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2. Contemporary Advances in Cardiac Remote Monitoring: A Comprehensive, Updated Mini-Review

Author

Preda, A, Falco, R, Tognola, C, Carbonaro, M, Vargiu, S, Gallazzi, M, Baroni, M, Gigli, L, Varrenti, M, Colombo, G, Zanotto, G, Giannattasio, C, Mazzone, P, Guarracini, F, Preda, Alberto, Falco, Raffaele, Tognola, Chiara, Carbonaro, Marco, Vargiu, Sara, Gallazzi, Michela, Baroni, Matteo, Gigli, Lorenzo, Varrenti, Marisa, Colombo, Giulia, Zanotto, Gabriele, Giannattasio, Cristina, Mazzone, Patrizio, Guarracini, Fabrizio, Preda, A, Falco, R, Tognola, C, Carbonaro, M, Vargiu, S, Gallazzi, M, Baroni, M, Gigli, L, Varrenti, M, Colombo, G, Zanotto, G, Giannattasio, C, Mazzone, P, Guarracini, F, Preda, Alberto, Falco, Raffaele, Tognola, Chiara, Carbonaro, Marco, Vargiu, Sara, Gallazzi, Michela, Baroni, Matteo, Gigli, Lorenzo, Varrenti, Marisa, Colombo, Giulia, Zanotto, Gabriele, Giannattasio, Cristina, Mazzone, Patrizio, and Guarracini, Fabrizio

Abstract

Over the past decade, remote monitoring (RM) has become an increasingly popular way to improve healthcare and health outcomes. Modern cardiac implantable electronic devices (CIEDs) are capable of recording an increasing amount of data related to CIED function, arrhythmias, physiological status and hemodynamic parameters, providing in-depth and updated information on patient cardiovascular function. The extensive use of RM for patients with CIED allows for early diagnosis and rapid assessment of relevant issues, both clinical and technical, as well as replacing outpatient follow-up improving overall management without compromise safety. This approach is recommended by current guidelines for all eligible patients affected by different chronic cardiac conditions including either brady- and tachy-arrhythmias and heart failure. Beyond to clinical advantages, RM has demonstrated cost-effectiveness and is associated with elevated levels of patient satisfaction. Future perspectives include improving security, interoperability and diagnostic power as well as to engage patients with digital health technology. This review aims to update existing data concerning clinical outcomes in patients managed with RM in the wide spectrum of cardiac arrhythmias and Hear Failure (HF), disclosing also about safety, effectiveness, patient satisfaction and cost-saving.

Published
2024

4. Noise Power Minimization in CMOS Brain-Chip Interfaces

Author

Stevenazzi, L, Baschirotto, A, Zanotto, G, Vallicelli, E, De Matteis, M, Stevenazzi L., Baschirotto A., Zanotto G., Vallicelli E. A., De Matteis M., Stevenazzi, L, Baschirotto, A, Zanotto, G, Vallicelli, E, De Matteis, M, Stevenazzi L., Baschirotto A., Zanotto G., Vallicelli E. A., and De Matteis M.

Abstract

This paper presents specific noise minimization strategies to be adopted in silicon–cell interfaces. For this objective, a complete and general model for the analog processing of the signal coming from cell–silicon junctions is presented. This model will then be described at the level of the single stages and of the fundamental parameters that characterize them (bandwidth, gain and noise). Thanks to a few design equations, it will therefore be possible to simulate the behavior of a time-division multiplexed acquisition channel, including the most relevant parameters for signal processing, such as amplification (or power of the analog signal) and noise. This model has the undoubted advantage of being particularly simple to simulate and implement, while maintaining high accuracy in estimating the signal quality (i.e., the signal-to-noise ratio, SNR). Thanks to the simulation results of the model, it will be possible to set an optimal operating point for the front-end to minimize the artifacts introduced by the time-division multiplexing (TDM) scheme and to maximize the SNR at the a-to-d converter input. The proposed results provide an SNR of 12 dB at 10 µVRMS of noise power and 50 µVRMS of signal power (both evaluated at input of the analog front-end, AFE). This is particularly relevant for cell–silicon junctions because it demonstrates that it is possible to detect weak extracellular events (of the order of few µVRMS) without necessarily increasing the total amplification of the front-end (and, therefore, as a first approximation, the dissipated electrical power), while adopting a specific gain distribution through the acquisition chain.

Published
2022

5. The value of wearable cardioverter defibrillator in adult patients with recent myocardial infarction: Economic and clinical implications from a health technology assessment perspective

Author

Botto, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Biffi, M, Capucci, A, Casu, G, Notarstefano, P, Scaglione, M, Zanotto, G, Boriani, G, Botto G. L., Mantovani L. G., Cortesi P. A., De Ponti R., D'Onofrio A., Biffi M., Capucci A., Casu G., Notarstefano P., Scaglione M., Zanotto G., Boriani G., Botto, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Biffi, M, Capucci, A, Casu, G, Notarstefano, P, Scaglione, M, Zanotto, G, Boriani, G, Botto G. L., Mantovani L. G., Cortesi P. A., De Ponti R., D'Onofrio A., Biffi M., Capucci A., Casu G., Notarstefano P., Scaglione M., Zanotto G., and Boriani G.

Abstract

Aims: Sudden cardiac death (SCD) causes high mortality and substantial societal burdens for healthcare systems (HSs). The risk of SCD is significantly increased in patients with reduced left ventricular ejection fraction after myocardial infarction (MI). Current guidelines recommend re-evaluation of cardioverter-defibrillator implantation 40 days post-MI, earliest. Medical therapy alone does not provide sufficient protection against SCD, especially in the first month post-MI, and needs time. Consequently, there is a gap in care of high-risk patients upon hospital discharge. The wearable cardioverter defibrillator (WCD) is a proven safe, effective therapy, which temporarily protects from SCD. Little information on WCD cost-effectiveness exists. We conducted this research to demonstrate the medical need of the device in the post-MI setting defining WCD cost-effectiveness. Methods & results: Based on a randomized clinical trials (RCTs) and Italian and international data, we developed a Markov-model comparing costs, patient survival, and quality-of-life, and calculated the Incremental Cost-Effectiveness Ratio (ICER) of a WCD vs. current standard of care in post-MI patients. The rather conservative base case analysis – based on the RCT intention-to-treat results - produced an ICER of €47,709 per Quality Adjusted Life Year (QALY) gained, which is far lower than the accepted threshold of €60,000 in the Italian National HS. The ICER per Life Year (LY) gained was €38,276. Conclusion: WCD utilization in post-MI patients is clinically beneficial and cost-effective. While improving guideline directed patient care, the WCD can also contribute to a more efficient use of resources in the Italian HS, and potentially other HSs as well.

Published
2022

8. Temporal association between drops in throracic impedance and malignant ventricular arrhythmia:A longitudinal analysis of remote monitoring trends

Author

Rodio, G., Iacopino, S., Pisanò, E., Calvi, V., Rovasis, G., Marini, M., Giammaria, M., Caravati, F., Maglia, G., Zanotto, G., Dellabella, P., Biffi, M., Curnis, A., Maines, M., Orsida, D., Santamaria, M., Bisignani, G., Forleo, G. B., Piemontese, C., Desalvia, A., Miracapillo, G., Celentano, E., Zecchin, M., Luzzi, G., Giacopelli, D., Gargaro, A., and D'Onofrio, A.

Published
2023

9. Ventricular arrhythmias and implantable cardioverter-defibrillator therapy in women: a propensity score-matched analysis

Author

Maglia, G, primary, Giammaria, M, additional, Zanotto, G, additional, D’onofrio, A, additional, Della Bella, P, additional, Marini, M, additional, Rovaris, G, additional, Iacopino, S, additional, Calvi, V, additional, Pisano’, EC, additional, Caravati, F, additional, Balestri, G, additional, Giacopelli, D, additional, Gargaro, A, additional, and Biffi, M, additional

Published
2022
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10. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Guerra, F., De Ponti, R., D'Onofrio, A., Accogli, M., Bertini, M., Bisignani, G., Forleo, G. B., Landolina, M., Lavalle, C., Notarstefano, P., Ricci, R. P., Zanotto, G., Palmisano, P., Luise, R., De Bonis, S., Pangallo, A., Talarico, A., Maglia, G., Aspromonte, V., Nigro, G., Bianchi, V., Rapacciuolo, A., Ammendola, E., Solimene, F., Stabile, G., Biffi, M., Ziacchi, M., Malpighi, P. S. O., Saporito, D., Casali, E., Turco, V., Malavasi, V. L., Vitolo, M., Imberti, J. F., Anna, A. S., Zardini, M., Placci, A., Quartieri, F., Bottoni, N., Carinci, V., Barbato, G., De Maria, E., Borghi, A., Ramazzini, O. B., Bronzetti, G., Tomasi, C., Boggian, G., Virzi, S., Sassone, B., Corzani, A., Sabbatani, P., Pastori, P., Ciccaglioni, A., Adamo, F., Scaccia, A., Spampinato, A., Patruno, N., Biscione, F., Cinti, C., Pignalberi, C., Calo, L., Tancredi, M., Di Belardino, N., Ricciardi, D., Cauti, F., Rossi, P., Cardinale, M., Ansalone, G., Narducci, M. L., Pelargonio, G., Silvetti, M., Drago, F., Santini, L., Pentimalli, F., Pepi, P., Caravati, F., Taravelli, E., Belotti, G., Rordorf, R., Mazzone, P., Bella, P. D., Rossi, S., Canevese, L. F., Cilloni, S., Doni, L. A., Vergara, P., Baroni, M., Perna, E., Gardini, A., Negro, R., Perego, G. B., Curnis, A., Arabia, G., Russo, A. D., Marchese, P., Dell'Era, G., Occhetta, E., Pizzetti, F., Amellone, C., Giammaria, M., Devecchi, C., Coppolino, A., Tommasi, S., Anselmino, M., Coluccia, G., Guido, A., Rillo, M., Palama, Z., Luzzi, G., Pellegrino, P. L., Grimaldi, M., Grandinetti, G., Vilei, E., Potenza, D., Scicchitano, P., Favale, S., Santobuono, V. E., Sai, R., Melissano, D., Candida, T. R., Bonfantino, V. M., Di Canda, D., Gianfrancesco, D., Carretta, D., Pisano, E. C. L., Medico, A., Giaccari, R., Aste, R., Murgia, C., Nissardi, V., Sanna, G. D., Firetto, G., Crea, P., Ciotta, E., Sgarito, G., Caramanno, G., Ciaramitaro, G., Faraci, A., Fasheri, A., Di Gregorio, L., Campsi, G., Muscio, G., Giannola, G., Padeletti, M., Del Rosso, A., Nesti, M., Miracapillo, G., Giovannini, T., Pieragnoli, P., Rauhe, W., Marini, M., Guarracini, F., Ridarelli, M., Fedeli, F., Mazza, A., Zingarini, G., Andreoli, C., Carreras, G., Zorzi, A., Rossillo, A., Ignatuk, B., Zerbo, F., Molon, G., Fantinel, M., Zanon, F., Marcantoni, L., Zadro, M., and Bevilacqua, M.

Subjects
Cardiac resynchronization therapy, Remote monitoring, Emergency Medicine, Internal Medicine, Ablation, Arrhythmia, Atrial fibrillation, COVID-19, Implantable cardioverter defibrillators, Pacemakers
Abstract

The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care.A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched.A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined.The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.

Published
2022

12. [The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Annual report 2019]

Author

Proclemer, A., Zecchin, M., Zanotto, G., D'Onofrio, A., De Ponti, R., Ricci, R. P., Facchin, D., Rebellato, L., Ghidina, M., Bianco, G., Bernardelli, E., Miconi, A., Zorzin, A. F., and Gregori, D.

Subjects
Aged, 80 and over, Pacemaker, Artificial, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Pacemaker, Italy, Artificial, Atrial Fibrillation, Aged, Humans, Registries, 80 and over, Implantable, Defibrillators
Abstract

The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2019 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers.The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards.PM Registry: data about 22 889 PM implantations were collected (19 621 first implants and 3268 replacements). The number of collaborating centers was 173. Median age of treated patients was 81 years (75 quartile I; 87 quartile III). ECG indications included atrioventricular conduction disorders in 33.3% of first PM implants, sick sinus syndrome in 16.4%, atrial fibrillation plus bradycardia in 11.6%, other in 38.7%. Among atrioventricular conduction defects, third-degree atrioventricular block was the most common type (18.3% of first implants). Use of single-chamber PMs was reported in 25.5% of first implants, of dual-chamber PMs in 67.1%, of PMs with cardiac resynchronization therapy (CRT) in 1.5%, and of single lead atrial-synchronized ventricular stimulation (VDD/R PMs) in 5.8%. ICD Registry: data about 17 328 ICD implantations were collected (12 129 first implants and 5199 replacements). The number of collaborating centers was 425. Median age of treated patients was 71 years (62 quartile I; 77 quartile III). Primary prevention indication was reported in 83.1% of first implants, secondary prevention in 16.9% (cardiac arrest in 5.9%). A single-chamber ICD was used in 26.1% of first implants, dual-chamber ICD in 28.0% and biventricular ICD in 45.9%.The PM and ICD Registry appears fundamental for monitoring PM and ICD utilization on a large national scale with rigorous examination of demographics and clinical indications. The PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The use of CRT-PM regards a very limited number of patients. The ICD Registry documented a large use of prophylactic and biventricular ICD, reflecting a favorable adherence to trials and guidelines in clinical practice. In order to increase and optimize the cooperation of Italian implanting centers, online data entry (https://www.aiac.it/riprid) should be adopted at large scale.

Published
2021

13. Cardiac resynchronization therapy defibrillators in patient with permanent atrial fibrillation

Author

Rapacciolo, A, Iacopino, S, D-Onofrio, A, Curnis, A, Pisan, Ec, Biffi, M, Della Bella, P, Dello Russo, A, Caravati, F, Zanotto, G, Calvi, V, Rovaris, G, Senatore, G, Nicolis, D, Santamaria, M, Gianmaria, M, Maglia, G, Duca, A, Ammirati, G, Romano, Sa, Piacenti, M, Celentano, E, Bisignani, G, Vaccaro, P, Miracapillo, G, Bertini, M, Nigro, G, Giacopelli, D, Gargaro, A, and Bisceglia, C

Published
2021

18. Evaluation of Short-Term Pacing Effect to Predict Long-Term Response to Cardiac Resynchronization Therapy: The TRAJECTORIES Study

Author

Santarelli G., Severi S., Tomasi C., Corsi C., Ciccotelli R., Molon G., Zanon F., Corzani A., Rossillo A., Biffi M., Zanotto G., Lanzoni L., Santarelli G., Severi S., Tomasi C., Corsi C., Ciccotelli R., Molon G., Zanon F., Corzani A., Rossillo A., Biffi M., Zanotto G., and Lanzoni L.

Subjects
Cardiac Resynchronization Therapy
Abstract

Cardiac resynchronization therapy (CRT) is an effective treatment for chronic symptomatic systolic heart failure with cardiac dyssynchrony, but about 1/3 of patients do not respond favorably to the therapy. We hypothesized that acute modifications of the coronary sinus (CS) pacing cathode movements induced by biventricular pacing may be related to resynchronization process and consequently may carry predictive power on CRT response. A method for the 3D reconstruction of CS lead's pacing cathode trajectory (3DTJ) throughout a cardiac cycle showed that trajectory's geometry suddenly changed in responders (R) upon starting of biventricular pacing, becoming less eccentric and more multi-directional. Our multicenter observational study aimed at evaluating the clinical value of 3DTJ. Out of 119 patients enrolled, 50 have ended follow-up and have been analyzed. Concordance between 3DTJ metrics and response was 82% overall (41/50), 91% in R (31/34), 62% in NR (10/16). The proposed 3DTJ metric showed high sensitivity (91%) with specificity=62%; PPV=84%, NPV=77%. From our data, 3DTJ seems a promising tool to acutely predict CS pacing site-specific response to CRT. Its investigational use as an intra-operatory, real-time guidance for selecting LV pacing sites may open new opportunities for CRT patients' selection and therapy delivery.

Published
2019

20. The unmet needs of sudden cardiac death. The role of the wearable cardioverter defibrillator when the risk is transient or uncertain

Author

Guerra, F., Palmisano, P., Bisignani, G., Forleo, G., Landolina, M., Soldati, E., Stabile, G., Zanotto, G., Berisso, M. Z., Boriani, G., De Ponti, R., and Ricci, R. P.

Subjects
Health Services Needs and Demand, Wearable Electronic Devices, Sudden cardiac death, Death, Sudden, Cardiac, Electric Countershock, Uncertainty, Humans, Implantable cardioverter-defibrillator, Ventricular fibrillation, Ventricular tachycardia, Wearable cardioverter-defibrillator, Defibrillators, Implantable
Abstract

Sudden cardiac death is defined as a natural death due to termination of cardiac activity associated with loss of consciousness, spontaneous breathing and circulation. Nowadays, the prevention of sudden cardiac death represents a major issue and many areas of uncertainty are not met by current evidences. Among those, reliable tools for risk stratification are still lacking, as well as solution for patients in which the risk of sudden cardiac death is due to a transient or correctable condition.The concept of the wearable cardioverter defibrillator is based on a potential solution for such grey areas. It merges long-term monitoring capabilities, shockable rhythm discrimination and shock delivery without the need for bystander assistance or invasive procedures. The present review aims to summarize current problems in dealing with this insidious condition, and to discuss potential options for patients in whom sudden cardiac death could be prevented more safely and cost-effectively.

Published
2020

21. Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Palmisano, P., Guerra, F., Bertini, M., Zanotto, G., Lavalle, C., Notarstefano, P., Accogli, M., Bisignani, G., Forleo, G. B., Landolina, M., D'Onofrio, A., Ricci, R., De Ponti, R., Luise, R., Grieco, P., Pangallo, A., Quirino, G., Talarico, A., De Bonis, S., Carbone, A., De Simone, A., Nappi, F., Rotondi, F., Stabile, G., Uran, C., Balla, C., Boggian, G., Carinci, V., Barbato, G., Corzani, A., Sabbatani, P., Erminio, M., Imberti, J. F., Malavasi, N., Pastori, P., Quartieri, F., Bottoni, N., Saporito, D., Virzi, S., Sassone, B., Zardini, M., Placci, A., Ziacchi, M., Massaro, G., Adamo, F., Scaccia, A., Spampinato, A., Biscione, F., Castro, A., Cauti, F., Rossi, P., Cinti, C., Gatto, M., Kol, A., Narducci, M. L., Pelargonio, G., Patruno, N., Pignalberi, C., Ricci, R. P., Ricciardi, D., Santini, L., Tancredi, M., Di Belardino, N., Pentimalli, F., Zoni-Berisso, M., Belotti, G., Chieffo, E., Cilloni, S., Doni, L. A., Gardini, A., Malaspina, D., Mazzone, P., Della Bella, P., Negro, R., Perego, G. B., Rordorf, R., Cipolletta, L., Russo, A. D., Luzi, M., Amellone, C., Ebrille, E., Favro, E., Lucciola, M. T., Devecchi, C., Rametta, F., Devecchi, F., Matta, M., Sant'Andrea, A. O., Santagostino, M., Dell'Era, G., Candida, T. R., Bonfantino, V. M., Gianfrancesco, D., Guido, A., Pellegrino, P. L., Pisano, E. C. L., Rillo, M., Palama, Z., Sai, R., Santobuono, V. E., Favale, S., Scicchitano, P., Nissardi, V., Campisi, G., Sgarito, G., Arena, G., Casorelli, E., Fumagalli, S., Giaccardi, M., Nesti, M., Padeletti, M., Rossi, A., Piacenti, M., Del Greco, M., Catanzariti, D., Manfrin, M., Werner, R., Marini, M., Andreoli, C., Fedeli, F., Mazza, A., Pagnotta, F., Ridarelli, M., Molon, G., and Rossillo, A.

Subjects
Male, Cardiac pacing, 030204 cardiovascular system & hematology, Ablation, Cardiac Resynchronization Therapy, 0302 clinical medicine, Surveys and Questionnaires, Health care, Pandemic, Registries, 030212 general & internal medicine, Acute management, Secondary prevention, Atrial fibrillation, Arrhythmia, COVID-19, Emergency, Implantable cardioverter defibrillators, Pacemakers, Remote monitoring, Middle Aged, Electrophysiology, Italy, Emergency Medicine, Female, Coronavirus Infections, Adult, medicine.medical_specialty, Atrial fbrillation, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Implantable cardioverter defbrillators, NO, 03 medical and health sciences, Physicians, medicine, Internal Medicine, Humans, Pandemics, Ablation, Arrhythmia, Atrial fbrillation, Emergency, Implantable cardioverter defbrillators, Pacemakers, Remote monitoring, COVID-19, Aged, business.industry, Outbreak, Arrhythmias, Cardiac, medicine.disease, Im - Original, Emergency medicine, business
Abstract

COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March–April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy. Electronic supplementary material The online version of this article (10.1007/s11739-020-02487-w) contains supplementary material, which is available to authorized users.

Published
2020

26. P531Cardiac resynchronization therapy in patients with permanent atrial fibrillation: insights from the HMEA database

Author

Rapacciuolo, A, primary, Solimene, F, additional, Iacopino, S, additional, D"onofrio, A, additional, Pisano", E, additional, Zanotto, G, additional, Curnis, A, additional, Capucci, A, additional, Senatore, G, additional, Pignalberi, C, additional, Maglia, G, additional, Santamaria, M, additional, Giacopelli, D, additional, Gargaro, A, additional, and Della Bella, P, additional

Published
2020
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27. 853Could baseline electrical parameters be a marker of arrhythmia occurrence and poorer prognosis in implantable cardioverter defibrillator patients?

Author

Zecchin, M, primary, Solimene, F, additional, D"onofrio, A, additional, Zanotto, G, additional, Iacopino, S, additional, Pignalberi, C, additional, Calvi, V, additional, Maglia, G, additional, Della Bella, P, additional, Quartieri, F, additional, Curnis, A, additional, Biffi, M, additional, Giacopelli, D, additional, Gargaro, A, additional, and Pisano", E, additional

Published
2020
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30. Italian Ablation Register 2017. Italian Association of Arrhythmology and Cardiostimulation

Author

Stabile, G., Bertaglia, E., Guerra, F., Palmisano, P., Berisso, M. Z., Soldati, E., Bisignani, G., Forleo, G. B., Zanotto, G., Landolina, M., De Ponti, R., Boriani, G., and Ricci, R. P.

Subjects
Registry, Italy, Medical, Arrhythmias, Catheter ablation, Arrhythmias, Cardiac, Cardiology, Catheter Ablation, Electrophysiologic Techniques, Cardiac, Humans, Retrospective Studies, Societies, Medical, Registries, Electrophysiologic Techniques, Societies, Cardiac
Published
2019

31. P6556Prevention of long-lasting atrial fibrillation through device therapy in dual-chamber pacemakers: analysis on 1384 patients of the role of Reactive ATP and atrial preventive pacing

Author

Boriani, G, primary, Pieragnoli, P, additional, Botto, G L, additional, Gulizia, M, additional, Landolina, M, additional, Ricci, R, additional, Proclemer, A, additional, Ziacchi, M, additional, Zanotto, G, additional, Ricciardi, G, additional, Facchin, D, additional, Comisso, J, additional, Grammatico, A, additional, and Biffi, M, additional

Published
2019
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32. P2592Combining home monitoring temporal trends and baseline patient risk profile for predicting impending heart failure hospitalizations. Results from the SELENE HF (BIO.Detect HF IV) study

Author

D'Onofrio, A, primary, Solimene, F, additional, Calo', L, additional, Calvi, V, additional, Viscusi, M, additional, Melissano, D, additional, Russo, V A, additional, Rapacciuolo, A, additional, Campana, A, additional, Bonfanti, P, additional, Caravati, F, additional, Zanotto, G, additional, Gronda, E, additional, Gargaro, A, additional, and Padeletti, L, additional

Published
2019
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33. 5045The effect of adaptive cardiac resynchronization therapy in reducing atrial fibrillation in heart failure patients: insights from multicenter observational experience

Author

Boriani, G, primary, Biffi, M, additional, Proclemer, A, additional, Iacopino, S, additional, Talarico, A, additional, Infusino, T, additional, Pisano, E, additional, Zanotto, G, additional, Vado, A, additional, Lamberti, F, additional, Zaca, V, additional, and Capucci, A, additional

Published
2018
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34. 1355Real-world observational data confirm the efficacy of atrial antitachycardia pacing in terminating slow and regular atrial tachyarrhythmias in patients wearing implantable cardiac electronic devices

Author

Boriani, G, primary, Iacopino, S, additional, De Rosa, F, additional, Proclemer, A, additional, Infusino, T, additional, Biffi, M, additional, Capucci, A, additional, Pisano, E, additional, Zanotto, G, additional, Tarricone, D, additional, Marras, E, additional, and Zaca, V, additional

Published
2018
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35. P5744Long-term response prediction to cardiac resynchronization therapy by acute pacing-induced changes in 3D trajectory of pacing cathode pole in coronary sinus: preliminary results of TRAJECTORIES study

Author

Tomasi, C, primary, Molon, G, additional, Marcantoni, L, additional, Zanon, F, additional, Corzani, A, additional, Rossillo, A, additional, Biffi, M, additional, Zanotto, G, additional, Severi, S, additional, Lanzoni, L, additional, and Corsi, C, additional

Published
2018
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39. 531The effect of Adaptive Cardiac Resynchronization Therapy in reducing atrial fibrillation in heart failure patients: insights from multicenter observational experience

Author

Proclemer, A, primary, Boriani, G, additional, Iacopino, S, additional, Talarico, A, additional, Biffi, M, additional, Capucci, A, additional, Infusino, T, additional, Pisano', E, additional, Zanotto, G, additional, Vado, A, additional, Lamberti, F, additional, Zaca', V, additional, and Padeletti, L, additional

Published
2018
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40. 741Procedural outcomes of pulmonary vein isolation with the pvac gold ablation catheter: results from the prospective multicenter gold af registry

Author

Boersma, L V A, primary, Kozluk, E, additional, Maglia, G, additional, De Sousa, J, additional, Grebe, O, additional, Eckhardt, L, additional, Park, H, additional, Rovaris, G, additional, Arribas, F, additional, Arenal, A, additional, Lorenzi, F, additional, Zanotto, G, additional, Czanady, Z, additional, Dupuis, J M, additional, and Goette, A, additional

Published
2018
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42. P894Real-world observational data confirm the efficacy of atrial antitachycardia pacing in terminating slow and regular atrial tachyarrhythmias in patients wearing implantable cardiac electronic devices

Author

Boriani, G, primary, Iacopino, S, additional, De Rosa, F, additional, Facchin, D, additional, Infusino, T, additional, Biffi, M, additional, Capucci, A, additional, Pisano', E, additional, Zanotto, G, additional, Tarricone, D, additional, Marras, E, additional, Zaca', V, additional, Vado, A, additional, and Padeletti, L, additional

Published
2018
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50. Impact of mitral regurgitation on the outcome of patients treated with CRT-D: Data from the InSync ICD Italian registry

Author

Giuseppe, Boriani, M. D., H. D., P, Maurizio, Gasparini, † MAURIZIO LANDOLINA, ‡ MAURIZIO LUNATI, MAURO BIFFI, Massimo, Santini, LUIGI PADELETTI, Giulio, Molon, †† GIANLUCA BOTTO, ‡‡ TIZIANA DE SANTO, B. S., and SERGIO VALSECCHI, Gasparini, M., Galimberti, P., Regoli, F., Ceriotti, C., Istituto Clinico Humanitas, Rozzano-, Milano, Lunati, M., Cattafi, G., Magenta, G., Paolucci, M., Vecchi, R., Niguarda, Hospital, Milano, Santini, M., Ricci, R., San Filippo Neri, Roma, Gaita, F., Bocchiardo, M., Didonna, P., Caponi, D., Civile, Hospital, Asti, Tavazzi, L., Landolina, M., Rordorf, R., Petracci, B., Vicentini, A., Savastano, S., Matteo, Pol. S., Pavia, Padeletti, L., Pieragnoli, P., Careggi, Firenze, Vincenti, A., Deceglia, S., Cir ` o, A., Gerardo Dei Tintori, S., Monza(MI), Curnis, A., Mascioli, G., Spedali, Civili, Brescia, Puglisi, A., Bianchi, S., Peraldo, C., Fatebenefratelli, Roma, Sassara, M., Achilli, A., Turreni, F., Rossi, P., Belcolle, Hospital, Viterbo, Perego, Gb., Luca Auxologico, S., Ravazzi, P. A., Diotallevi, P., Antonio e Biagio, Ss., Alessandria, Tritto, M., Mater, Domini, Castellanza, (VA), Carboni, A., Ardissino, D., Gonzi, G., Serra, V., Civile, Parma, Vergara, G., Maria Del Carmine, S., Rovereto, (TN), Boriani, G., Biffi, M., Martignani, C., Diemberger, I., Orsola-Mailpighi, S., Bologna, Luzzi, G., Policlinico, Bari, Laurenzi, F., Camillo, S., Pistis, G., Mauriziano, Torino, Cesario, A., Grassi, G. B., Ostia, (RM), Zanotto, G., Civile, Verona, Orazi, S., Rieti, Ometto, R., Bonanno, C., Bortolo, S., Vicenza, Molon, G., Barbieri, E., Cuore, S., Negrar, (VR), Raviele, A., Gasparini, G., Umbertoi, Mestre, (VE), Botto, G., Luzi, M., Sagone, A., Anna, S., Como, Vado, A., Croce, S., Cuneo, Montenero, A., Multimedica, Giovanni (MI), Sestos., Inama, G., Maggiore, Crema, Sassone, B., Civile, Bentivoglio, (BO), Briedda, M., Zardo, F., Maria, S., Pordenone, E. Bertaglia, Mirano (VE), Proclemer, A., Udine, Zanon, F., Civile, Rovigo, Disertori, M., Gramegna, L., Delgreco, M., Dallafior, D., Chiara, S., Trento, Tomasi, C., Maresta, A., Piancastelli, M., Maria Croci, S., Ravenna, Bridda, A., Martino, S., Belluno, Mantovan, R., C`afoncello, Treviso, Fusco, A., Pederzoli, Peschiera, (VR), Baraldi, P., Agostino, S., Modena, G. Lonardi, Legnago (VR), Rahue, W., Maurizio, S., Bolzano, P. Delise, Conegliano (TV), Menozzi, C., Marianuova, S., Reggioemilia, Babudri, P., Borgoroma, Verona, Marconi, R., Mazzoni, Ascolipiceno, Alfano, G. DeFabrizio F., Moscati, G., Avellino, Barbato, G., Maggiore, Bologna, P. Gelmini, Desenzano (BS), Disabato, Leopoldo, S., Merate, (LC), Ricci, S., Ramazzini, Carpi, (MO), Aulerio, M. D., Biagio, S., Domodossola, (VB), Morgagni, G. L., Latini, R., Macerata, Bardelli, G., Fornaroli, Magenta, (MI), R. Paulichl, F. Tappeiner Merano (BZ), Bernasconi, M., Marzegalli, M., Carlo, S., Neri, G., Montebelluna, Treviso, E. Occhetta, Novara, Bocconcelli, P., Salvatore, S., Pesaro, A. Capucci, Piacenza, Campana, A., Giovanni, S., Salerno, N. Dibelardino, Velletri (RM), Vaglio, A., Giovanni, e Paolo, Venezi, A., Boriani G, Gasparini M, Landolina M, Lunati M, Biffi M, Santini M, Padeletti L, Molon G, Botto G, de Santo T, Valsecchi S, and InSync/InSync ICD Italian Registry Investigators.

Subjects
Male, Mitral Valve Insufficiency, Socio-culturale, heart failure, Comorbidity, CARDIAC RESYNCHRONIZATION THERAPY, mitral regurgitation, Risk Assessment, Survival Analysis, Survival Rate, Treatment Outcome, Italy, Risk Factors, Prevalence, Humans, Female, Registries, Aged
Abstract

We assessed the influence of clinically significant mitral regurgitation (MR) on clinical-echocardiographic response and outcome in heart failure (HF) patients treated with a biventricular defibrillator (cardiac resynchronization therapy defibrillator [CRT-D]). METHODS AND RESULTS: A total of 659 HF patients underwent successful implantation of CRT-D and were enrolled in a multicenter prospective registry (median follow-up of 15 months). Following baseline echocardiographic evaluation, patients were stratified into two groups according to the severity of MR: 232 patients with more than mild MR (Group MR+: grade 2, 3, and 4 MR) versus 427 patients with mild (grade 1) or no functional MR (Group MR-). On 6- and 12-month echocardiographic evaluation, MR was seen to have improved in the vast majority of MR+ patients, while it remained unchanged in most MR- patients. On 12-month follow-up evaluation, a comparable response to CRT was observed in the two groups, in terms of the extent of left ventricular reverse remodeling and combined clinical and echocardiographic response. During long-term follow-up, event-free survival did not differ between MR+ and MR- patients, even when subpopulations of patients with ischemic heart disease and with dilated cardiomyopathy were analyzed separately. On multivariate analysis, the only independent predictor of death from any cause was the lack of β-blocker use. CONCLUSIONS: This observational analysis supports the use of CRT-D in HF patients with clinically significant MR; MR had no major influence on patient outcome.

Published
2012

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