, Tetralogy of Fallot, business.industry, medicine.disease, Implantable cardioverter-defibrillator, Tetralogy of Fallot/epidemiology, Defibrillators, Implantable, 3. Good health, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, and sudden cardiac death represents an important mode of death in these patients. Data evaluating the implantable cardioverter defibrillator (ICD) in this patient population remain scarce. Methods: A Nationwide French Registry including all patients with tetralogy of Fallot with an ICD was initiated in 2010 by the French Institute of Health and Medical Research. The primary time to event end point was the time from ICD implantation to first appropriate ICD therapy. Secondary outcomes included ICD-related complications, heart transplantation, and death. Clinical events were centrally adjudicated by a blinded committee. Results: A total of 165 patients (mean age, 42.2±13.3 years, 70.1% males) were included from 40 centers, including 104 (63.0%) in secondary prevention. During a median (interquartile range) follow-up of 6.8 (2.5–11.4) years, 78 (47.3%) patients received at least 1 appropriate ICD therapy. The annual incidence of the primary outcome was 10.5% (7.1% and 12.5% in primary and secondary prevention, respectively; P =0.03). Overall, 71 (43.0%) patients presented with at least 1 ICD complication, including inappropriate shocks in 42 (25.5%) patients and lead dysfunction in 36 (21.8%) patients. Among 61 (37.0%) patients in primary prevention, the annual rate of appropriate ICD therapies was 4.1%, 5.3%, 9.5%, and 13.3% in patients with, respectively, 0, 1, 2, or ≥3 guidelines-recommended risk factors. QRS fragmentation was the only independent predictor of appropriate ICD therapies (hazard ratio, 3.47 [95% CI, 1.19–10.11]), and its integration in a model with current criteria increased the 5-year time-dependent area under the curve from 0.68 to 0.81 ( P =0.006). Patients with congestive heart failure or reduced left ventricular ejection fraction had a higher risk of nonarrhythmic death or heart transplantation (hazard ratio, 11.01 [95% CI, 2.96–40.95]). Conclusions: Patients with tetralogy of Fallot and an ICD experience high rates of appropriate therapies, including those implanted in primary prevention. The considerable long-term burden of ICD-related complications, however, underlines the need for careful candidate selection. A combination of easy-to-use criteria including QRS fragmentation might improve risk stratification. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03837574.

Published
2020

16. Subcutaneous Implantable Cardioverter-Defibrillator Lead Extraction

Author

Christelle Marquié, Vincent Galand, Cédric Giraudeau, Hugues Blangy, Peggy Jacon, Alain Lebon, Nathalie Behar, Benoit Guy-Moyat, Christine Alonso, Christophe Leclercq, Nicolas Badenco, Rim El Bouazzaoui, and Raphaël P. Martins

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Mean age, 030204 cardiovascular system & hematology, Implantable cardioverter-defibrillator, 3. Good health, Surgery, 03 medical and health sciences, 0302 clinical medicine, Median time, Parasternal line, Primary prevention, Clinical endpoint, Medicine, 030212 general & internal medicine, business, Lead (electronics), Lead extraction
Abstract

Objectives The aim of this multicenter study was to characterize the efficacy and safety of subcutaneous implantable cardioverter-defibrillators (S-ICDs) lead extraction procedures. Background S-ICDs have been developed to limit lead-related complications inherent to transvenous ICD devices. To date, no study has specifically investigated the safety and feasibility of S-ICD lead extraction procedures. Methods Patients requiring S-ICD lead extraction between February 1, 2014, and February 28, 2019, were retrospectively included in 10 centers. The primary endpoint of the study was procedural success, defined as the removal of all the lead and lead material from the subcutaneous space. Secondary endpoints included procedural complications and the need for specific extraction tools. Results S-ICD lead extraction procedures were performed in 32 patients (mean age 45.7 ± 13.8 years, 75.0% men, 65.6% in primary prevention). The median time from S-ICD lead implantation was 9.3 months (5.4 to 17.5 months). The primary endpoint, that is, complete removal of the material, was achieved in 96.9% of the patients, and only 1 procedural failure occurred (3.1%). Simple traction of the S-ICD lead was successful in 19 patients (59.4%), whereas 3 patients (9.4%) needed an additional incision and 9 patients (28.1%) required mechanical sheath to remove lead adhesions around the coil. No procedure-related complications occurred. Patients with successful simple traction extraction were implanted more recently (7.1 months [2.8 to 12.2 months] vs. 16.5 months [7.5 to 20.8 months]; p = 0.04) and had less prior history of sternotomy (2 [10.5%] vs. 5 [38.5%] patients; p = 0.09). Conclusions S-ICD lead extraction is an efficient and safe procedure, but may require some specific tools like mechanical sheath, specifically when fibrotic adhesions developed around the parasternal coil.

Published
2020

17. Current results of left ventricular assist device therapy in France: the ASSIST-ICD registry

Author

Hoang Minh Tam, Marylou Para, Olivier Chavanon, Clément Delmas, Marie Cecile Bories, Constance Verdonk, Vlad Gariboldi, Magali Michel, Fabrice Colas, Marie Bielefeld, Amedeo Anselmi, Martin Kloeckner, Jean-Philippe Verhoye, Thierry Bourguignon, André Vincentelli, Stéphane Boulé, Fabrice Vanhuyse, Michel Kindo, Julien Guihaire, Camille Dambrin, Annette Belin, Costin Radu, Nicolas D'Ostrevy, Hugues Blangy, Jérôme Jouan, Jean-François Obadia, Pierre-Yves Litzler, Vincent Galand, Gerard Babatasi, Edeline Pelcé, Laurent Barandon, Mathieu Pernot, Benjamin Duband, Philippe Rouvière, Philippe Gaudard, Nicolas Lellouche, Thomas Senage, Erwan Flecher, Aude Boignard, Fabien Garnier, Raphaël P. Martins, Matteo Pozzi, Frédéric Anselme, Thibaud Genet, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Coeur Poumon [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Les Hôpitaux Universitaires de Strasbourg (HUS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Michallon, Clinique de chirurgie cardiaque, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Charles Nicolle [Rouen], Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université Paris-Sud - Paris 11 (UP11), Hôpital Henri Mondor, CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-Normandie Université (NU), CHU Henri Mondor [Créteil], and MORNET, Dominique

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Temporal trends, Outcomes, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Clinical endpoint, Humans, Cumulative incidence, Registries, Retrospective Studies, Heart Failure, business.industry, Cardiogenic shock, General Medicine, equipment and supplies, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Surgery, Transplantation, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Ventricular assist device, Life support, Left ventricular assist devices, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Heart-Assist Devices, Implant, Cardiology and Cardiovascular Medicine, business, Destination therapy
Abstract

OBJECTIVES Our goal was to provide a picture of left ventricular assist device (LVAD) activity in France between 2007 and 2016 based on the multicentric ASSIST-ICD registry. METHODS We retrospectively collected 136 variables including in-hospital data, follow-up survival rates and adverse events from 671 LVAD recipients at 20 out of 24 LVAD implant centres in France. The average follow-up time was 1.2 years (standard deviation: 1.4); the total follow-up time was 807.5 patient-years. RESULTS The included devices were the HeartMate II®, HeartWare LVAS® or Jarvik 2000®. The overall likelihood of being alive while on LVAD support or having a transplant (primary end point) at 1, 2, 3 and 5 years postimplantation was 65.2%, 59.7%, 55.9% and 47.7%, respectively, given a cumulative incidence of 29.2% of receiving a transplant at year 5. At implantation, 21.5% of patients were on extracorporeal life support. The overall rate of cardiogenic shock at implantation was 53%. The major complications were driveline infection (26.1%), pump pocket or cannula infection (12.6%), LVAD thrombosis (12.2%), ischaemic (12.8%) or haemorrhagic stroke (5.4%; all strokes 18.2%), non-cerebral haemorrhage (9.1%) and LVAD exchange (5.2%). The primary end point (survival) was stratified by age at surgery and by the type of device used, with inference from baseline profiles. The primary end point combined with an absence of complications (secondary end point) was also stratified by device type. CONCLUSIONS The ASSIST-ICD registry provides a real-life picture of LVAD use in 20 of the 24 implant centres in France. Despite older average age and a higher proportion of patients chosen for destination therapy, survival rates improved compared to those in previous national registry results. This LVAD registry contrasts with other international registries because patients with implants have more severe disease, and the national policy for graft attribution is distinct. We recommend referring patients for LVAD earlier and suggest a discussion of the optimal timing of a transplant for bridged patients (more dismal results after the second year of support?).

Published
2020

18. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators

Author

Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessière, Fabien Labombarda, Christelle Marquié, Jean-Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Alain Al Arnaout, Frédéric Anselme, Caroline Audinet, Yvette Bernard, Serge Boveda, Sok Sithikun Bun, Morgane Chassignolle, Gaël Clerici, Antoine Da Costa, Maxime de Guillebon, Pascal Defaye, Nathalie Elbaz, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Franck Halimi, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Anne Messali, Kumar Narayanan, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Penelope Pujadas, Frédéric Sacher, Pascal Sagnol, Ardalan Sharifzadehgan, Camille Walton, Pierre Winum, Cyril Zakine, Laurent Fauchier, Raphaël Martins, Jean-Luc Pasquié, Jean-Benoit Thambo, Xavier Jouven, Nicolas Combes, Eloi Marijon, Chrystelle Akret, Jean-Paul Albenque, Vincent Algalarrondo, Christine Alonso, Denis Amet, Frédéric Ansselme, Anouk Asselin, Nicolas Badenco, Hugues Bader, Marc Badoz, Pierre Baudinaud, Nathalie Behar, Mouna Ben Kilani, Géraldine Bertaux, Cathy Bertrand, Francis Bessiere, Hughes Blangy, Damien Bonnet, Pierre Bordchar, Paul Bru, Adrien Carabelli, Christèle Cardin, Bruno Cauchemez, Tej Chalbia, Laure Champ-Rigot, Thomas Chastre, Philippe Chevallier, Nicolas Clementy, Stéphane Combes, Christian De Chillou, Maxime De Guillebon, Bruno Degand, Jean-Claude Deharo, Nicolas Derval, Sylvie Di Filippo, Guillaume Domain, Antoine Dompnier, Arnaud Dulac, Alexandre Duparc, D Cécile Duplantier, Rim El Bouazzaoui, Bogdan Enache, Fabrice Extramiana, Pierre Fiorello, Pierre Frey, Luc Freysz, Vincent Galand, Estelle Gandjbakhch, Kevin Gardey, Olivier Geoffroy, Bénédicte Godin, Samuel Goussot, Caroline Grimard, Jean-Baptiste Guichard, Michel Haissaguerre, David Hamon, Sébastien Hascoet, Karim Hasni, Jean-Sylvain Hermida, Françoise Hidden-Lucet, Mélèze Hocini, Jérome Hourdain, Peggy Jacon, Gaël Jauvert, Frédéric Jean, Nicolas Johnson, Pierre Khattar, Ziad Khoueiry, Rita Koutbi, Guillaume Laborie, Gabriel Lactu, Pierre-Marc Lallemand, Gabriel Laurent, Thomas Lavergne, Arnaud Lazarus, Laurianne Le Gloan, Christophe Leclercq, Antoine Leenhardt, Nicolas Lellouche, Christophe Loose, Philippe Mabo, Alice Maltret, Franck Mandel, Christelle Marquie, Carole Maupain, Antoine Milhelm, Paul Milliez, Adrian Mirolo, Ghassan Moubarak, Stéphane Mourot, Jacky Ollitrault, Pierre Ollitrault, Akli Otmani, Jean-Luc Pasquie, Dominique Pavin, Séverinne Philibert, Damien Poindron, Charlotte Potelle, Vincent Probst, Paul Puie, Anne Rollin, Cécile Romeyer-Bouchard, Nicolas Sadoul, Audrey Sagnard, Arnaud Savoure, Didier Scarlatti, Fabien Squara, Nikita Tanese, Jean Benoit Thambo, Olivier Thomas, Emie Varlet, Sandrine Venier, Quentin Voglimacci Stephanopoli, Xavier Waintraub, Françoise Wiart, Alexandre Zhao, Amir Zouaghi, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Clinique Pasteur, Clinique Pasteur [Toulouse], and This work was supported by the French Institute of Health and Medical Research, Fédération Française de Cardiologie, and Société Française de Cardiologie. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Subjects
Male, Adult, Heart Defects, Congenital, Sex Characteristics, sudden death, Middle Aged, congenital heart disease, Defibrillators, Implantable, Cohort Studies, implantable cardioverter-defibrillator, Death, Sudden, Cardiac, Tetralogy of Fallot, sex, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, women, ventricular arrhythmia
Abstract

International audience; Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010. Clinical events were centrally adjudicated by a blinded committee.Results: A total of 165 patients (mean age 42.2 ± 13.3 years) were enrolled from 40 centers, including 49 women (29.7%). Among the 9,692 patients with TOF recorded in the national database, the proportion of women with ICDs was estimated to be 1.1% (95% CI: 0.8%-1.5%) vs 2.2% (95% CI: 1.8%-2.6%) in men (P < 0.001). The clinical profiles of patients at implantation, including the number of risk factors for ventricular arrhythmias, were similar between women and men. During a median follow-up period of 6.8 years (IQR: 2.5-11.4 years), 78 patients (47.3%) received at least 1 appropriate ICD therapy, without significant difference in annual incidences between women (12.1%) and men (9.9%) (HR: 1.22; 95% CI: 0.76-1.97; P = 0.40). The risk for overall ICD-related complications was similar in women and men (HR: 1.33; 95% CI: 0.81-2.19; P = 0.30), with 24 women (49.0%) experiencing at least 1 complication.Conclusions: Our findings suggest that women with TOF at high risk for sudden cardiac death have similar benefit/risk balance from ICD therapy compared with men. Whether ICD therapy is equally offered to at-risk women vs men warrants further evaluation in TOF as well as in other congenital heart disease populations. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574)

Published
2022

19. A Man in His 60s With Severe Heart Failure and Incessant Ventricular Arrhythmias

Author

Karim, Benali, Vincent, Galand, Raphaël, Martins, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Saint-Etienne, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Heart Failure, Male, Shock, Cardiogenic, Tachycardia, Ventricular, Heart Transplantation, Humans, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Middle Aged, Cardiology and Cardiovascular Medicine, Severity of Illness Index, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2022

20. Outcome of Temporary Circulatory Support As a Bridge-to-Left Ventricular Assist Device Strategy in Cardiogenic Shock Patients

Author

Auriane Bidaut, Erwan Flécher, Nicolas Nesseler, Karl Bounader, André Vincentelli, Mouhammed Moussa, Clément Delmas, Jean Porterie, Karine Nubret, Mathieu Pernot, Michel Kindo, Clément Schneider, Philippe Gaudard, Philippe Rouvière, Magali Michel, Thomas Sénage, Aude Boignard, Olivier Chavanon, Constance Verdonk, Marylou Para, Baptiste Maille, Vlad Gariboldi, Matteo Pozzi, Elisabeth Hugon-Vallet, Pierre-Yves Litzler, Frédéric Anselme, Katrien Blanchart, Gerard Babatasi, Marie Bielefeld, Sandrine Grosjean, Costin Radu, David Hamon, Thierry Bourguignon, Thibaud Genet, Romain Eschalier, Nicolas D’Ostrevy, Hélène Nougue, Anne Cécile Martin, Fabrice Vanhuyse, Hugues Blangy, Christophe Leclercq, Raphael P. Martins, Vincent Galand, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)

Subjects
Heart Failure, 2. Zero hunger, [SDV]Life Sciences [q-bio], Shock, Cardiogenic, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, 3. Good health, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, Treatment Outcome, 0302 clinical medicine, 030228 respiratory system, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, Heart-Assist Devices, Retrospective Studies
Abstract

International audience; Objectives: Temporary circulatory support (TCS) as a bridge-to-left ventricular assist device (BTL) in cardiogenic shock patients has been increasing, but limited data exists on this BTL strategy. We aimed at analyzing the outcome of BTL patients in a population of cardiogenic shock patients compared with those without TCS at the time of the left ventricular assist device (LVAD) surgery and identify predictors of postoperative mortality in this specific population.Design: A multicenter retrospective observational study conducted in 19 centers from 2006 to 2016.Setting: Nineteen French centers.Patients: A total of 329 cardiogenic shock patients at the time of LVAD implantation were analyzed. Patients were divided in three groups: those under TCS at the time of LVAD implantation (n = 173), those with TCS removal before LVAD surgery (n = 24), and those who did not undergo a bridging strategy (n = 152). Primary endpoint was 30-day mortality.Interventions: None.Measurements and main results: Among the BTL group, 68 (39.3%), 18 (10.4%), and 15 (8.7%) patients were under venoarterial extracorporeal membrane oxygenation, Impella, and IABP support alone, and 72 patients (20.6%) were under multiple TCS support. BTL patients presented similar 30 days survival compared with the TCS removal and non-BTL groups. However, BTL group had a significantly longer ICU duration stay, with two-fold duration of mechanical ventilation time, but the three groups experienced similar postoperative complications. Multivariate analysis identified three independent predictors of mortality in the BTL group: combined surgery with LVAD, body mass index (BMI), and heart failure (HF) duration. BTL strategy was not an independent predictor of mortality in cardiogenic shock patients who underwent LVAD.Conclusions: BTL strategy is not associated with a lower survival among cardiogenic shock patients with LVAD implantation. Predictors of mortality are combined surgery with LVAD, higher BMI, and HF duration.

Published
2022

21. Left ventricular wall thickness assessed by cardiac computed tomography and cardiac resynchronization therapy outcomes

Author

Saumya Das, Judy Hung, Quynh A. Truong, Vincent Galand, Brian B. Ghoshhajra, Jagmeet P. Singh, Jackie Szymonifka, Christophe Leclercq, Mary Orencole, Raphaël P. Martins, Valentin Barré, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Harvard Medical School [Boston] (HMS), New York University [New York] (NYU), NYU System (NYU), Weill Cornell Medicine, L30HL093896, National Institutes of Health, K23HL098370, National Heart, Lung, and Blood Institute, Abbott Laboratories, French Federation of Cardiology and the Rennes University Hospital, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, Weill Cornell Medicine [Cornell University], and Cornell University [New York]

Subjects
Left ventricular wall thickness, medicine.medical_specialty, Heart Ventricles, medicine.medical_treatment, Cardiac resynchronization therapy, Heart failure, Computed tomography, 030204 cardiovascular system & hematology, Ventricular Function, Left, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Physiology (medical), Internal medicine, Response to cardiac resynchronization therapy, Humans, Medicine, cardiovascular diseases, Tomography, Papillary muscle, Mitral regurgitation, Outcome, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Ejection fraction, Ventricular Remodeling, medicine.diagnostic_test, business.industry, Stroke Volume, medicine.disease, 3. Good health, Treatment Outcome, medicine.anatomical_structure, cardiovascular system, Cardiology, End-diastolic volume, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Mace
Abstract

Aims Up to 30% of selected heart failure patients do not benefit clinically from cardiac resynchronization therapy (CRT). Left ventricular (LV) wall thickness (WT) analysed using computed tomography (CT) has rarely been evaluated in response to CRT and mitral regurgitation (MR) improvement. We examined the association of LVWT and the ability to reverse LV remodelling and MR improvement after CRT. Methods and results Fifty-four patients scheduled for CRT underwent pre-procedural CT. Reduced LVWT was defined as WT Conclusion WT evaluated using CT could help to stratify the response to CRT and predict MR improvement and outcomes. Clinical trial registration NCT01097733.

Published
2019

22. Cardiac stereotactic ablative radiotherapy for refractory ventricular arrhythmias: A radical alternative? A narrative review of rationale and cardiological aspects

Author

Karim Benali, Antoine Da Costa, Louis Rigal, Renaud de Crevoisier, Vincent Galand, Raphaël P. Martins, Nefissa Hammache, Antoine Simon, N. Jaksic, J. Bellec, Pierre Caille, CHU Saint-Etienne, Centre Eugène Marquis (CRLCC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), CRLCC Eugène Marquis (CRLCC), CHU Pontchaillou [Rennes], Jonchère, Laurent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)

Subjects
medicine.medical_specialty, cardiac radioablation, medicine.medical_treatment, Catheter ablation, 030204 cardiovascular system & hematology, Radiosurgery, 03 medical and health sciences, cardiac SBRT, 0302 clinical medicine, Refractory, Ablative case, catheter ablation, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, cardiovascular diseases, Cardiac disorders, Intensive care medicine, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Radiological and Ultrasound Technology, business.industry, ventricular arrhythmias, Arrhythmias, Cardiac, Heart, refractory ventricular tachycardia, 3. Good health, Radiation therapy, cardiovascular system, Narrative review, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, cardiac sterteotactic radiotherapy
Abstract

International audience; Ventricular arrhythmias are serious life-threatening cardiac disorders. Despite many technological improvements, a non-negligible number of patients present refractory ventricular tachycardias, resistant to a catheter ablation procedure, placing these patients in a therapeutic impasse. Recently, a cardiac stereotactic radioablative technique has been developed to treat patients with refractory ventricular arrhythmias, as a bail out strategy. This new therapeutic option historically brings together two fields of expertise unknown to each other, pointing out the necessity of an optimal partnership between cardiologists and radiation oncologists. As described in this narrative review, the understanding of cardiological aspects of the technique for radiation oncologists and treatment technical aspects comprehension for cardiologists represent a major challenge for the application and the future development of this promising treatment.

Published
2021

23. Left Ventricular Assist Device Implantation As a Bailout Strategy for the Management of Refractory Electrical Storm and Cardiogenic Shock

Author

Frederic Sacher, Raphaël P. Martins, Baptiste Maille, Christian de Chillou, Pierre Baudinaud, Jean-Baptiste Gourraud, Karim Benali, Francis Bessière, Philippe Maury, Vincent Galand, Vincent Algalarrondo, Charles Guenancia, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Shock, Cardiogenic, Hemodynamics, Catheter ablation, 030204 cardiovascular system & hematology, Ventricular tachycardia, hemodynamics, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Refractory, Physiology (medical), Internal medicine, catheter ablation, medicine, Humans, 030212 general & internal medicine, hospital, ComputingMilieux_MISCELLANEOUS, business.industry, Cardiogenic shock, informed consent, Middle Aged, medicine.disease, Treatment Outcome, Ventricular assist device, Tachycardia, Ventricular, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, ventricular tachycardia, Cardiology and Cardiovascular Medicine, business, Bailout
Abstract

International audience

Published
2021

24. Leadless pacemakers in critically ill patients requiring prolonged cardiac pacing: A multicenter international study

Author

Christian Veltmann, Sylvain Ploux, Philippe Ritter, Clemens Steinwender, Raphaël P. Martins, José María Tolosana, Vincent Galand, Eloi Marijon, Edouard Simeon, Margarida Pujol-López, Romain Eschalier, Johanna Mueller-Leisse, Roxane Coelho, Hermann Blessberger, Dominique Babuty, Nicolas Clementy, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hannover Medical School [Hannover] (MHH), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University of Barcelona, CHU Pontchaillou [Rennes], CHU Pessac, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Kepler University Hospital, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Jonchère, Laurent

Subjects
Pacemaker, Artificial, leadless, Critical Illness, [SDV]Life Sciences [q-bio], Population, 030204 cardiovascular system & hematology, Intracardiac injection, temporary pacing, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Physiology (medical), Intensive care, Medicine, Humans, 030212 general & internal medicine, education, Aged, Retrospective Studies, intensive care, education.field_of_study, business.industry, Mortality rate, Cardiac Pacing, Artificial, Arrhythmias, Cardiac, Equipment Design, medicine.disease, Intensive care unit, pacemaker, 3. Good health, Transvenous pacing, [SDV] Life Sciences [q-bio], Treatment Outcome, Bacteremia, Anesthesia, Cardiology and Cardiovascular Medicine, business, Complication
Abstract

Background Temporary transvenous pacing in critically ill patients requiring prolonged cardiac pacing is associated with a high risk of complications. We sought to evaluate the safety and efficacy of self-contained intracardiac leadless pacemaker (LPM) implantation in this population. Methods and results Consecutive patients implanted with a Micra LPM during the hospitalization in an intensive care unit were retrospectively included. Inclusion criteria were: ≥1 supracaval central venous, or a ventilation tube, or intravenous antibiotic therapy for ongoing sepsis or bacteremia. Patients with a history of previous implantation of a pacemaker were excluded. Out of 1,016 patients implanted with an LPM, 99 met the inclusion criteria. Mean age was 75 years and Charlson comorbidity index 7. LPM implantation was successfully performed in 98% of cases, with a peri-operative complication rate of 5%, mainly cardiac injuries. In-hospital mortality rate was 6%. No late (>30 days) device-related complication occurred, especially no infection. Conclusions LPM appears as an acceptable alternative to conventional temporary transvenous pacing in selected critically ill patients requiring prolonged cardiac pacing, especially regarding the risk of infection. This article is protected by copyright. All rights reserved.

Published
2021

25. Distance between the descending aorta and the left inferior pulmonary vein as a determinant of biophysical parameters during paroxysmal atrial fibrillation cryoablation

Author

Jean Baptiste Guichard, Antoine Da Costa, Karim Benali, Dominique Pavin, Laurent Macle, Cécile Romeyer, Christophe Leclercq, Raphaël P. Martins, Vincent Galand, Nefissa Hammache, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Montreal Heart Institute - Institut de Cardiologie de Montréal, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, cryoballoon, Aorta, Thoracic, 030204 cardiovascular system & hematology, Cryosurgery, aortic imprint, 03 medical and health sciences, 0302 clinical medicine, cryolesion, Recurrence, Physiology (medical), medicine.artery, Internal medicine, medicine, Left inferior pulmonary vein, Humans, blood flow, 030212 general & internal medicine, Aged, Retrospective Studies, Aorta, business.industry, left inferior pulmonary vein, temperature, Cryoablation, Atrial fibrillation, Blood flow, Middle Aged, medicine.disease, Ablation, Ostium, aorta, Treatment Outcome, Pulmonary Veins, cryoablation, Descending aorta, Catheter Ablation, cardiovascular system, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; INTRODUCTION: The distance from the descending aorta (DA) to the posterior wall of the left atrium (LA) is variable. We aimed to determine whether the proximity between the DA and the left inferior pulmonary vein (LIPV) ostium has an impact on biophysical parameters and cryoballoon (CB) ablation efficacy during LIPV freezing. METHODS: Patients referred for CB-ablation of atrial fibrillation (AF) in two high-volume centers were included. Cryoablation data were collected prospectively for each patient. The anatomical relationships between the LIPV and the DA (distance LIPV ostium-DA, presence of an aortic imprint on the posterior aspect of the LIPV) were then retrospectively analysed on the LA computed tomography (CT) scans realized before AF ablation. RESULTS: 350 patients were included (70% men, 59.7±11.5 yo). The decrease in the Ostium-DA distance was significantly correlated to the increase in the Time-To-Isolation (TTI) (r=-0.31; p=0.036), with less negative temperature (r=-0.11; p=0.045). Similarly, the presence of an aortic imprint on the LIPV was associated with a longer TTI (p

Published
2021

26. Implantable Cardioverter- Defibrillator Interference After LVAD Implantation

Author

Stéphane Boulé, Raphaël P. Martins, Matteo Pozzi, Sylvain Ploux, Nicolas Lellouche, Pascal Defaye, Christophe Leclercq, Constance Verdonk, Vincent Galand, and Pierre Mondoly

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, 030204 cardiovascular system & hematology, equipment and supplies, Implantable cardioverter-defibrillator, medicine.disease, Electromagnetic interference, Defibrillators, Implantable, 03 medical and health sciences, 0302 clinical medicine, Interference (communication), Internal medicine, Heart failure, Ventricular assist device, Cardiology, Humans, Medicine, In patient, Heart-Assist Devices, 030212 general & internal medicine, business
Abstract

Left ventricular assist device (LVAD) implantation has become an important therapeutic option in patients with end-stage heart failure, with many of them already having an implantable cardioverter-defibrillator (ICD) at the time of LVAD surgery. LVAD electromagnetic interference (EMI) with loss

Published
2020

27. Optimal Lead Placement Strategy for Cardiac Resynchronization Therapy in Non–Left Bundle Branch Block Patients

Author

Jean-Claude Daubert and Vincent Galand

Subjects
medicine.medical_specialty, Tailored approach, Left bundle branch block, business.industry, medicine.medical_treatment, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Heart failure, Internal medicine, medicine, Cardiology, 030212 general & internal medicine, Lead Placement, business
Published
2020

28. Localization of Residual Conduction Gaps After Wide Antral Circumferential Ablation of Pulmonary Veins

Author

Christophe Leclercq, Nathalie Behar, Vincent Galand, Raphaël P. Martins, Jean-Claude Daubert, D. Pavin, Philippe Mabo, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
gaps, business.industry, medicine.medical_treatment, Atrial fibrillation, 030204 cardiovascular system & hematology, Ablation, Thermal conduction, medicine.disease, Residual, ablation, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Heart Conduction System, Pulmonary Veins, Catheter Ablation, reconnection, medicine, Humans, atrial fibrillation, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Electrophysiologic Techniques, Cardiac, business, Biomedical engineering
Abstract

International audience; Ablation of atrial fibrillation (AF) is the cornerstone therapy for patients with symptomatic AF resistant to anti-arrhythmic drugs or as first-line therapy, and is based on permanent pulmonary vein (PV) isolation. The presence of a conduction gap in a wide antral circumferential ablation lesion around PVs is often sufficient to transform an initially successful ablation into a procedural failure, thus necessitating a redo intervention. The strategy during a redo procedure is based on the detection and ablation of the reconnection gap. Finding gaps is often simple, but also sometimes challenging, because gaps may be difficult to detect, resulting in unnecessary radiofrequency delivery. The present review aimed to describe the various techniques published thus far to detect residual reconnections along the encircling ablation lines around PVs, to help electrophysiologists to detect and ablate reconnection gaps. © 2019 American College of Cardiology Foundation

Published
2019

29. Impact of COVID-19 on the incidence of cardiac arrhythmias in implantable cardioverter defibrillator recipients followed by remote monitoring

Author

Raphaël P. Martins, Estelle Gandjbakhch, Arnaud Rosier, Eloi Marijon, Frederic Sebag, Elliot Hwang, Serge Boveda, Christophe Leclercq, Vincent Galand, Pascal Defaye, and Clinical sciences

Subjects
Male, medicine.medical_treatment, Ventricular tachycardia, France/epidemiology, Monitoring, Ambulatory/instrumentation, heart rate, Tachycardia, Ventricular/diagnosis, OHCA, out-of-hospital cardiac arrest, Prospective Studies, Prospective cohort study, COVID-19, coronavirus disease 2019, COVID-19/epidemiology, Incidence (epidemiology), Défibrillateur automatique implantable, Arrhythmias, Cardiac/diagnosis, Atrial fibrillation, General Medicine, Remote Sensing Technology/instrumentation, Middle Aged, Implantable cardioverter-defibrillator, Defibrillators, Implantable, ATP, antitachycardia pacing, Quarantine, Ventricular arrhythmia, Cardiology, cardiovascular system, Female, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Heart Ventricles, COVID-19 pandemic, Monitoring, Ambulatory, Heart Ventricles/physiopathology, Clinical Research, Implantable cardioverter defibrillator: Remote monitoring, Internal medicine, Heart rate, medicine, Humans, cardiovascular diseases, ICD, implantable cardioverter defibrillator, Télé-cardiologie, Aged, Épidémie du COVID-19, business.industry, SARS-CoV-2, VA, ventricular arrhythmia, COVID-19, Arrhythmias, Cardiac, Arythmies ventriculaires, medicine.disease, Remote Sensing Technology, Ventricular fibrillation, Tachycardia, Ventricular, Antitachycardia Pacing, incidence, business, Follow-Up Studies
Abstract

Graphical abstract Incidence of ventricular arrhythmias per week compared with the number of new coronavirus disease 2019 (COVID-19) cases per week in France (blue line) and the daily percentage of COVID-19 information on 24-hour television information channels per week (red line). TV: television; VF: ventricular fibrillation; VT: ventricular tachycardia., Background The coronavirus disease 2019 (COVID-19) has been a fast-growing worldwide pandemic. Aims We aimed to investigate the incidence of cardiac arrhythmias among a large French cohort of implantable cardioverter defibrillator recipients over the first 5 months of 2020. Methods Five thousand nine hundred and fifty-four implantable cardioverter defibrillator recipients were followed by remote monitoring during the COVID-19 period (from 01 January to 31 May 2020). Data were obtained from automated remote follow-up of implantable cardioverter defibrillators utilizing the Implicity® platform. For all patients, the type of arrhythmia (atrial fibrillation, ventricular tachycardia or ventricular fibrillation), the number of ventricular arrhythmia episodes and the type of implantable cardioverter defibrillator-delivered therapy were recorded. Results A total of 472 (7.9%) patients presented 4917 ventricular arrhythmia events. An increase in ventricular arrhythmia incidence was observed after the first COVID-19 case in France, and especially during weeks #10 and #11, at the time of major governmental measures, with an increase in the incidence of antitachycardia pacing delivered therapy. During the 11 weeks before the lockdown order, the curve of the percentage of live-stream television coverage of COVID-19 information matched the ventricular arrhythmia incidence. During the lockdown, the incidence of ventricular arrhythmia decreased significantly compared with baseline (0.05 ± 0.7 vs. 0.09 ± 1.2 episodes per patient per week, respectively; P

Published
2021

30. Evolving Cardiac Electrical Therapies for Advanced Heart Failure Patients

Author

William J. Hucker, Zain I. Sharif, Vincent Galand, Jagmeet P. Singh, Massachusetts General Hospital [Boston], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
medicine.medical_specialty, Pacemaker, Artificial, Baroreceptor, Vagus Nerve Stimulation, medicine.medical_treatment, Cardiac resynchronization therapy, heart failure, Electric Stimulation Therapy, 030204 cardiovascular system & hematology, Autonomic Nervous System, Ventricular Function, Left, Cardiac contractility modulation, Food and drug administration, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Prevalence, Animals, 030212 general & internal medicine, pressoreceptors, Disease management (health), humans, Spinal Cord Stimulation, business.industry, Cardiac Pacing, Artificial, Heart, Stroke Volume, Recovery of Function, medicine.disease, Neuromodulation (medicine), 3. Good health, Treatment Outcome, disease management, Heart failure, Cardiology, cardiovascular system, [SDV.IB]Life Sciences [q-bio]/Bioengineering, myocardial contraction, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Symptomatic heart failure (HF) patients despite optimal medical therapy and advances such as invasive hemodynamic monitoring remain challenging to manage. While cardiac resynchronization therapy remains a highly effective therapy for a subset of HF patients with wide QRS, a majority of symptomatic HF patients are poor candidates for such. Recently, cardiac contractility modulation, neuromodulation based on carotid baroreceptor stimulation, and phrenic nerve stimulation have been approved by the US Food and Drug Administration and are emerging as therapeutic options for symptomatic HF patients. This state-of-the-art review examines the role of these evolving electrical therapies in advanced HF.

Published
2021

31. Electrophysiological Study-Guided Permanent Pacemaker Implantation In Patients With Conduction Disturbances Following Transcatheter Aortic Valve Implantation

Author

Raphaël P. Martins, Camille Pichard, Baptiste Polin, Marc Bedossa, Hamed Bourenane, Dominique Boulmier, Christophe Leclercq, Guillaume Leurent, Hervé Le Breton, Marielle Le Guellec, Vincent Auffret, Jacques Tomasi, D. Pavin, Vincent Galand, Sam Sharobeem, Erwan Donal, Jean-Philippe Verhoye, Nathalie Behar, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], No funding, Jonchère, Laurent, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, Pacemaker, Artificial, Transcatheter aortic, Bundle-Branch Block, 030204 cardiovascular system & hematology, Prosthesis Implantation, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Cardiac Conduction System Disease, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, atrioventricular block, medicine, bundle branch block, Humans, In patient, False Positive Reactions, 030212 general & internal medicine, False Negative Reactions, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Aged, 80 and over, business.industry, Cardiac Pacing, Artificial, Aortic Valve Stenosis, Ventricular pacing, medicine.disease, Transcatheter aortic valve replacement, Optimal management, pacemaker, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Electrophysiology, Treatment Outcome, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Electrophysiological study, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business, Index hospitalization, Electrophysiologic Techniques, Cardiac, Atrioventricular block
Abstract

International audience; Conduction disturbances remain common following transcatheter aortic valve implantation (TAVI). Aside from high-degree atrioventricular block (HAVB), their optimal management remains elusive. Invasive electrophysiological studies (EPS) may help stratify patients at low or high risk of HAVB allowing for an early discharge or permanent pacemaker (PPM) implantation among patients with conduction disturbances. We evaluated the safety and diagnostic performances of an EPS-guided PPM implantation strategy among TAVI recipients with conduction disturbances not representing absolute indications for PPM. All patients who underwent TAVI at a single expert center from June 2017 to July 2020 who underwent an EPS during the index hospitalization were included in the present study. False negative outcomes were defined as patients discharged without PPM implantation who required PPM for HAVB within 6 months of the initial EPS. False positive outcomes were defined as patients discharged with a PPM with a ventricular pacing percentage < 1% at follow-up. A total of 78 patients were included (median age: 82.4 years, 38% female), among whom 35 patients (45%) received a PPM following EPS. The sensitivity, specificity, positive and negative predictive values of the EPS-guided PPM implantation strategy were 100%, 89.6%, 81.5%, and 100%, respectively. Six patients suffered a mechanical HAVB during EPS and received a PPM. These 6 patients showed PPM dependency at follow-up. In conclusion, an EPS-guided PPM implantation strategy for managing post-TAVI conduction disturbances appears effective to identify patients who can be safely discharged without PPM implantation.

Published
2021

32. Validation of the VT-LVAD score for prediction of late VAs in LVAD recipients

Author

Christophe Leclercq, Raphaël P. Martins, Michael Kühl, Michael A. Borger, Arash Arya, Angeliki Darma, Sandra Eifert, Gerhard Hindricks, Vincent Galand, Nikolaos Dagres, Diyar Saeed, Heart Centre Leipzig, University Hospital Coventry, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent

Subjects
medicine.medical_specialty, Multivariate analysis, LVAD, medicine.medical_treatment, risk stratification, 030204 cardiovascular system & hematology, late ventricular arrhythmia, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, Idiopathic dilated cardiomyopathy, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Heart Failure, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Ejection fraction, business.industry, ICD, Arrhythmias, Cardiac, Atrial fibrillation, Odds ratio, Middle Aged, medicine.disease, equipment and supplies, mortality, Defibrillators, Implantable, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Heart failure, Ventricular assist device, Cohort, Tachycardia, Ventricular, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Objectives This study sought to validate the performance of the VT-LVAD risk model in predicting late ventricular arrhythmias (VAs) in patients after left ventricular assist device (LVAD) implantation. Background The need for implantable cardioverter-defibrillator (ICD)-implantation in LVAD recipients is not well studied. A better selection of the patients with high risk for late VAs could lead to a more targeted ICD-implantation or replacement. Methods The study evaluated the performance of the VT-LVAD prognostic score (VAs prior LVAD, no ACE-inhibitor in medication, heart failure duration > 12 months, early VAs post-LVAD implantation, atrial fibrillation prior LVAD, idiopathic dilated cardiomyopathy) for the endpoint of the occurrence of late VAs in 357 LVAD patients in Heart Centre of Leipzig. Results From the initial 460 patients, 357 (age: 58 +/- 10 years; left ventricular ejection fraction: 20 +/- 6%; HeartWare: 50%; HeartMate III: 42%) were assigned to four risk groups according to their VT-LVAD score varying from low risk to very high risk. After 25 months, late VAs occurred in 130 patients. The VT-LVAD score was an independent predictor of late VAs (multivariate analysis; p = < .001; goodness-of-tip p = .347; odds ratio: 4.8). While there was no statistically significant difference between the low- and intermediate-risk group, risk stratification for patients with high risk and very high risk performed more accurately (pairwise comparison p = .005 and p < .001, respectively). Conclusions The VT-LVAD score predicted accurately the occurrence of late VAs in high-risk LVAD recipients in a large external cohort of LVAD recipients supporting its utility for more targeted ICD implantations.

Published
2021

33. Comparison of Outcomes and Mortality in Patients Having Left Ventricular Assist Device Implanted Early -vs- Late After Diagnosis of Cardiomyopathy

Author

Raphaël P. Martins, Matteo Pozzi, Nicolas Lellouche, Thomas Senage, Fabrice Vanhuyse, Nicolas Nesseler, Fabien Garnier, Pierre Baudinaud, Mathieu Pernot, Olivier Chavanon, Frédéric Anselme, Michel Kindo, Philippe Rouvière, Pierre-Yves Litzler, Christophe Leclercq, Marylou Para, Hugues Blangy, Constance Verdonk, Nicolas D'Ostrevy, Guillaume Baudry, Vincent Galand, André Vincentelli, Marie Bielefeld, Magali Michel, Edeline Pelcé, Vlad Gariboldi, Philippe Gaudard, Erwan Flecher, Gerard Babatasi, Katrien Blanchart, Karine Nubret, Costin Radu, Thierry Bourguignon, Céline Goéminne, Tam Hoang Minh, Aude Boignard, Thibaud Genet, Marie-Cécile Bories, Jean Porterie, Clément Delmas, Elisabeth Chen, Romain Eschalier, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Les Hôpitaux Universitaires de Strasbourg (HUS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Charles Nicolle [Rouen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Fédération Française de Cardiologie, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Population, Cardiomyopathy, 030204 cardiovascular system & hematology, Prosthesis Design, remotely diagnosed cardiomyopathy, survival, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Clinical endpoint, medicine, Humans, In patient, education, Aged, Retrospective Studies, education.field_of_study, Ischemic cardiomyopathy, LVAD implantation, business.industry, 030208 emergency & critical care medicine, Sudden cardiac arrest, Recently diagnosed cardiomyopathy, Middle Aged, Prognosis, medicine.disease, equipment and supplies, 3. Good health, Cardiac surgery, Survival Rate, Ventricular assist device, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Heart-Assist Devices, medicine.symptom, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; LVAD implantation in patients with a recently diagnosed cardiomyopathy has been poorly investigated. This work aims at describing the characteristics and outcomes of patients receiving a LVAD within 30 days following the diagnosis of cardiomyopathy. Patients from the ASSIST-ICD study was divided into recently and remotely diagnosed cardiomyopathy based on the time from initial diagnosis of cardiomyopathy to LVAD implantation using the cut point of 30 days. The primary end point of the study was all-cause mortality at 30-day and during follow-up. A total of 652 patients were included and followed during a median time of 9.1 (2.5 to 22.1) months. In this population, 117 (17.9%) had a recently diagnosed cardiomyopathy and had LVAD implantation after a median time of 15.0 (9.0 to 24.0) days following the diagnosis. This group of patients was significantly younger, with more ischemic cardiomyopathy, more sudden cardiac arrest (SCA) events at the time of the diagnosis and were more likely to receive temporary mechanical support before LVAD compared with the remotely diagnosed group. Postoperative in-hospital survival was similar in groups, but recently diagnosed patients had a better long-term survival after hospital discharge. SCA before LVAD and any cardiac surgery combined with LVAD implantation were identified as 2 independent predictors of postoperative mortality in recently diagnosed patients. In conclusion, rescue LVAD implantation for recently diagnosed severe cardiomyopathy is common in clinical practice. Such patients experience a relatively low postoperative mortality and have a better long-term survival compared with remotely diagnosed patients.

Published
2021

34. Left ventricular strain for predicting the response to cardiac resynchronization therapy: two methods for one question

Author

Arnaud Hubert, Elena Galli, Alban Gallard, Christophe Leclercq, Jean-Uwe Voigt, Erwan Donal, Vincent Galand, Otto A. Smiseth, Alfredo Hernandez, Virginie Le Rolle, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Oslo University Hospital [Oslo], University of Oslo (UiO), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
2D longitudinal strain, medicine.medical_specialty, Longitudinal strain, medicine.medical_treatment, Cardiac resynchronization therapy, cardiac resynchronization therapy, heart failure, 030204 cardiovascular system & hematology, myocardial work speckle tracking echocardiography, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Receiver operating characteristic, business.industry, Area under the curve, General Medicine, medicine.disease, Heart failure, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Left ventricular strain
Abstract

Aims Myocardial work (manually controlled software) and integral-derived longitudinal strain (automatic quantification of strain curves) are two promising tools to quantify dyssynchrony and potentially select the patients that are most likely to have a reverse remodelling due to cardiac resynchronization therapy (CRT). We sought to test and compare the value of these two methods in the prediction of CRT-response. Materials and results Two hundred and forty-three patients undergoing CRT-implantation from three European referral centres were considered. The characteristics from the six-segment of the four-chamber view were computed to obtain regional myocardial work and the automatically generated integrals of strain. The characteristics were studied in mono-parametric and multiparametric evaluations to predict CRT-induced 6-month reverse remodelling. For each characteristic, the performance to estimate the CRT response was determined with the receiver operating characteristic (ROC) curve and the difference between the performances was statistically evaluated. The best area under the curve (AUC) when only one characteristic used was obtained for a myocardial work (AUC = 0.73) and the ROC curve was significantly better than the others. The best AUC for the integrals was 0.63, and the ROC curve was not significantly greater than the others. However, with the best combination of works and integrals, the ROC curves were not significantly different and the AUCs were 0.77 and 0.72. Conclusion Myocardial work used in a mono-parametric estimation of the CRT-response has better performance compared to other methods. However, in a multiparametric application such as what could be done in a machine-learning approach, the two methods provide similar results.

Published
2021

35. An unusual story of electrical storm on the graft

Author

Céline Chabanne, Bernard Lelong, Vincent Galand, Erwan Flecher, and etienne charbonneau

Subjects
medicine.medical_specialty, Poor prognosis, business.industry, Radiofrequency ablation, medicine.medical_treatment, MEDLINE, Implantable cardioverter-defibrillator, medicine.disease, Sudden death, Lymphoma, Surgery, law.invention, law, Male patient, hemic and lymphatic diseases, medicine, business, Complication
Abstract

Background: Cancers, and specifically lymphomas, are one of the main causes of morbidity and mortality after heart transplant. We encountered this complication on a 54-year-old male patient, which brought to our attention the lack of a specific and appropriate treatment for a primary cardiac lymphoma on the graft. Objective: This case report highlights the challenging management of primitive heart transplant lymphoma and its treatment. Method: electronic medical record literature reviewed through Pubmed interface of Medline. Result: We report the case of an Epstein-Barr Virus (EBV) induced primary cardiac lymphoma on the graft. The lymphoma spread quickly in spite of the numerous treatments we tried and resulted in rhythmic complication. Endocavitary implantable cardioverter defibrillator was implanted but quickly removed due to local complications. The patient died from a sudden death at home shortly after. Conclusions: Primary cardiac lymphoma on the graft is highly rare with poor prognosis and rhythmic complications. Further studies are needed to assess the benefits of other treatment approaches, such as radiofrequency ablation techniques.

Published
2020

36. Efficacy of deep sedation for patients with intractable electrical storm refractory to anti-arrhythmic drugs

Author

Charles Guenancia, Nicolas Clementy, David Hamon, Jean-Marie Urien, Josselin Duchateau, Nicolas Barbarot, C. De Chillou, Laure Champ-Rigot, Jean-Marc Sellal, Vincent Galand, R Martins, Eloi Marijon, Rodrigue Garcia, Estelle Gandjbakhch, and F. Sacher

Subjects
business.industry, Sedation, medicine.medical_treatment, Hospital mortality, Sedation procedure, Refractory, Anesthesia, Extracorporeal membrane oxygenation, Medicine, Anti arrhythmic, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Anti-Arrhythmia Agents
Abstract

Background Sympathetic overactivity is implicated in the initiation and maintenance of electrical storm (ES). Deep sedation has empirically been considered as an efficient therapeutic option to blunt sympathetic tone and control ES. Purpose The aim of this multicenter study was to determine the efficacy of deep sedation in patients presenting intractable ES refractory to anti-arrhythmic drugs. Methods Patients requiring deep sedation for refractory ES from January 1st 2007 to July 31st 2018 were retrospectively included in 13 centers. The primary endpoint was the rate of acute response to sedation, defined as ES termination within 15 minutes after deep sedation. Results Among the 116 patients, 55 (47.4%) had ES termination within 15 minutes and were considered “acute responders” to deep sedation. Clinical signs of congestive heart failure before deep sedation (OR=3.31, 95% CI:1.001–10.97, p=0.049) was the only independent predictor of non-acute response. Twenty-one non-acute responders (34.4%) had an extracorporeal membrane oxygenation (ECMO) implanted. Non-acute responders had a significantly lower in-hospital survival (Log-rank, p=0.010). ECMO implantation did not influence survival in non-acute responders to sedation. Acute response to deep sedation was an independent protector of in-hospital mortality, decreasing by 73% the risk of death (OR 0.27; 95% CI:0.10–0.70, p=0.008). Conclusion To the best of our knowledge, this multicenter study is the first analysis of the efficacy of deep sedation in patients with intractable ES refractory to anti-arrhythmic drugs, and demonstrating the positive impact of “acute response” on in-hospital survival. Funding Acknowledgement Type of funding source: None

Published
2020

37. Cryoballoon ablation of atrial fibrillation in patients with atypical right pulmonary vein anatomy

Author

Camille Pichard, Raphaël P. Martins, Nathalie Behar, Mathieu Lederlin, Celine Chérel, Amélie Nicolas, Vincent Galand, Christophe Leclercq, Philippe Mabo, Jean-Claude Daubert, D. Pavin, Charlène Coquard, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and CCSD, Accord Elsevier

Subjects
Male, Cryoablation, medicine.medical_treatment, Action Potentials, Catheter ablation, 030204 cardiovascular system & hematology, Arrhythmias, Cryosurgery, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Risk Factors, medicine, Humans, In patient, Sinus rhythm, Prospective Studies, 030212 general & internal medicine, Cryoballoon ablation, Aged, Phrenic nerve, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Atrial fibrillation, General Medicine, Anatomy, Middle Aged, medicine.disease, 3. Good health, Electrophysiology, Treatment Outcome, Pulmonary Veins, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Background - Cryoballoon ablation is widely used for pulmonary vein isolation in patients with atrial fibrillation. There are no data regarding the clinical efficacy of cryoballoon ablation in patients with atypical right pulmonary vein anatomy. Aim - We aimed to evaluate the impact of right pulmonary vein anatomy on the safety and efficacy of cryoballoon ablation. Methods - Patients referred for cryoballoon ablation of paroxysmal atrial fibrillation were enrolled prospectively. Left atrial computed tomography was performed before cryoballoon ablation to determine whether the right pulmonary vein anatomy was "normal" or "atypical". For patients with atypical anatomy, cryoballoon ablation was only performed for right superior and right inferior pulmonary veins, neglecting accessory pulmonary veins. Results - Overall, 303 patients were included: 254 (83.8%) with normal and 49 (16.2%) with atypical right pulmonary vein anatomy. First-freeze isolation for right superior and right inferior pulmonary veins occurred in 44 (89.8%) and 37 (75.5%) patients with atypical pulmonary vein anatomy, and in 218 (85.8%) and 217 (85.4%) patients with typical pulmonary vein anatomy, respectively (P not significant). Phrenic nerve palsies were only observed in patients with normal anatomy (0 vs. 26 [8.6%]; P=0.039). Mid-term survival free from atrial arrhythmia was similar, regardless of right pulmonary vein anatomy. Conclusions - A significant proportion of patients have atypical right pulmonary vein anatomy. Procedural characteristics, acute pulmonary vein isolation success and mid-term procedural efficacy were similar, regardless of right pulmonary vein anatomy. In addition to left-side pulmonary vein isolation, cryoballoon ablation of right superior and right inferior pulmonary veins only, neglecting accessory pulmonary veins, is sufficient to obtain acute right-side pulmonary vein isolation and mid-term sinus rhythm maintenance in patients with atypical anatomy.

Published
2020

38. Effectiveness of Deep Sedation for Patients With Intractable Electrical Storm Refractory to Antiarrhythmic Drugs

Author

Nicolas Barbarot, Charles Guenancia, Christophe Leclercq, Audrey Sagnard, Arnaud Bisson, David Hamon, Laure Champ-Rigot, Paul Milliez, Estelle Gandjbakhch, Lionel Borella, D. Pavin, Bruno Degand, Nathalie Behar, Frederic Sacher, Nicolas Lellouche, Pierre Bouju, Rodrigue Garcia, Vincent Galand, Jean-Marc Sellal, Philippe Mabo, Raphaël P. Martins, Angélique Goepp, Josselin Duchateau, E. Varlet, Romain Tixier, Nicolas Clementy, Guillaume Rieul, Jean-Marie Urien, Christian de Chillou, Stéphane Schumacher, Eloi Marijon, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital de St Brieuc, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de cardiologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Service de Cardiologie [Bordeaux], CHU Bordeaux [Bordeaux], Centre hospitalier de Vannes, Service de Cardiologie [Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de cardiologie et de pathologie vasculaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de cardiologie [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre hospitalier de Lorient, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de Saint-Brieuc, CHU Trousseau [Tours], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CH Vannes, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CH de Lorient, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
cardiac, [SDV]Life Sciences [q-bio], Sedation, Hospital mortality, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Refractory, Physiology (medical), Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, hospital mortality, business.industry, Storm, 3. Good health, Anesthesia, Tachycardia, Ventricular, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Deep Sedation, Cardiology and Cardiovascular Medicine, business, arrhythmias, Anti-Arrhythmia Agents
Abstract

International audience

Published
2020

39. Relation of Body Mass Index to Outcomes in Patients With Heart Failure Implanted With Left Ventricular Assist Devices

Author

Céline Chabanne, Romain Eschalier, Marylou Para, Marion Charton, Edeline Pelcé, Fabrice Vanhuyse, Michel Kindo, Raphaël P. Martins, Matteo Pozzi, Thierry Bourguignon, E. Varlet, Nicolas Sadoul, Bernard Lelong, David Hamon, Tam Hoang Minh, Fabien Garnier, Mathieu Pernot, Céline Goéminne, Vlad Gariboldi, Philippe Rouvière, Jean Porterie, Pierre-Yves Litzler, Constance Verdonk, Thibaud Genet, Christophe Leclercq, Magali Michel, Philippe Gaudard, Marie-Cécile Bories, Marie Bielefeld, Katrien Blanchart, Clément Delmas, Olivier Chavanon, Thomas Senage, Costin Radu, Erwan Flecher, Karine Nubret, Nicolas D'Ostrevy, Frédéric Anselme, Vincent Galand, Aude Boignard, Gerard Babatasi, André Vincentelli, Jean-François Obadia, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Bordeaux (UB), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Lapeyronie [Montpellier] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Institut d'Aménagement et d'Urbanisme de la Région d'Ile-de-France (IAU Île-de-France), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHI Créteil, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], The French Federation of Cardiology, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent

Subjects
Male, medicine.medical_specialty, Population, Left ventricular assist device, 030204 cardiovascular system & hematology, Overweight, 03 medical and health sciences, 0302 clinical medicine, Thinness, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, Humans, Medicine, Obesity, education, Body mass index, Aged, Retrospective Studies, Heart Failure, 2. Zero hunger, education.field_of_study, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, mortality, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Cardiac surgery, Survival Rate, Treatment Outcome, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Heart failure, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Underweight, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Destination therapy
Abstract

International audience; We aimed at characterizing the impact of low and high body mass index (BMI) on outcomes after left-ventricular assist device (LVAD) surgery and define the predictors of mortality in patients with abnormal BMI (low/high). This study was conducted in 19 centers from 2006 to 2016. Patients were divided based on their baseline BMI into 3 groups of BMI: low (BMI ≤18.5 kg/m²); normal (BMI = 18.5 to 24.99 kg/m²) and high (BMI ≥25 kg/m²) (including overweight (BMI = 25 to 29.99 kg/m²), and obesity (BMI ≥30 Kg/m²)). Among 652 patients, 29 (4.4%), 279 (42.8%) and 344 (52.8%) had a low-, normal-, and high BMI, respectively. Patients with high BMI were significantly more likely men, with more co-morbidities and more history of ventricular/supra-ventricular arrhythmias before LVAD implantation. Patients with abnormal BMI had significantly lower survival than those with normal BMI. Notably, those with low BMI experienced the worst survival whereas overweight or obese patients had similar survival. Four predictors of mortality for LVAD candidates with abnormal BMI were defined: total bilirubin ≥16 µmol/L before LVAD, hypertension, destination therapy, and cardiac surgery with LVAD. Depending on the number of predictor per patients, those with abnormal BMI may be divided in 3 groups of 1-year mortality risk, i.e., low (0 to 1 predictor: 29% and 31%), intermediate (2 to 3 predictors, 51% and 52%, respectively), and high (4 predictors: 83%). In conclusion, LVAD recipients with abnormal BMI experience lower survival, especially underweight patients. Four predictors of mortality have been identified for LVAD population with abnormal BMI, differentiating those a low-, intermediate-, and high risks of death.

Published
2020

40. Implantable cardiac defibrillator leads dysfunction after LVAD implantation

Author

Gerard Babatasi, Nicolas D'Ostrevy, Pierre-Yves Litzler, Christophe Leclercq, Raphaël P. Martins, Matteo Pozzi, Philippe Gaudard, Edeline Pelcé, Vincent Galand, Eloi Marijon, Nicolas Lellouche, Thierry Bourguignon, Jean-Luc Pasquié, Marie Bielefeld, Aude Boignard, Bertrand Pierre, Marylou Para, André Vincentelli, Fabien Garnier, Frédéric Anselme, Stéphane Boulé, Philippe Maury, David Hamon, Pascal Defaye, Nicolas Welte, Hamed Bourenane, Emilie Varlet, Hugues Blangy, Vincent Probst, Michel Kindo, François Picard, Erwan Flecher, Thomas Cardi, Nicolas Sadoul, Katrien Blanchart, Jean-François Obadia, Vincent Algalarrondo, Jean-Baptiste Gourraud, Pierre Mondoly, Vlad Gariboldi, Romain Eschalier, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université de Bordeaux (UB), CHU Strasbourg, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), NA, Fédération Française de Cardiologie, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
Male, medicine.medical_specialty, implantable cardioverter defibrillator, medicine.medical_treatment, Lead impedance, [SDV]Life Sciences [q-bio], Icd lead, lead parameters dysfunction, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, left ventricular assist device, Humans, 030212 general & internal medicine, Lead (electronics), ComputingMilieux_MISCELLANEOUS, Aged, Pacing impedance, business.industry, General Medicine, Middle Aged, equipment and supplies, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Electrodes, Implanted, Prosthesis Failure, Ventricular assist device, Cardiology, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract

Background Implantable cardioverter-defibrillator (ICD) lead dysfunction has been reported after left ventricular assist device (LVAD) implantation in limited single-center studies. We aimed at describing and characterizing the incidence of ICD lead parameters dysfunction after LVAD implantation. Methods Among the 652 patients enrolled in the ASSIST-ICD study, only patients with an ICD prior to LVAD were included (n = 401). ICD lead parameters dysfunction following LVAD implantation is defined as follows: (a) >50% decrease in sensing threshold, (b) pacing lead impedance increase/decrease by >100Ω, and (c) >50% increase in pacing threshold. Results One hundred twenty-two patients with an ICD prior to LVAD had available ICD interrogation reports prior and after LVAD. A total of 67 (55%) patients exhibited at least one significant lead dysfunction: 17 (15%) exhibited >50% decrease in right ventricular (RV) sensing, 51 (42%) had >100 Ω increase/decrease in RV pacing impedance, and 24 (20%) experienced >50% increase in RV pacing threshold. A total of 52 patients experienced ventricular arrhythmia during follow-up and all were successfully detected and treated by the device. All lead dysfunction could be managed conservatively. Conclusion More than 50% of LVAD-recipients may experience >1 significant change in lead parameters but none had severe clinical consequences.

Published
2020

42. Outcomes of Left Ventricular Assist Device Implantation in Patients With Uncommon Etiology Cardiomyopathy

Author

Romain Eschalier, Marie Bielefeld, Nicolas D'Ostrevy, Philippe Rouvière, Aude Boignard, Vincent Galand, Olivier Chavanon, François Picard, Céline Chabanne, Fabien Garnier, Frédéric Anselme, Jérôme Jouan, Katrien Blanchart, Erwan Flecher, Camille Dambrin, Hugues Blangy, Fabrice Vanhuyse, Gerard Babatasi, Edeline Pelcé, Walid Ghodhbane, Tam Hoang Minh, Céline Goéminne, Thierry Bourguignon, Raphaël P. Martins, Matteo Pozzi, Pierre-Yvesl Litzler, Frederic Sacher, Philippe Gaudard, E. Varlet, Constance Verdonk, Nicolas Lellouche, Thomas Senage, Magali Michel, Vlad Gariboldi, Bernard Lelong, Thibaud Genet, Michel Kindo, Christophe Leclercq, David Hamon, Jean-François Obadia, Clément Delmas, André Vincentelli, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Carnegie Mellon University [Pittsburgh] (CMU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Fédération Française de Cardiologie, Rennes University Hospital, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Henri Mondor, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre de recherches (CRT), Société Lafarge, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Nouvel Hôpital Civil, Strasbourg, France., Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Hospital Bichat Paris, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Caen (CHRU Caen), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie et maladies vasculaires, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and MORNET, Dominique

Subjects
Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Myocarditis, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cardiomyopathy, Myocardial Ischemia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Idiopathic dilated cardiomyopathy, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Mortality rate, valvular heart disease, Hypertrophic cardiomyopathy, Cardiomyopathy, Hypertrophic, Middle Aged, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Ventricular assist device, Etiology, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; The impact of uncommon etiology cardiomyopathies on Left-ventricular assist device (LVAD)-recipient outcomes is not very well known. This study aimed to characterize patients with uncommon cardiomyopathy etiologies and examine the outcomes between uncommon and ischemic/idiopathic dilated cardiomyopathy. This observational study was conducted in 19 centers between 2006 and 2016. Baseline characteristics and outcomes of patients with uncommon etiology were compared to patients with idiopathic dilated/ischemic cardiomyopathies. Among 652 LVAD-recipients included, a total of 590 (90.5%) patients were classified as ischemic/idiopathic and 62 (9.5%) patients were classified in the "uncommon etiologies" group. Main uncommon etiologies were: hypertrophic (n = 12(19%)); cancer therapeutics-related cardiac dysfunction (CTRCD) (n = 12(19%)); myocarditis (n = 11(18%)); valvulopathy (n = 9(15%)) and others (n = 18(29%)). Patients with uncommon etiologies were significantly younger with more female and presented less co-morbidities. Additionally, patients with uncommon cardiomyopathies were less implanted as destination therapy compared with ischemic/idiopathic group (29% vs 38.8%). During a follow-up period of 9.1 months, both groups experienced similar survival. However, subgroup of hypertrophic/valvular cardiomyopathies and CTRCD had significantly higher mortality compared to the ischemic/idiopathic or myocarditis/others cardiomyopathies. Conversely, patients with myocarditis/others etiologies experienced a better survival. Indeed, the 12-months survival in the myocarditis/others; ischemic/idiopathic and hypertrophic/CTRCD/valvulopathy group were 77%; 65%, and 46% respectively. In conclusion, LVAD-recipients with hypertrophic cardiomyopathy, valvular heart disease and CTRCD experienced the higher mortality rate.

Published
2020

43. Analysis of wall thickness to help identify critical isthmuses during ventricular tachycardia ablation

Author

Raphaël P. Martins, Vincent Galand, and Dominique Pavin

Subjects
medicine.medical_specialty, business.industry, Ventricular tachycardia ablation, Internal medicine, RC666-701, Catheter Ablation, Tachycardia, Ventricular, Cardiology, medicine, Humans, General Earth and Planetary Sciences, Diseases of the circulatory (Cardiovascular) system, Cardiology and Cardiovascular Medicine, Wall thickness, business, General Environmental Science
Published
2020

44. Subcutaneous Implantable Cardioverter-Defibrillator Lead Extraction: First Multicenter French Experience

Author

Nathalie, Behar, Vincent, Galand, Raphaël P, Martins, Peggy, Jacon, Nicolas, Badenco, Hugues, Blangy, Christine, Alonso, Benoit, Guy-Moyat, Rim, El Bouazzaoui, Alain, Lebon, Cédric, Giraudeau, Christelle, Marquie, and Christophe, Leclercq

Subjects
Male, Treatment Outcome, Humans, Female, Tissue Adhesions, Middle Aged, Device Removal, Defibrillators, Implantable, Retrospective Studies
Abstract

The aim of this multicenter study was to characterize the efficacy and safety of subcutaneous implantable cardioverter-defibrillators (S-ICDs) lead extraction procedures.S-ICDs have been developed to limit lead-related complications inherent to transvenous ICD devices. To date, no study has specifically investigated the safety and feasibility of S-ICD lead extraction procedures.Patients requiring S-ICD lead extraction between February 1, 2014, and February 28, 2019, were retrospectively included in 10 centers. The primary endpoint of the study was procedural success, defined as the removal of all the lead and lead material from the subcutaneous space. Secondary endpoints included procedural complications and the need for specific extraction tools.S-ICD lead extraction procedures were performed in 32 patients (mean age 45.7 ± 13.8 years, 75.0% men, 65.6% in primary prevention). The median time from S-ICD lead implantation was 9.3 months (5.4 to 17.5 months). The primary endpoint, that is, complete removal of the material, was achieved in 96.9% of the patients, and only 1 procedural failure occurred (3.1%). Simple traction of the S-ICD lead was successful in 19 patients (59.4%), whereas 3 patients (9.4%) needed an additional incision and 9 patients (28.1%) required mechanical sheath to remove lead adhesions around the coil. No procedure-related complications occurred. Patients with successful simple traction extraction were implanted more recently (7.1 months [2.8 to 12.2 months] vs. 16.5 months [7.5 to 20.8 months]; p = 0.04) and had less prior history of sternotomy (2 [10.5%] vs. 5 [38.5%] patients; p = 0.09).S-ICD lead extraction is an efficient and safe procedure, but may require some specific tools like mechanical sheath, specifically when fibrotic adhesions developed around the parasternal coil.

Published
2020

45. Utility of Computed Tomography to Predict Ventricular Arrhythmias in Patients With Nonischemic Cardiomyopathy Receiving Cardiac Resynchronization Therapy

Author

Christophe Leclercq, Jackie Szymonifka, Raphaël P. Martins, Vincent Galand, Brian B. Ghoshhajra, Jagmeet P. Singh, Saumya Das, Quynh A. Truong, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Harvard Medical School [Boston] (HMS), CHU Pontchaillou [Rennes], New York University [New York] (NYU), NYU System (NYU), Center for neurogenetics [Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York], Weill Medical College of Cornell University [New York], K23HL098370, Foundation for the National Institutes of Health, National Heart, Lung, and Blood Institute, Abbott Pharmaceuticals, Jonchère, Laurent, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Tachycardia, Male, medicine.medical_specialty, genetic structures, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, Cardiac resynchronization therapy, Computed tomography, Pilot Projects, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, medicine, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, medicine.diagnostic_test, business.industry, Middle Aged, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Nonischemic cardiomyopathy, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Predictive value of tests, Cardiology, Tachycardia, Ventricular, cardiovascular system, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Wall thickness, Cardiomyopathies, Tomography, X-Ray Computed
Abstract

International audience; The residual risk of ventricular arrhythmia (VA) after cardiac resynchronization therapy (CRT) implantation in patients with nonischemic cardiomyopathy (NICM) remains difficult to evaluate. The impact of left ventricular (LV) wall thickness (WT) measured using computed tomography (CT) on the occurrence of VA after CRT implantation has never been investigated. In this pilot study, we examined the association of LV WT and the occurrence of VA in NICM patients receiving CRT. Thirty three patients with NICM scheduled for CRT underwent preprocedural CT. Reduced LV WT was defined as WT

Published
2020

46. CRT-Pacemaker Versus CRT-Defibrillator: Who Needs Sudden Cardiac Death Protection?

Author

Raphaël P. Martins, Camille Pichard, Nathalie Behar, Christophe Leclercq, Vincent Galand, Philippe Mabo, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Pacemaker, Artificial, medicine.medical_specialty, medicine.medical_treatment, Cardiomyopathy, Cardiac resynchronization therapy, Heart failure, 030204 cardiovascular system & hematology, Ventricular Function, Left, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Ventricular arrhythmias, Physiology (medical), Internal medicine, Implantable cardioverter defibrillator, medicine, Humans, 030212 general & internal medicine, cardiovascular diseases, Cardiac imaging, Ejection fraction, Ventricular Remodeling, business.industry, Stroke Volume, Implantable cardioverter-defibrillator, medicine.disease, Defibrillators, Implantable, 3. Good health, Cardiac surgery, Death, Sudden, Cardiac, Emergency Medicine, Cardiology, cardiovascular system, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Purpose of the review - Patients with cardiomyopathy and impaired left ventricular (LV) ejection fraction are at risk of sudden cardiac death (SCD). In selected heart failure patients, cardiac resynchronization therapy (CRT) provides LV reverse remodeling and improves the cellular and molecular function leading to a reduced risk of ventricular arrhythmia and SCD. Consequently, some CRT candidates may not need concomitant ICD therapy. This review aimed at focusing on the residual risk of SCD in patients receiving CRT and discussing the requirement of a concomitant ICD therapy in CRT candidates. Recent findings - New imaging diagnostic tools may be helpful to accurately predict patient with a residual risk of SCD and who required a CRT-D implantation. Recent data highlighted that cardiac computed tomography (CT) or myocardial scar tissue analysis using contrast-enhanced cardiac magnetic resonance (CMR) was able to predict the occurrence of VA in patients with bi-ventricular pacing. Cardiac imaging and specifically myocardial scar analysis seem promising to evaluate the risk of SCD following bi-ventricular pacing and will probably be of great help in the future to accurately identify those who needs concomitant defibrillator's protection.

Published
2020

47. Reply

Author

Raphaël P. Martins, Dominique Pavin, and Vincent Galand

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, General surgery, Catheter ablation, 030204 cardiovascular system & hematology, Ablation, Review article, Connection (mathematics), 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, business
Abstract

We thank Dr. Madaffari and colleagues for their interest in our review article ([1][1]) and for raising a crucial comment. Indeed, in their letter, the authors summarize a few seminal papers describing the role of direct interpulmonary myocardial connections, leading to the presence of connected

Published
2019

48. Clinical predictors of challenging atrioventricular node ablation procedure for rate control in patients with atrial fibrillation

Author

Christophe Leclercq, Vincent Auffret, Jean-Claude Daubert, Vincent Galand, Raphaël P. Martins, Philippe Mabo, Baptiste Polin, Nathalie Behar, Albin Behaghel, D. Pavin, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cardiac resynchronization therapy, Ablation, 030204 cardiovascular system & hematology, Body Mass Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Predictive Value of Tests, Risk Factors, Internal medicine, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Atrioventricular node ablation, Intraoperative Complications, Aged, Retrospective Studies, Aged, 80 and over, 2. Zero hunger, Ejection fraction, business.industry, Atrial fibrillation, Odds ratio, Middle Aged, medicine.disease, Atrioventricular node, Confidence interval, 3. Good health, Surgery, medicine.anatomical_structure, Atrioventricular Node, Catheter Ablation, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Body mass index
Abstract

International audience; Introduction Atrioventricular node (AVN) ablation is usually a simple procedure but may sometimes be challenging. We aimed at identifying pre-procedural clinical predictors of challenging AVN ablation. Methods Patients referred for AVN ablation from 2009 to 2015 were retrospectively included. Baseline clinical data, procedural variables and outcomes of AVN ablation were collected. A “challenging procedure” was defined 1) total radiofrequency delivery to get persistent AVN block ≥ 400 s, 2) need for left-sided arterial approach or 3) failure to obtain AVN ablation. Results 200 patients were included (71 ± 10 years). A total of 37 (18.5%) patients had “challenging” procedures (including 9 failures, 4.5%), while 163 (81.5%) had “non-challenging” ablations. In multivariable analysis, male sex (Odds ratio (OR) = 4.66, 95% confidence interval (CI): 1.74–12.46), body mass index (BMI, OR = 1.08 per 1 kg/m2, 95%CI 1.01–1.16), operator experience (OR = 0.40, 95%CI 0.17–0.94), and moderate-to-severe tricuspid regurgitation (TR, OR = 3.65, 95%CI 1.63–8.15) were significant predictors of “challenging” ablations. The proportion as a function of number of predictors was analyzed (from 0 to 4, including male sex, operator inexperience, a BMI andgt; 23.5 kg/m2 and moderate-to-severe TR). There was a gradual increase in the risk of “challenging” procedure with the number of predictors by patient (No predictor: 0%; 1 predictor: 6.3%; 2 predictors: 16.5%; 3 predictors: 32.5%; 4 predictors: 77.8%). Conclusions Operator experience, male sex, higher BMI and the degree of TR were independent predictors of “challenging” AVN ablation procedure. The risk increases with the number of predictors by patient. © 2017

Published
2017

49. I had a dream…

Author

Christophe Leclercq, Raphaël P. Martins, Nathalie Behar, and Vincent Galand

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, media_common.quotation_subject, Cardiac resynchronization therapy, Atrial fibrillation, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Heart failure, Internal medicine, Cardiology, Medicine, 030212 general & internal medicine, Dream, Cardiology and Cardiovascular Medicine, business, media_common
Published
2018

50. The European Society of Cardiology Cardiac Resynchronization Therapy Survey II A comparison of cardiac resynchronization therapy implantation practice in Europe and France

Author

Jean-Claude Deharo, Cecilia Linde, Serge Boveda, Jacques Mansourati, Philippe Rumeau, Pascal Defaye, Jerome Horvilleur, Pascal Sagnol, Salem Younsi, Nicolas Lellouche, Camilla Normand, Mathieu Steinbach, Antoine Da Costa, Vincent Galand, Kenneth Dickstein, Christophe Leclercq, Paul Bru, Thierry Beard, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Karolinska University Hospital [Stockholm], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), CHU Marseille, Centre Hospitalier Chalon-sur-Saône William Morey, Clinique Pasteur, Clinique Pasteur [Toulouse], University of Stavanger, University of Bergen (UiB), CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CCSD, Accord Elsevier, and Clinical sciences

Subjects
Male, Time Factors, genetic structures, medicine.medical_treatment, Comorbidity, 030204 cardiovascular system & hematology, Ventricular Function, Left, French population, Heart Failure/diagnosis, 0302 clinical medicine, 030212 general & internal medicine, Practice Patterns, Physicians', Survey, Aged, 80 and over, Cardiac resynchronization therapy, Ejection fraction, Guideline adherence, General Medicine, Middle Aged, Clinical Practice, Europe, Treatment Outcome, Registre, Healthcare Disparities/trends, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, circulatory and respiratory physiology, medicine.medical_specialty, Population européennes, Heart failure, 03 medical and health sciences, medicine, Population française, Humans, In patient, Cardiac Resynchronization Therapy Devices/trends, Implantation procedure, Cardiac Resynchronization Therapy Devices, cardiovascular diseases, Healthcare Disparities, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Patient Selection, Europe population, Stroke Volume, European population, Recovery of Function, medicine.disease, Practice Patterns, Physicians'/trends, Insuffisance cardiaque, Health Care Surveys, Emergency medicine, Cardiac Resynchronization Therapy/adverse effects, business
Abstract

International audience; Background - The first European Cardiac Resynchronization Therapy (CRT) Survey, conducted in 2008-2009, showed considerable variations in guideline adherence and implantation practice. A second prospective survey (CRT Survey II) was then performed to describe contemporary clinical practice regarding CRT among 42 European countries. Aim - To compare the characteristics of French CRT recipients with the overall European population of CRT Survey II. Methods - Demographic and procedural data from French centres recruiting all consecutive patients undergoing either de novo CRT implantation or an upgrade to a CRT system were collected and compared with data from the European population. Results - A total of 11,088 patients were enrolled in CRT Survey II, 754 of whom were recruited in France. French patients were older (44.7% aged≥75 years vs 31.1% in the European group), had less severe heart failure symptoms, a higher baseline left ventricular ejection fraction and fewer co-morbidities. Additionally, French patients had a shorter intrinsic QRS duration (19.1% had a QRS

Published
2019

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