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1. Epidemiology of atrial fibrillation: European perspective

Author

Zoni-Berisso M, Lercari F, Carazza T, and Domenicucci S

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Massimo Zoni-Berisso, Fabrizio Lercari, Tiziana Carazza, Stefano DomenicucciDepartment of Cardiology, ASL 3, Padre A Micone Hospital, Genoa, ItalyAbstract: In the last 20 years, atrial fibrillation (AF) has become one of the most important public health problems and a significant cause of increasing health care costs in western countries. The prevalence of AF is increasing due to our greater ability to treat chronic cardiac and noncardiac diseases, and the improved ability to suspect and diagnose AF. At the present time, the prevalence of AF (2%) is double that reported in the last decade. The prevalence of AF varies with age and sex. AF is present in 0.12%–0.16% of those younger than 49 years, in 3.7%–4.2% of those aged 60–70 years, and in 10%–17% of those aged 80 years or older. In addition, it occurs more frequently in males, with a male to female ratio of 1.2:1. The incidence of AF ranges between 0.21 and 0.41 per 1,000 person/years. Permanent AF occurs in approximately 50% of patients, and paroxysmal and persistent AF in 25% each. AF is frequently associated with cardiac disease and comorbidities. The most common concomitant diseases are coronary artery disease, valvular heart disease, and cardiomyopathy. The most common comorbidities are hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, renal failure, stroke, and cognitive disturbance. Paroxysmal AF occurs in younger patients and with a reduced burden of both cardiac disease and comorbidities. Generally, the history of AF is long, burdened by frequent recurrences, and associated with symptoms (in two thirds of patients). Patients with AF have a five-fold and two-fold higher risk of stroke and death, respectively. We estimate that the number of patients with AF in 2030 in Europe will be 14–17 million and the number of new cases of AF per year at 120,000–215,000. Given that AF is associated with significant morbidity and mortality, this increasing number of individuals with AF will have major public health implications.Keywords: atrial fibrillation, epidemiology, risk factors, mortality, stroke

Published
2014

5. 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

6. P5238Rate, cause and costs of Heart Failure hospitalizations following ICD/CRT-D replacement: preliminary data from an Italian multicenter registry

Author

Zaca', V, primary, Narducci, M L, additional, Parisi, Q, additional, Quartieri, F, additional, Zanon, F, additional, Zoni Berisso, M, additional, Saporito, D, additional, Notarstefano, P, additional, Miracapillo, G, additional, Ferretti, C, additional, Calo', L, additional, Del Rosso, A, additional, Carinci, V, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2019
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7. Appropriate implantable cardioverter-defibrillator interventions in cardiac resynchronization therapy-defibrillator (CRT-D) patients undergoing device replacement: time to downgrade from CRT-D to CRT-pacemaker? Insights from real-world clinical practice in the DECODE CRT-D analysis

Author

Narducci, Ml, Biffi, M, Ammendola, E, Vado, A, Campana, A, Potenza, Dr, Iori, M, Zanon, F, Zacà, V, Zoni Berisso, M, Bertini, M, Lissoni, F, Bandini, A, Malacrida, M, Crea, F, Narducci ML, Crea F (ORCID:0000-0001-9404-8846), Narducci, Ml, Biffi, M, Ammendola, E, Vado, A, Campana, A, Potenza, Dr, Iori, M, Zanon, F, Zacà, V, Zoni Berisso, M, Bertini, M, Lissoni, F, Bandini, A, Malacrida, M, Crea, F, Narducci ML, and Crea F (ORCID:0000-0001-9404-8846)

Abstract

AIM: Ventricular tachycardia (VT)/ventricular fibrillation (VF) occurrence after cardiac resynchronization therapy-defibrillator (CRT-D) replacement is unknown; hence, there is no practical guideline to recommend either CRT-D or CRT-pacemaker at the time of device replacement. We observed the 1-year VT/VF occurrence after CRT-D replacement in a subanalysis of the Detect Long-term Complications after ICD Replacement (DECODE) registry. METHODS AND RESULTS: A total of 332 consecutive patients who had undergone CRT-D replacement from 2013 to 2015 were enrolled in 36 Italian centres. The primary endpoint was the number of patients with any appropriate implantable cardioverter-defibrillator (ICD) interventions during 12-month follow-up. The secondary endpoint comprised death from any cause and appropriate ICD interventions. At replacement, 214 (64.5%) patients had a left ventricular ejection fraction ≤ 35% and 138 (41.6%) patients had a secondary prevention indication for ICD. Seventy (21.1%) patients had no longer indication to ICD therapy. During a median follow-up period of 406.5 (362-533) days, VT/VF requiring therapy delivery occurred in 57 (17%) patients, specifically in 7% of those who no longer had an ICD indication. On multivariate analysis, number of criteria for ICD replacement independently predicted appropriate ICD intervention during follow-up [hazard ratio (HR) = 1.62, 95% confidence interval (CI) 1.07-2.46; log-rank P = 0.02]. The combined endpoint of death from any cause or appropriate ICD therapy occurred in 76 (23%) patients. Only NYHA class remained associated with this combined endpoint (HR = 1.97, 95% CI 1.23-3.14; P = 0.005). CONCLUSIONS: The DECODE registry showed the 'real-world' experience of CRT-D recipients approaching device replacement, in which 7% of patients who no longer had an indication for ICD therapy experienced appropriate ICD interventions.

Published
2018

8. 5305Heart failure-related hospitalizations in ICD/CRT-D recipients following device replacement or upgrade: insights from the DECODE registry

Author

Zaca', V, primary, Narducci, M L, additional, Nigro, G, additional, Menardi, E, additional, Zanon, F, additional, Zoni Berisso, M, additional, Bertini, M, additional, Lissoni, F, additional, Calzolari, V, additional, Bandini, A, additional, Tomasi, C, additional, Carinci, V, additional, Ferretti, C, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2018
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9. P3158Health care consumption after ICD/CRT-D replacement: preliminary results from the DECODE registry

Author

Zaca', V, primary, Menardi, E, additional, Zanon, F, additional, Ammendola, E, additional, Narducci, M L, additional, Giofre', F, additional, Zoni Berisso, M, additional, Bertini, M, additional, Tomasi, C, additional, Lissoni, F, additional, Pierantozzi, A, additional, Zingarini, G, additional, Carinci, V, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2018
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10. P441Heart Failure-related hospitalizations among patients with ICD/CRTD after device replacement or upgrade

Author

Narducci, M, primary, Nigro, G, additional, Menardi, E, additional, Zanon, F, additional, Bandini, A, additional, Quartieri, F, additional, Zoni Berisso, M, additional, Saporito, D, additional, Zaca', V, additional, Notarstefano, P, additional, Miracapillo, G, additional, Ferretti, C, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2018
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11. P914Health Care Consumption after ICD/CRT-D replacement: preliminary results from the DECODE registry

Author

Menardi, E, primary, Zanon, F, additional, Ammendola, E, additional, Narducci, M L, additional, Giofre', F, additional, Zoni Berisso, M, additional, Bertini, M, additional, Tomasi, C, additional, Lissoni, F, additional, Pierantozzi, A, additional, Zingarini, G, additional, Carinci, V, additional, Merlotti, G, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2018
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12. 59Manufacturer change and risk of system-related complications after ICD replacement: data from the DECODE registry

Author

Biffi, M., primary, Menardi, E., additional, Campana, A., additional, Iori, M., additional, De Filippo, P., additional, Narducci, ML., additional, Ferretti, C., additional, Saporito, D., additional, Zoni Berisso, M., additional, Licciardello, G., additional, Sabbatani, P., additional, Del Rosso, A., additional, Bonfantino, V., additional, Malacrida, M., additional, and Parisi, Q., additional

Published
2017
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13. P1069Mortality after ICD replacement: 2 years data from the DECODE registry

Author

De Filippo, P., primary, Nigro, G., additional, Menardi, E., additional, Parisi, Q., additional, Narducci, ML., additional, Zoni Berisso, M., additional, Zanon, F., additional, Potenza, D., additional, Iori, M., additional, Zaca', V., additional, Tomasi, C., additional, Bertini, M., additional, Lissoni, F., additional, Malacrida, M., additional, and Biffi, M., additional

Published
2017
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14. Considerazioni sulle raccomandazioni delle linee guida all’impianto del cardioverter-defibrillatore per la prevenzione primaria della morte cardiaca improvvisa nei pazienti con grave disfunzione ventricolare. Documento di Consenso dell’Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)/Società Italiana di Cardiologia (SIC)/Associazione Italiana di Aritmologia e Cardiostimolazione (AIAC)

Author

ZONI BERISSO, M, Bongiorni, Mg, Curnis, A, Calvi, V, Catanzariti, D, Gaita, F, Gulizia, Mm, Inama, G, Landolina, Me, LA ROVERE MT, Mantovan, R, Mascioli, G, Occhetta, E, Padeletti, L, SALERNO URIARTE JA, Santini, M, Sassone, B, Senni, M, and Zecchin, M

Subjects
Guidelines, Heart failure, Implantable cardioverter-defibrillators
Published
2013

15. Remarks on the guidelines recommendation for cardioverter-defibrillator implatation for primary prevention of sudden cardiac death in patients wirh severe ventricular dysfunction. Consensus document of ANMCO, SIC and AIAC

Author

Zoni Berisso, M, Bongiorni, Mg, Curnis, A, Calvi, V, Catanzariti, D, Gaita, F, Gulizia, Mm, Inama, G, Landolina, Me, La Rovere MT, Mantovani, R, Mascioli, G, Occhetta, E, Padeletti, L, SALERNO URIARTE, JORGE ANTONIO, Santini, M, Sassone, B, Senni, M, and Zecchin, M.

Published
2013

17. The cost of atrial fibrillation in Italy: a five-year analysis of healthcare expenditure in the general population. From the Italian Survey of Atrial Fibrillation Management (ISAF) study.

Author

ZONI BERISSO, M., LANDOLINA, M., ERMINI, G., PARRETTI, D., ZINGARINI, G. L., DEGLI ESPOSTI, L., CRICELLI, C., and BORIANI, G.

Abstract

OBJECTIVE: Atrial fibrillation (AF) is a relevant item of expenditure for the National Healthcare systems. The aim of the study was to estimate the annual costs of AF in Italy. PATIENTS AND METHODS: The Italian Survey of Atrial Fibrillation Management Study enrolled 6.036 patients with AF among 295.906 subjects representative of the Italian population. Data were collected by 233 General Practitioners (GPs) distributed across Italy. Quantities of resources used during the 5 years preceding the ISAF screening were inferred from the survey data and multiplied by the current Italian unit costs of 2015 in order to estimate the mean per patient annual cumulative cost of AF. Patients were subdivided on the basis of the number of hospitalizations, invasive/non-invasive diagnostic tests and invasive therapeutic procedures in 3 different clinical subsets: “low cost”, “ medium cost” and “high cost clinical scenario”. RESULTS: The estimated mean costs per patient per year were 613 €, 891 € and 1213 € for the “Low cost”, “Medium cost” and “High Cost Clinical Scenario” respectively. Hospitalizations and inpatient interventional procedures accounted for more than 80% of the cumulative annual costs. The mean annual costs among patients pursuing “Rhythm control” strategy was 956 €. CONCLUSIONS: In Italy, the estimated costs of AF per patient per year are lower than those reported in other developed countries and vary widely related to the different characteristics of AF patients. Hospitalizations and interventional procedures are the main drivers of costs. The mean annual cost of AF is mainly influenced by the duration of the period of observation and the patients’ characteristics. Measures to reduce hospitalizations are needed. [ABSTRACT FROM AUTHOR]

Published
2017

20. Poster Session 3

Author

Fabbri, G. M. T., primary, Baldasseroni, S., additional, Panuccio, D., additional, Zoni Berisso, M., additional, Scherillo, M., additional, Lucci, D., additional, Di Pasquale, G., additional, Mathieu, G., additional, Burazor, I., additional, Burazor, M., additional, Perisic, Z., additional, Atanaskovic, V., additional, Erakovic, V., additional, Stojkovic, A., additional, Vogtmann, T., additional, Schoebel, C., additional, Sogorski, S., additional, Sebert, M., additional, Schaarschmidt, J., additional, Fietze, I., additional, Baumann, G., additional, Penzel, T., additional, Mornos, C., additional, Ionac, A., additional, Cozma, D., additional, Dragulescu, D., additional, Mornos, A., additional, Petrescu, L., additional, Pescariu, L., additional, Brembilla-Perrot, B., additional, Khachab, H., additional, Lamberti, F., additional, Bellini, C., additional, Remoli, R., additional, Cogliandro, T., additional, Nardo, R., additional, Bellusci, F., additional, Mazzuca, V., additional, Gaspardone, A., additional, Aguinaga Arrascue, L. E., additional, Bravo, A., additional, Garcia Freire, P., additional, Gallardo, P., additional, Hasbani, E., additional, Quintana, R., additional, Dantur, J., additional, Inoue, K., additional, Ueoka, A., additional, Tsubakimoto, Y., additional, Sakatani, T., additional, Matsuo, A., additional, Fujita, H., additional, Kitamura, M., additional, Wegrzynowska, M., additional, Konduracka, E., additional, Pietrucha, A. Z., additional, Mroczek-Czernecka, D., additional, Paradowski, A., additional, Bzukala, I., additional, Nessler, J., additional, Igawa, O., additional, Adachi, M., additional, Atarashi, H., additional, Kusama, Y., additional, Kodani, E., additional, Okazaki, R., additional, Nakagomi, A., additional, Endoh, Y., additional, Baez-Escudero, J. L., additional, Dave, A. S., additional, Sasaridis, C. M., additional, Valderrabano, M., additional, Tilz, R., additional, Bai, R., additional, Di Biase, L., additional, Gallinghouse, G. J., additional, Gibson, D., additional, Pisapia, A., additional, Wazni, O., additional, Natale, A., additional, Arujuna, A., additional, Karim, R., additional, Rinaldi, A., additional, Cooklin, M., additional, Rhode, K., additional, Razavi, R., additional, O'neill, M., additional, Gill, J., additional, Kusa, S., additional, Komatsu, Y., additional, Kakita, K., additional, Takayama, K., additional, Taniguchi, H., additional, Otomo, K., additional, Iesaka, Y., additional, Ammar, S., additional, Reents, T., additional, Fichtner, S., additional, Wu, J., additional, Zhu, P., additional, Kolb, C., additional, Hessling, G., additional, Deisenhofer, I., additional, Gilbert, G., additional, Mohanty, P., additional, Cunningham, J., additional, Metz, T., additional, Horton, R., additional, Tao, S., additional, Yamauchi, Y., additional, Okada, H., additional, Maeda, S., additional, Obayashi, T., additional, Isobe, M., additional, Chan, J., additional, Johar, S., additional, Wong, T., additional, Markides, V., additional, Hussain, W., additional, Konstantinidou, M., additional, Wissner, E., additional, Fuernkranz, A., additional, Yoshiga, Y., additional, Metzner, A., additional, Kuck, K.- H., additional, Ouyang, F., additional, Kettering, K., additional, Gramley, F., additional, Mollnau, H., additional, Weiss, C., additional, Bardeleben, S., additional, Biasco, L., additional, Scaglione, M., additional, Caponi, D., additional, Di Donna, P., additional, Sergi, D., additional, Cerrato, N., additional, Blandino, A., additional, Gaita, F., additional, Fiala, M., additional, Wichterle, D., additional, Sknouril, L., additional, Bulkova, V., additional, Chovancik, J., additional, Nevralova, R., additional, Pindor, J., additional, Januska, J., additional, Choi, J. I., additional, Ban, J. E., additional, Yasutsugu, N., additional, Park, J. S., additional, Jung, J. S., additional, Lim, H. E., additional, Park, S. W., additional, Kim, Y. H., additional, Kuhne, M., additional, Reichlin, T., additional, Ammann, P., additional, Schaer, B., additional, Osswald, S., additional, Sticherling, C., additional, Ohe, M., additional, Goya, M., additional, Hiroshima, K., additional, Hayashi, K., additional, Makihara, Y., additional, Nagashima, M., additional, Fukunaga, M., additional, An, Y., additional, Dorwarth, U., additional, Schmidt, M., additional, Wankerl, M., additional, Krieg, J., additional, Straube, F., additional, Hoffmann, E., additional, Kathan, S., additional, Defaye, P., additional, Mbaye, A., additional, Cassagneau, R., additional, Gagniere, V., additional, Jacon, P., additional, Pokushalov, E., additional, Romanov, A., additional, Artemenko, S., additional, Shabanov, V., additional, Elesin, D., additional, Stenin, I., additional, Turov, A., additional, Losik, D., additional, Kondo, K., additional, Miake, J., additional, Yano, A., additional, Ogura, K., additional, Kato, M., additional, Shigemasa, C., additional, Sekiguchi, Y., additional, Tada, H., additional, Yoshida, K., additional, Naruse, Y., additional, Yamasaki, H., additional, Igarashi, M., additional, Machino, T., additional, Aonuma, K., additional, Chen, S., additional, Liu, S., additional, Chen, G., additional, Meng, W., additional, Zhang, F., additional, Yan, Y., additional, Sciarra, L., additional, Dottori, S., additional, Lanzillo, C., additional, De Ruvo, E., additional, De Luca, L., additional, Minati, M., additional, Lioy, E., additional, Calo', L., additional, Lin, J., additional, Nie, Z., additional, Zhu, M., additional, Wang, X., additional, Zhao, J., additional, Hu, W., additional, Tao, H., additional, Ge, J., additional, Johansson, B., additional, Houltz, B., additional, Edvardsson, N., additional, Schersten, H., additional, Karlsson, T., additional, Wandt, B., additional, Berglin, E., additional, Hoyt, R. H., additional, Jenson, B. P., additional, Trines, S. A. I. P., additional, Braun, J., additional, Tjon Joek Tjien, A., additional, Zeppenfeld, K., additional, Tavilla, G., additional, Klautz, R. J. M., additional, Schalij, M. J., additional, Krausova, R., additional, Cihak, R., additional, Peichl, P., additional, Kautzner, J., additional, Pirk, J., additional, Skalsky, I., additional, Maly, J., additional, Imai, K., additional, Sueda, T., additional, Orihashi, K., additional, Picarra, B. C., additional, Santos, A. R., additional, Dionisio, P., additional, Semedo, P., additional, Matos, R., additional, Leitao, M., additional, Banha, M., additional, Trinca, M., additional, Elder, D. H. J., additional, George, J., additional, Jain, R., additional, Lang, C. C., additional, Choy, A. M., additional, Konert, M., additional, Loescher, S., additional, Hartmann, A., additional, Aversa, E., additional, Chirife, R., additional, Sztyglic, E., additional, Mazzetti, H., additional, Mascheroni, O., additional, Tentori, M. C., additional, Pop, R. M., additional, Margulescu, A. D., additional, Dulgheru, R., additional, Enescu, O., additional, Siliste, C., additional, Vinereanu, D., additional, Menezes Junior, A., additional, Castro Carneiro, A. R., additional, De Oliveira, B. L., additional, Shah, A. N., additional, Kantharia, B., additional, De Lucia, R., additional, Soldati, E., additional, Segreti, L., additional, Di Cori, A., additional, Zucchelli, G., additional, Viani, S., additional, Paperini, L., additional, Bongiorni, M. G., additional, Kutarski, A., additional, Czajkowski, M., additional, Pietura, R., additional, Malecka, B., additional, Heintze, J., additional, Eckardt, L., additional, Bauer, A., additional, Meine, M., additional, Van Erven, L., additional, Bloch Thomsen, P. E., additional, Lopez Chicharro, M. P., additional, Merhi, O., additional, Soga, Y., additional, Andou, K., additional, Nobuyoshi, M., additional, Gonzalez-Mansilla, A., additional, Martin-Asenjo, R., additional, Unzue, L., additional, Torres, J., additional, Garralda, E., additional, Coma, R. R., additional, Rodriguez Garcia, J. E., additional, Yaegashi, T., additional, Furusho, H., additional, Kato, T., additional, Chikata, A., additional, Takashima, S., additional, Usui, S., additional, Takamura, M., additional, Kaneko, S., additional, Chudzik, M., additional, Mitkowski, P., additional, Przybylski, A., additional, Lewek, J., additional, Smukowski, T., additional, Maciag, A., additional, Castrejon Castrejon, S., additional, Perez-Silva, A., additional, Estrada, A., additional, Doiny, D., additional, Ortega, M., additional, Lopez-Sendon, J. L., additional, Merino, J. L., additional, O'mahony, C., additional, Coats, C., additional, Cardona, M., additional, Garcia, A., additional, Calcagnino, M., additional, Lachmann, R., additional, Hughes, D., additional, Elliott, P. M., additional, Conti, S., additional, Pruiti, G. P., additional, Puzzangara, E., additional, Romano, S. A., additional, Di Grazia, A., additional, Ussia, G. P., additional, Tamburino, C., additional, Calvi, V., additional, Radinovic, A., additional, Sala, S., additional, Latib, A., additional, Mussardo, M., additional, Sora, S., additional, Paglino, G., additional, Gullace, M., additional, Colombo, A., additional, Ohlow, M.- A. G., additional, Lauer, B., additional, Wagner, A., additional, Schreiber, M., additional, Buchter, B., additional, Farah, A., additional, Fuhrmann, J. T., additional, Geller, J. C., additional, Nascimento Cardoso, R. M., additional, Batista Sa, L. A., additional, Campos Filho, L. F. C., additional, Rodrigues, S. V., additional, Dutra, M. V. F., additional, Borges, T. R. S. A., additional, Portilho, D. R., additional, Deering, T., additional, Bernardes, A., additional, Veiga, A., additional, Gartenlaub, O., additional, Goncalves, A., additional, Jimenez, A., additional, Rousseauplasse, A., additional, Deharo, J. 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H., additional, Hero, M., additional, Mizobuchi, M., additional, Enjoji, Y., additional, Yazaki, Y., additional, Shibata, K., additional, Funatsu, A., additional, Kobayashi, T., additional, Nakamura, S., additional, Amit, G., additional, Pertzov, B., additional, Zahger, D., additional, Medesani, L., additional, Rana, R., additional, Albano, F., additional, Fraguas, H., additional, Pedersen, S. S., additional, Hoogwegt, M. T., additional, Theuns, D. A. M. J., additional, Van Den Broek, K. C., additional, Tekle, F. B., additional, Habibovic, M., additional, Alings, M., additional, Van Der Voort, P., additional, Denollet, J., additional, Vrazic, H., additional, Jilek, C., additional, Lesevic, H., additional, Tzeis, S., additional, Semmler, V., additional, Gold, M. R., additional, Burke, M. C., additional, Bardy, G. H., additional, Varma, N., additional, Pavri, B., additional, Stambler, B., additional, Michalski, J., additional, Investigators, T. R. U. S. 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A., additional, Iitsuka, K., additional, Kondo, T., additional, Goebbert, K., additional, Karossiene, Z., additional, Goldman, D., additional, Kallen, B., additional, Kerpi, E., additional, Sardo, J., additional, Arsenos, P., additional, Gatzoulis, K., additional, Manis, G., additional, Dilaveris, P., additional, Tsiachris, D., additional, Mytas, D., additional, Asimakopoulos, S., additional, Stefanadis, C., additional, Sideris, S., additional, Kartsagoulis, E., additional, Barbosa, O., additional, Marocolo Junior, M., additional, Silva Cortes, R., additional, Moraes Brandolis, R. A., additional, Oliveira, L. F., additional, Pertili Rodrigues De Resende, L. A., additional, Vieira Da Silva, M. A., additional, Dias Da Silva, V. J., additional, Hegazy, R. A., additional, Sharaf, I. A., additional, Fadel, F., additional, Bazaraa, H., additional, Esam, R., additional, Deshko, M. S., additional, Snezhitsky, V. A., additional, Stempen, T. P., additional, Kuroki, K., additional, Igawa, M., additional, Kuga, K., additional, Ferreira Santos, L., additional, Dionisio, T., additional, Nunes, L., additional, Machado, J., additional, Castedo, S., additional, Henriques, C., additional, Matos, A., additional, Oliveira Santos, J., additional, Kraaier, K., additional, Olimulder, M. A. G. M., additional, Galjee, M. A., additional, Van Dessel, P. F. H. M., additional, Van Der Palen, J., additional, Wilde, A. A. M., additional, Scholten, M. F., additional, Chouchou, F., additional, Poupard, L., additional, Philippe, C., additional, Court-Fortune, I., additional, Barthelemy, J.- C., additional, Roche, F., additional, Dolgoshey, T. S., additional, Madekina, G. 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2011
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21. Poster Session 2

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Andersson, T., primary, Magnusson, A., additional, Bryngelsson, I.- L., additional, Frobert, O., additional, Henriksson, K. M., additional, Edvardsson, N., additional, Poci, D., additional, Polovina, M., additional, Potpara, T., additional, Licina, M., additional, Mujovic, N., additional, Kocijancic, A., additional, Simic, D., additional, Ostojic, M. C., additional, Providencia, R. A., additional, Botelho, A., additional, Trigo, J., additional, Nascimento, J., additional, Quintal, N., additional, Mota, P., additional, Leitao-Marques, A. M., additional, Bosch, R. F., additional, Kirch, W., additional, Rosin, L., additional, Willich, S. N., additional, Pittrow, D., additional, Bonnemeier, H., additional, Valenza, M. C., additional, Martin, L., additional, Munoz Casaubon, T., additional, Valenza, G., additional, Botella, M., additional, Serrano, M., additional, Valenza, B., additional, Cabrera, I., additional, Anderson, K., additional, Benzaquen, B. S., additional, Koziolova, N., additional, Nikonova, J., additional, Shilova, Y., additional, Scherr, D., additional, Narayan, S., additional, Wright, M., additional, Krummen, D., additional, Jadidi, A., additional, Jais, P., additional, Haissaguerre, M., additional, Hocini, M., additional, Hunter, R., additional, Liu, Y., additional, Lu, Y., additional, Wang, W., additional, Schilling, R. J., additional, Bernstein, S., additional, Wong, B., additional, Rooke, R., additional, Vasquez, C., additional, Shah, R., additional, Rosenberg, S., additional, Chinitz, L., additional, Morley, G., additional, Bashir Choudhary, M., additional, Holmqvist, F., additional, Carlson, J., additional, Nilsson, H.- J., additional, Platonov, P. G., additional, Jadidi, A. S., additional, Cochet, H., additional, Miyazaki, S., additional, Shah, A. J., additional, Marrouche, N., additional, Calvo, N., additional, Nadal, M., additional, Andreu, D., additional, Tamborero, D., additional, Diaz, F. E., additional, Berruezo, A., additional, Brugada, J., additional, Mont, L., additional, Fichtner, S., additional, Hessling, G., additional, Estner, H. L., additional, Jilek, C., additional, Reents, T., additional, Ammar, S., additional, Wu, J., additional, Deisenhofer, I., additional, Nakanishi, H., additional, Kashiwase, K., additional, Hirata, A., additional, Wada, M., additional, Ueda, Y., additional, Skoda, J., additional, Neuzil, P., additional, Popelova, J., additional, Petru, J., additional, Sediva, L., additional, Reddy, V. Y., additional, Uldry, L., additional, Forclaz, A., additional, Virag, N., additional, Vesin, J.- M., additional, Kappenberger, L., additional, Sehra, R., additional, Briggs, C., additional, Rappel, W.- J., additional, Janotka, M., additional, Chovanec, M., additional, Yamashiro, K., additional, Takami, K., additional, Sakamoto, Y., additional, Satoh, K., additional, Suzuki, T., additional, Nakagawa, H., additional, Romanov, A., additional, Pokushalov, E., additional, Artemenko, S., additional, Shabanov, V., additional, Stenin, I., additional, Elesin, D., additional, Turov, A., additional, Yakubov, A., additional, Hioki, M., additional, Matsuo, S., additional, Ito, K., additional, Narui, R., additional, Yamashita, S., additional, Sugimoto, K., additional, Yoshimura, M., additional, Yamane, T., additional, Di Biase, L., additional, Gallinghouse, J. 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S., additional, Di Mambro, C., additional, Ammirati, A., additional, Gimigliano, G., additional, Prosperi, M., additional, Drago, F., additional, Santos, A. R., additional, Picarra, B., additional, Semedo, P., additional, Dionisio, P., additional, Matos, R., additional, Leitao, M., additional, Jacinto, A., additional, Trinca, M., additional, Mazzone, P., additional, Ciconte, G., additional, Marzi, A., additional, Paglino, G., additional, Vergara, P., additional, Sora, N., additional, Gulletta, S., additional, Della Bella, P., additional, Koppitz, P., additional, Fach, A., additional, Hobbiesiefken, S., additional, Fiehn, E., additional, Hambrecht, R., additional, Sperzel, J., additional, Jung, M., additional, Schmitt, J., additional, Pajitnev, D., additional, Burger, H., additional, Goebel, G., additional, Ehrlich, W., additional, Walther, T., additional, Ziegelhoeffer, T., additional, Vancura, V., additional, Wichterle, D., additional, Melenovsky, V., additional, Glikson, M., additional, Goldenberg, G., additional, Segev, A., additional, Dvir, D., additional, Kuzniec, J., additional, Finkelstein, A., additional, Hay, I., additional, Guetta, V., additional, Choo, W. 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G., additional, Schimpf, R., additional, Borggrefe, M., additional, Luesebrink, U., additional, Gardiwal, A., additional, Oswald, H., additional, Koenig, T., additional, Duncker, D., additional, Klein, G., additional, Bastiaenen, R., additional, Batchvarov, V., additional, Atty, O., additional, Cheng, J. H., additional, Behr, E. R., additional, Gallagher, M. M., additional, Starrenburg, A. H., additional, Kraaier, K., additional, Scholten, M. F., additional, Van Der Palen, J., additional, Adhya, S., additional, Smith, L. A., additional, Zhao, T., additional, Bannister, C., additional, Kamdar, R. H., additional, Martinelli, M., additional, Siqueira, S., additional, Greco, R., additional, Nishioka, S. A. D., additional, Pedrosa, A. A. A., additional, Alkmim-Teixeira, R., additional, Peixoto, G. L., additional, Costa, R., additional, Nielsen, J. C., additional, Mortensen, P. T., additional, Johansen, J. B., additional, Kwasniewski, W., additional, Filipecki, A., additional, Urbanczyk-Swic, D., additional, Orszulak, W., additional, Trusz - Gluza, M., additional, Jimenez-Candil, J., additional, Morinigo, J., additional, Ledesma, C., additional, Martin-Luengo, C., additional, Vogtmann, T., additional, Gomer, M., additional, Stiller, S., additional, Kuehlkamp, V., additional, Zach, G., additional, Loescher, S., additional, Kespohl, S., additional, Baumann, G., additional, Snell, J. D., additional, Korsun, N., additional, Snell, J. R., additional, Morley, B., additional, Bharmi, R., additional, Nabutovsky, Y., additional, Mollerus, M., additional, Naslund, L., additional, Meyer, A., additional, Lipinski, M., additional, Libey, B., additional, Dornfeld, K., additional, Martin, A., additional, Gallego, M., additional, De Bie, M. K., additional, Van Rees, J. B., additional, Borleffs, C. J., additional, Thijssen, J., additional, Jukema, J. W., additional, Schalij, M. J., additional, Van Erven, L., additional, Van Der Velde, E. T., additional, Witteman, T. A., additional, Foeken, H., additional, Szili-Torok, T., additional, Akca, F., additional, Caliskan, K., additional, Ten Cate, F., additional, Michels, M., additional, Cozma, D. C., additional, Petrescu, L., additional, Mornos, C., additional, Dragulescu, S. I., additional, Groeneweg, J. A., additional, Velthuis, B. K., additional, Cox, M. G. P. J., additional, Loh, P., additional, Dooijes, D., additional, Cramer, M. J., additional, De Bakker, J. M. T., additional, Hauer, R. N. W., additional, Park, S. D., additional, Shin, S. H., additional, Woo, S. I., additional, Kwan, J., additional, Park, K. S., additional, Kim, D. H., additional, Iorio, A., additional, Vitali Serdoz, L., additional, Brun, F., additional, Daleffe, E., additional, Zecchin, M., additional, Dal Ferro, M., additional, Santangelo, S., additional, Sinagra, G. 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F., additional, Revishvili, A. S., additional, Simonyan, G., additional, Dzhordzhikiya, T., additional, Sopov, O., additional, Kalinin, V., additional, Locati, E. T., additional, Vecchi, A. M., additional, Cattafi, G., additional, Sachero, A., additional, Lunati, M., additional, Sayah, S., additional, Alizadeh, A., additional, Nazari, N., additional, Hekmat, M., additional, Moradi, M., additional, Zeighami, M., additional, Ghanji, H., additional, Suzuki, K., additional, Takagi, M., additional, Maeda, K., additional, Tatsumi, H., additional, Vieira, P., additional, Reis, H., additional, Toth, A., additional, Vago, H., additional, Takacs, P., additional, Edes, E., additional, Marki, A., additional, Balazs, G. Y., additional, Huttl, K., additional, Merkely, B., additional, Lainis, F., additional, Buckley, M. M., additional, Johns, E. J., additional, Seifer, C. 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Published
2011
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29. The cost of atrial fibrillation in Italy: a five-year analysis of healthcare expenditure in the general population. From the Italian Survey of Atrial Fibrillation Management (ISAF) study

Author

Zoni Berisso, M., Maurizio Eugenio Landolina, Ermini, G., Parretti, D., Zingarini, G. L., Degli Esposti, L., Cricelli, C., and Boriani, G.

Subjects
Male, Italy, Surveys and Questionnaires, Atrial Fibrillation, Costs and Cost Analysis, Humans, Female, Health Expenditures
Abstract

Atrial fibrillation (AF) is a relevant item of expenditure for the National Healthcare systems. The aim of the study was to estimate the annual costs of AF in Italy.The Italian Survey of Atrial Fibrillation Management Study enrolled 6.036 patients with AF among 295.906 subjects representative of the Italian population. Data were collected by 233 General Practitioners (GPs) distributed across Italy. Quantities of resources used during the 5 years preceding the ISAF screening were inferred from the survey data and multiplied by the current Italian unit costs of 2015 in order to estimate the mean per patient annual cumulative cost of AF. Patients were subdivided on the basis of the number of hospitalizations, invasive/non-invasive diagnostic tests and invasive therapeutic procedures in 3 different clinical subsets: "low cost", " medium cost" and "high cost clinical scenario".The estimated mean costs per patient per year were 613 €, 891 € and 1213 € for the "Low cost", "Medium cost" and "High Cost Clinical Scenario" respectively. Hospitalizations and inpatient interventional procedures accounted for more than 80% of the cumulative annual costs. The mean annual costs among patients pursuing "Rhythm control" strategy was 956 €.In Italy, the estimated costs of AF per patient per year are lower than those reported in other developed countries and vary widely related to the different characteristics of AF patients. Hospitalizations and interventional procedures are the main drivers of costs. The mean annual cost of AF is mainly influenced by the duration of the period of observation and the patients' characteristics. Measures to reduce hospitalizations are needed.

31. Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry

Author

Giuseppe Boriani, Marco Proietti, Matteo Bertini, Igor Diemberger, Pietro Palmisano, Stefano Baccarini, Francesco Biscione, Nicola Bottoni, Antonio Ciccaglioni, Alessandro Dal Monte, Franco Alberto Ferrari, Saverio Iacopino, Marcello Piacenti, Daniele Porcelli, Stefano Sangiorgio, Luca Santini, Michele Malagù, Giuseppe Stabile, Jacopo Francesco Imberti, Davide Caruso, Massimo Zoni-Berisso, Roberto De Ponti, Renato Pietro Ricci, on behalf of RI-AIAC Registry Investigators, Boriani G., Proietti M., Bertini M., Diemberger I., Palmisano P., Baccarini S., Biscione F., Bottoni N., Ciccaglioni A., Monte A.D., Ferrari F.A., Iacopino S., Piacenti M., Porcelli D., Sangiorgio S., Santini L., Malagu M., Stabile G., Imberti J.F., Caruso D., Zoni-Berisso M., De Ponti R., and Ricci R.P.

Subjects
Pacemaker, cardiac implantable electronic device, implantable defibrillator, pacemaker, infection, outcome, Cardiac implantable electronic device, Socio-culturale, Medicine, Medicine (miscellaneous), Implantable defibrillator, Infection, Article, Outcome
Abstract

Background: The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. Aim: To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. Methods: In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. Results: A total of 2675 patients (64.3% male, age 78 (70–84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38–12.08) and diabetes (OR: 2.22, 95% CI: 1.02–4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60–3.55 for each point), with a c-index = 0.64 (0.52–0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63−0.71) p < 0.001. Conclusions: In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status.

Published
2022

32. Evaluation of damaging effects of splicing mutations: Validation of an in vitro method for diagnostic laboratories

Author

Chiara Di Resta, Gabriele Siciliano, Sara Benedetti, Maurizio Ferrari, Martina Manzoni, Massimo Zoni Berisso, DI RESTA, Chiara, Manzoni, M, Berisso Zoni Berisso, M, Siciliano, G, Benedetti, S, and Ferrari, Maurizio

Subjects
Expression vectors, Male, In vitro studies, RNA Splicing, In silico, Clinical Biochemistry, Biology, medicine.disease_cause, Biochemistry, LMNA, Young Adult, Exon, Minigene, medicine, Humans, Computer Simulation, Gene, Genetics, Mutation, Base Sequence, Splicing defects, Clinical Laboratory Techniques, Medicine (all), Biochemistry (medical), Exons, General Medicine, RNA analysis, Middle Aged, Lamin Type A, RNA splicing, In silico tools, Ex vivo
Abstract

Background Pre-mRNA splicing defects may have an important impact on clinical phenotype in several diseases, but often their pathogenic role is difficult to demonstrate. The aim of this study was to validate an in vitro method to assess the effects of putative splicing variants. Materials and methods We studied three novel variants in vitro using a novel minigene approach and compared results with in silico and ex vivo strategies from patient samples. Results For the c.1146C>T variant in the LMNA gene, in vitro and ex vivo studies were concordant with the prediction obtained by in silico tools, confirming the loss of 13 bp at the end of exon 6. In the second case (c.1140+1G>A, SCN5A gene), in vitro experiments identified the insertion of 94 intronic bp in exon 9 as well as exon 9 skipping, but these results were not correctly predicted by ex vivo data and in silico tools. In the third case (c.1608+1C>T, LMNA gene) in vitro and ex vivo studies suggested the recognition of an exonic cryptic site leading to the loss of 29 bp in exon 9, not predicted by in silico analysis. Conclusion Our results revealed how in silico tools are often unreliable requiring “wet” RNA analysis. Since ex vivo studies are not always feasible, the use of an in vitro construct represents an efficient and useful method for the evaluation of damaging effects of unknown splicing variants, especially in diagnostic laboratories.

Published
2014

33. Use of implantable cardioverter defibrillator and cardiac resynchronization therapy in high-risk patients: an Italian survey study on 220 cardiology departments

Author

Inama, G., Pedrinazzi, C., Maurizio Eugenio Landolina, Oliva, F., Senni, M., Proclemer, A., Berisso, M. Zoni, Inama, G, Pedrinazzi, C, Landolina, M, Oliva, F, Senni, M, Proclemer, A, and Zoni Berisso, M

Subjects
mplantable cardioverter defibrillator, cardiac resynchronization therapy, high-risk patients, Italian survey study , cardiology departments

34. Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry.

Author

Boriani G, Proietti M, Bertini M, Diemberger I, Palmisano P, Baccarini S, Biscione F, Bottoni N, Ciccaglioni A, Dal Monte A, Ferrari FA, Iacopino S, Piacenti M, Porcelli D, Sangiorgio S, Santini L, Malagù M, Stabile G, Imberti JF, Caruso D, Zoni-Berisso M, De Ponti R, Ricci RP, and On Behalf Of Ri-Aiac Registry Investigators

Abstract

Background: The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known., Aim: To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes., Methods: In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded., Results: A total of 2675 patients (64.3% male, age 78 (70-84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38-12.08) and diabetes (OR: 2.22, 95% CI: 1.02-4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60-3.55 for each point), with a c-index = 0.64 (0.52-0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63-0.71) p < 0.001., Conclusions: In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status.

Published
2022
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35. Estimate and reporting of longevity for cardiac implantable electronic devices: a proposal for standardized criteria.

Author

Censi F, Calcagnini G, Mattei E, Ricci RP, Zoni Berisso M, Landolina M, and Boriani G

Subjects
Cardiac Resynchronization Therapy Devices, Electric Countershock, Electronics, Humans, Cardiac Resynchronization Therapy, Defibrillators, Implantable
Abstract

Background: Cardiac implantable electronic devices (CIEDs) are widely used according to consensus guidelines in various patient categories. The longevity of CIED is a major determinant of the frequency with which patients require device replacement. Given the mismatch between the useful life of the devices and patient survival, device replacement is often needed. There is a great variability in the criteria used by manufacturers to determine the longevity of pacemakers (PM), implantable defibrillators (ICDs), and devices for cardiac resynchronization therapy (CRT). Thus, a fair comparison and an effective device evaluation is often difficult., Methods: The objective of this paper is to provide standardized criteria based on typical clinical settings for estimating the longevity of single and dual chamber ICDs, cardiac resynchronization defibrillators (CRT-D), single and dual chamber PMs, and cardiac resynchronization PMs (CRT- P) to be used in health technology assessment for an appropriate comparison among different devices., Results: The proposed parameters, if applied to the current marketed devices, provide longevity values in the range 5-17.2 years., Conclusion: The values of longevity with the non-standardized criteria used by the manufacturers result in higher maximum values respect to the proposed standardized criteria for CRT-D, CRTD-MPP, CRT-P, and Dual-chamber PM.

Published
2021
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36. Organization and procedures in contemporary catheter ablation centres: data from the 2018 Italian Catheter Ablation Registry.

Author

Stabile G, Bertaglia E, Guerra F, Palmisano P, Zoni Berisso M, Soldati E, Bisignani G, Forleo GB, Zanotto G, Landolina M, Boriani G, D'Onofrio A, De Ponti R, and Ricci RP

Subjects
Humans, Italy epidemiology, Registries, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Atrial Fibrillation surgery, Atrial Flutter diagnosis, Atrial Flutter epidemiology, Atrial Flutter surgery, Cardiac Electrophysiology methods, Cardiac Electrophysiology organization & administration, Cardiac Electrophysiology statistics & numerical data, Cardiology Service, Hospital organization & administration, Catheter Ablation methods, Catheter Ablation statistics & numerical data, Tachycardia, Atrioventricular Nodal Reentry diagnosis, Tachycardia, Atrioventricular Nodal Reentry epidemiology, Tachycardia, Atrioventricular Nodal Reentry surgery
Abstract

Aims: This report describes the findings of the 2018 Italian Catheter Ablation Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC)., Methods: The Italian Catheter Ablation Registry systematically collects data on the ablation procedures performed in Italy. Data collection was retrospective. A standardized questionnaire was completed by participating centres., Results: We collected data on 15 714 catheter ablation procedures performed in Italy during 2018 in 94 electrophysiology centres. In most centres (75/94, 80%), a single electrophysiology laboratory was available, and a hybrid electrophysiology laboratory was available in 15% (14/94) of centres. In most (93%) centres, at least two electrophysiologists were involved in the catheter ablation procedures. In only 13 out of 94 (14%) electrophysiology laboratories, an anaesthesiologist assists every electrophysiology procedure; in most cases (74/94, 79%), an on-demand anaesthesiology service was available. On-site cardiothoracic surgery was reported in 43 out of 94 (46%) centres.Nonfluoroscopic navigation systems were available in most centres (88/94, 93%). Intracardiac echocardiography was used in 59 out of 94 (63%) electrophysiology laboratories. Atrial fibrillation (31%) was the most frequently treated ablation target, followed by atrioventricular nodal re-entrant tachycardia (20%) and cavo-tricuspid isthmus (15%). In 61.7% of all procedures, a 3D mapping system was used. In about one-third of procedures, a near-zero approach was performed., Conclusion: In most Italian electrophysiology centres, a single electrophysiology laboratory was available and at least two electrophysiologists were involved in the ablation procedures. An increasing number of procedures were performed by means of a nonfluoroscopic mapping system with a near-zero approach., (Copyright © 2021 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Published
2021
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37. Mortality after cardioverter-defibrillator replacement: Results of the DECODE survival score index.

Author

Zoni-Berisso M, Martignani C, Ammendola E, Narducci ML, Caruso D, Miracapillo G, Notarstefano P, Carinci V, Pierantozzi A, Ciaramitaro G, Calò L, Zennaro M, Infusino T, Ferretti C, Sassone B, Licciardello G, Setti S, Terzaghi C, Malacrida M, and Biffi M

Subjects
Aged, Aged, 80 and over, Death, Sudden, Cardiac epidemiology, Electrocardiography, Female, Follow-Up Studies, Heart Failure mortality, Humans, Italy epidemiology, Male, Middle Aged, Prospective Studies, Survival Rate trends, Time Factors, Death, Sudden, Cardiac prevention & control, Decision Making, Shared, Defibrillators, Implantable adverse effects, Heart Failure therapy
Abstract

Background: Device replacement is the ideal time to reassess health care goals regarding continuing implantable cardioverter-defibrillator (ICD) therapy. Only few data are available on the decision making at this time., Objectives: The goals of this study were to identify factors associated with poor prognosis at the time of ICD replacement and to develop a prognostic index able to stratify those patients at risk of dying early., Methods: DEtect long-term COmplications after implantable cardioverter-DEfibrillator replacement (DECODE) was a prospective, single-arm, multicenter cohort study aimed at estimating long-term complications in a large population of patients who underwent ICD/cardiac resynchronization therapy - defibrillator replacement. Potential predictors of death were investigated, and all these factors were gathered into a survival score index (SUSCI)., Results: We included 983 consecutive patients (median age 71 years (63-78)); 750 (76%) were men, 537 (55%) had ischemic cardiomyopathy; 460 (47%) were implanted with cardiac resynchronization therapy - defibrillator. During a median follow-up period of 761 days (interquartile range 628-904 days), 114 patients (12%) died. In multivariate Cox regression analysis, New York Heart Association class III/IV, ischemic cardiomyopathy, body mass index < 26 kg/m 2 , insulin administration, age ≥ 75 years, history of atrial fibrillation, and hospitalization within 30 days before ICD replacement remained associated with death. The survival score index showed a good discriminatory power with a hazard ratio of 2.6 (95% confidence interval 2.2-3.1; P < .0001). The risk of death increased according to the severity of the risk profile ranging from 0% (low risk) to 47% (high risk)., Conclusion: A simple score that includes a limited set of variables appears to be predictive of total mortality in an unselected real-world population undergoing ICD replacement. Evaluation of the patient's profile may assist in predicting vulnerability and should prompt individualized options, especially for high-risk patients., (Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Published
2021
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38. Lead choice in cardiac implantable electronic devices: an Italian survey promoted by AIAC (Italian Association of Arrhythmias and Cardiac Pacing).

Author

Ziacchi M, Palmisano P, Biffi M, Guerra F, Stabile G, Forleo GB, Zanotto G, D'Onofrio A, Landolina M, De Ponti R, Zoni Berisso M, Ricci RP, and Boriani G

Subjects
Female, Geography, Heart Atria pathology, Heart Ventricles pathology, Humans, Italy, Surveys and Questionnaires, Arrhythmias, Cardiac therapy, Defibrillators, Implantable, Electronics, Medical, Pacemaker, Artificial
Abstract

Background : Few data are available regarding lead preferences of electrophysiologists during cardiac implantable electronic devices (CIEDs) implantation. Aim of this survey is to evaluate the leads used, and the reasons behind these choices, in a large population of implanters. Methods : A questionnaire was sent to all 314 Italian centers with experience in CIED implantation. Results : 103 operators from 100 centers (32% of centers) responded. For atrium, passive leads represented first choice for pacemakers and defibrillators (71% and 64% of physicians, respectively), mainly for safety. For right ventricle, active fixation was preferred (61% and 93% operators in pacemaker and defibrillator patients), for higher versatility in positioning and lower dislodgement risk. For left ventricular stimulation, quadripolar leads were preferred by more than 80% of respondents, for better phrenic nerve and myocardial threshold management; active-fixation leads represent a second choice, in order to prevent or manage dislodgement (78% and 17% of respondents, respectively), but 44% of operators considered them dangerous. Conclusions : The choice of leads is heterogeneous. Trends are toward active-fixation right ventricular leads and passive-fixation atrial leads (particularly in pacemaker patients, considered frailer). For left ventricular stimulation, operators' majority want to disposition all kind of leads, although quadripolar leads are the favorites.

Published
2019
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39. Clinical and organizational management of cardiac implantable electronic device replacements: an Italian Survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

Author

Palmisano P, Ziacchi M, Belotti G, Rapacciuolo A, Santini L, Stabile G, Zoni Berisso M, De Ponti R, Landolina M, Ricci RP, and Boriani G

Subjects
Ambulatory Surgical Procedures, Cardiac Pacing, Artificial economics, Defibrillators, Implantable economics, Device Removal adverse effects, Device Removal economics, Drug Administration Schedule, Electric Countershock economics, Electric Countershock instrumentation, Health Care Costs, Health Care Surveys, Humans, Italy, Length of Stay, Pacemaker, Artificial economics, Patient Admission, Practice Patterns, Physicians' economics, Prosthesis Failure, Time Factors, Treatment Outcome, Antibiotic Prophylaxis trends, Anticoagulants administration & dosage, Cardiac Pacing, Artificial trends, Defibrillators, Implantable trends, Device Removal trends, Electric Countershock trends, Pacemaker, Artificial trends, Practice Patterns, Physicians' trends
Abstract

Aims: The aim of this survey was to assess the management and organization of cardiac implantable electronic device (CIED) replacement in Italy., Methods: A questionnaire consisting of 24 questions on organizational aspects and on the peri-procedural management of anticoagulant therapies and antibiotic prophylaxis was sent via the Internet to 154 Italian arrhythmia centers., Results: A total of 103 out of 154 centers completed the questionnaire (67% response rate). In 43% of the centers, the procedures were performed under day-case admission, in 40% under ordinary admission, and in 17% under either day-case or ordinary admission. The most frequent reason (66%) for choosing ordinary admission rather than day-case admission was to obtain full reimbursement. Although warfarin therapy was continued in 73% of the centers, nonvitamin K oral anticoagulants were discontinued, without bridging, 24 h or less prior to replacement procedures in 88%. Prophylactic antibiotic therapy was systematically administered in all centers; in 97%, the first antibiotic dose was administered 1-2 h prior to procedures. Local antibacterial envelopes were also used in 43% of the centers in patients with a higher risk of device infection., Conclusion: This survey provides a representative picture of how CIED replacements are organized and managed in current Italian clinical practice. The choice of the type of hospitalization (short versus ordinary) was more often motivated by economic reasons (reimbursement of the procedure) than by clinical and organizational factors. Peri-procedural management of anticoagulation and prophylactic antibiotic therapy was consistent with current scientific evidence.

Published
2019
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40. Appropriate implantable cardioverter-defibrillator interventions in cardiac resynchronization therapy-defibrillator (CRT-D) patients undergoing device replacement: time to downgrade from CRT-D to CRT-pacemaker? Insights from real-world clinical practice in the DECODE CRT-D analysis.

Author

Narducci ML, Biffi M, Ammendola E, Vado A, Campana A, Potenza DR, Iori M, Zanon F, Zacà V, Zoni Berisso M, Bertini M, Lissoni F, Bandini A, Malacrida M, and Crea F

Subjects
Aged, Cardiac Resynchronization Therapy, Device Removal, Female, Humans, Italy, Male, Middle Aged, Practice Guidelines as Topic, Proportional Hazards Models, Stroke Volume, Atrial Fibrillation therapy, Cardiac Resynchronization Therapy Devices, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Prosthesis Implantation, Tachycardia, Ventricular epidemiology, Ventricular Fibrillation epidemiology
Abstract

Aim: Ventricular tachycardia (VT)/ventricular fibrillation (VF) occurrence after cardiac resynchronization therapy-defibrillator (CRT-D) replacement is unknown; hence, there is no practical guideline to recommend either CRT-D or CRT-pacemaker at the time of device replacement. We observed the 1-year VT/VF occurrence after CRT-D replacement in a subanalysis of the Detect Long-term Complications after ICD Replacement (DECODE) registry., Methods and Results: A total of 332 consecutive patients who had undergone CRT-D replacement from 2013 to 2015 were enrolled in 36 Italian centres. The primary endpoint was the number of patients with any appropriate implantable cardioverter-defibrillator (ICD) interventions during 12-month follow-up. The secondary endpoint comprised death from any cause and appropriate ICD interventions. At replacement, 214 (64.5%) patients had a left ventricular ejection fraction ≤ 35% and 138 (41.6%) patients had a secondary prevention indication for ICD. Seventy (21.1%) patients had no longer indication to ICD therapy. During a median follow-up period of 406.5 (362-533) days, VT/VF requiring therapy delivery occurred in 57 (17%) patients, specifically in 7% of those who no longer had an ICD indication. On multivariate analysis, number of criteria for ICD replacement independently predicted appropriate ICD intervention during follow-up [hazard ratio (HR) = 1.62, 95% confidence interval (CI) 1.07-2.46; log-rank P = 0.02]. The combined endpoint of death from any cause or appropriate ICD therapy occurred in 76 (23%) patients. Only NYHA class remained associated with this combined endpoint (HR = 1.97, 95% CI 1.23-3.14; P = 0.005)., Conclusions: The DECODE registry showed the 'real-world' experience of CRT-D recipients approaching device replacement, in which 7% of patients who no longer had an indication for ICD therapy experienced appropriate ICD interventions.

Published
2018
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41. Clinically oriented device programming in bradycardia patients: part 1 (sinus node disease). Proposals from AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

Author

Ziacchi M, Palmisano P, Biffi M, Ricci RP, Landolina M, Zoni-Berisso M, Occhetta E, Maglia G, Botto G, Padeletti L, and Boriani G

Subjects
Algorithms, Atrial Fibrillation prevention & control, Atrial Fibrillation therapy, Consensus, Hemodynamics, Humans, Italy, Societies, Medical, Tachycardia prevention & control, Tachycardia therapy, Bradycardia therapy, Cardiac Pacing, Artificial standards, Pacemaker, Artificial classification, Sick Sinus Syndrome complications
Abstract

: Modern pacemakers have an increasing number of programable parameters and specific algorithms designed to optimize pacing therapy in relation to the individual characteristics of patients. When choosing the most appropriate pacemaker type and programing, the following variables must be taken into account: the type of bradyarrhythmia at the time of pacemaker implantation; the cardiac chamber requiring pacing, and the percentage of pacing actually needed to correct the rhythm disorder; the possible association of multiple rhythm disturbances and conduction diseases; the evolution of conduction disorders during follow-up. The goals of device programing are to preserve or restore the heart rate response to metabolic and hemodynamic demands; to maintain physiological conduction; to maximize device longevity; to detect, prevent, and treat atrial arrhythmia. In patients with sinus node disease, the optimal pacing mode is DDDR. Based on all the available evidence, in this setting, we consider appropriate the activation of the following algorithms: rate responsive function in patients with chronotropic incompetence; algorithms to maximize intrinsic atrioventricular conduction in the absence of atrioventricular blocks; mode-switch algorithms; algorithms for autoadaptive management of the atrial pacing output; algorithms for the prevention and treatment of atrial tachyarrhythmias in the subgroup of patients with atrial tachyarrhythmias/atrial fibrillation. The purpose of this two-part consensus document is to provide specific suggestions (based on an extensive literature review) on appropriate pacemaker setting in relation to patients' clinical features.

Published
2018
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42. Clinically oriented device programming in bradycardia patients: part 2 (atrioventricular blocks and neurally mediated syncope). Proposals from AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

Author

Palmisano P, Ziacchi M, Biffi M, Ricci RP, Landolina M, Zoni-Berisso M, Occhetta E, Maglia G, Botto G, Padeletti L, and Boriani G

Subjects
Algorithms, Atrial Fibrillation prevention & control, Atrial Fibrillation therapy, Consensus, Hemodynamics, Humans, Italy, Sick Sinus Syndrome complications, Societies, Medical, Atrioventricular Block complications, Bradycardia therapy, Cardiac Pacing, Artificial standards, Pacemaker, Artificial classification, Syncope, Vasovagal complications
Abstract

: The purpose of this two-part consensus document is to provide specific suggestions (based on an extensive literature review) on appropriate pacemaker setting in relation to patients' clinical features. In part 2, criteria for pacemaker choice and programming in atrioventricular blocks and neurally mediate syncope are proposed. The atrioventricular blocks can be paroxysmal or persistent, isolated or associated with sinus node disease. Neurally mediated syncope can be related to carotid sinus syndrome or cardioinhibitory vasovagal syncope. In sinus rhythm, with persistent atrioventricular block, we considered appropriate the activation of mode-switch algorithms, and algorithms for auto-adaptive management of the ventricular pacing output. If the atrioventricular block is paroxysmal, in addition to algorithms mentioned above, algorithms to maximize intrinsic atrioventricular conduction should be activated. When sinus node disease is associated with atrioventricular block, the activation of rate-responsive function in patients with chronotropic incompetence is appropriate. In permanent atrial fibrillation with atrioventricular block, algorithms for auto-adaptive management of the ventricular pacing output should be activated. If the atrioventricular block is persistent, the activation of rate-responsive function is appropriate. In carotid sinus syndrome, adequate rate hysteresis should be programmed. In vasovagal syncope, specialized sensing and pacing algorithms designed for reflex syncope prevention should be activated.

Published
2018
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43. Indication to cardioverter-defibrillator therapy and outcome in real world primary prevention. Data from the IRIDE [Italian registry of prophylactic implantation of defibrillators] study.

Author

Proclemer A, Muser D, Campana A, Zoni-Berisso M, Zecchin M, Locatelli A, Brieda M, Gramegna L, Santarone M, Chiodi L, Mazzone P, Rebellato L, and Facchin D

Subjects
Aged, Electric Countershock trends, Female, Follow-Up Studies, Humans, Italy epidemiology, Male, Middle Aged, Primary Prevention trends, Prospective Studies, Survival Rate trends, Treatment Outcome, Defibrillators, Implantable trends, Electric Countershock methods, Primary Prevention methods, Registries
Abstract

Aims: Several trials demonstrated the life saving role of implantable cardioverter-defibrillators (ICD) in primary prevention of sudden cardiac death (SCD). The aim was to evaluate the clinical characteristics and 4-year outcome of consecutive patients treated in clinical practice by prophylactic ICD implantation on the basis of class I recommendations and up-to-date ICD programming., Methods and Results: IRIDE multi-center, prospective and observational study enrolled 604 consecutive patients (mean age: 66 ± 10 years) treated by ICD between 01/01/2006 and 30/06/2010. Main characteristics were similarly distributed among the inclusion criteria of MADIT II (24%), SCD-HeFT (24%), COMPANION (26%) and MADIT-CRT (18%) trials, while a small number of patients met the MUSTT and MADIT (7%) inclusion criteria. Single-chamber ICDs were implanted in 168 (28%) patients, dual-chamber in 167 (28%) and biventricular in 269 (43%) patients. ATP programming was activated in 546 (90%) patients. Overall survival and rate of appropriate ICD intervention by ATP and/or shock at 12-24-36-48 months of follow-up were 94%, 89%, 80%, 75% and 16%, 28%, 37% and 50%, respectively. No difference in mortality rate between the groups who received or did not receive appropriate ICD interventions was demonstrated (p=ns)., Conclusions: The IRIDE study confirms the effectiveness in real world practice of ICD implantation in patients at risk of SCD. The life saving role of ICD therapy increases as the duration of follow-up is prolonged and the survival benefit is similar in patients who received or did not receive appropriate device treatment, thus suggesting a beneficial effect of up-to-date device programming., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Published
2013
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44. Stroke prophylaxis in high-risk patients with atrial fibrillation: rhythm vs. rate control strategy.

Author

Filippi A, Zoni-Berisso M, Ermini G, Landolina M, Brignoli O, D'Ambrosio G, Zingarini G, and Pedrinazzi C

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Atrial Fibrillation complications, Atrial Fibrillation physiopathology, Female, Heart Rate, Humans, Male, Middle Aged, Practice Guidelines as Topic, Practice Patterns, Physicians' statistics & numerical data, Stroke etiology, Surveys and Questionnaires, Anticoagulants therapeutic use, Atrial Fibrillation drug therapy, Stroke prevention & control, Warfarin therapeutic use
Abstract

Purpose: "Rhythm" and "Rate" control strategies require partially different organization, and a different involvement of Specialists and General Practitioners; we verified whether the strategy assignment modified the approach to stroke prophylaxis., Methods: Survey in general practice: 233 GPs identified all patients with codified atrial fibrillation (AF) diagnosis, checked the diagnosis (ECG/hospital discharge document), and filled a structured questionnaire on stroke risk-factors, prophylactic therapy, and reasons for warfarin non prescription in CHADS ≥2 patients. Data were collected as an "aggregate.", Results: Population observed: 295,906 patients aged >14; 6,036 with confirmed AF; 5,888 with complete data about anti-thrombotic prophylaxis are analyzed here. In the "rhythm strategy" group 45.6% of the CHADS score ≥2 patients (594) were on warfarin, vs. 73.2% (1,741) in the "rate strategy" group (p<0.0001). Overall reasons for warfarin non-use were significantly different in the two groups: clinical contraindications (12.3% vs. 19.7%), side effects (5.5% vs. 8.5%), patients' refusal (12.2% vs. 15.2%), unreliable patient/care-giver (14.4% vs. 25.9%); reasons were unknown to the GP in 55.6% in rhythm control vs. 30.9% in rate control group., Conclusions: Anti-thrombotic prophylaxis in CHADS ≥2 patients is different in subjects assigned to the Rhythm vs. the Rate control strategy, as well as reported reasons for warfarin non use. GPs do not know why warfarin is not used in a large percentage of cases, mainly in the rhythm control strategy group. Improving efforts should probably be differently tailored for patients assigned to the "rhythm" or the "rate" control strategy., (Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Published
2013
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45. Frequency, patient characteristics, treatment strategies, and resource usage of atrial fibrillation (from the Italian Survey of Atrial Fibrillation Management [ISAF] study).

Author

Zoni-Berisso M, Filippi A, Landolina M, Brignoli O, D'Ambrosio G, Maglia G, Grimaldi M, and Ermini G

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Anticoagulants therapeutic use, Atrial Fibrillation physiopathology, Atrial Fibrillation therapy, Electrocardiography, Female, Humans, Italy epidemiology, Male, Middle Aged, Morbidity, Registries, Retrospective Studies, Stroke epidemiology, Stroke etiology, Stroke prevention & control, Surveys and Questionnaires, Young Adult, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation epidemiology, Catheter Ablation, Health Resources statistics & numerical data, Physicians statistics & numerical data, Practice Guidelines as Topic
Abstract

Atrial fibrillation (AF) is 1 of the most important healthcare issues and an important cause of healthcare expenditure. AF care requires specific arrhythmologic skills and complex treatment. Therefore, it is crucial to know its real affect on healthcare systems to allocate resources and detect areas for improving the standards of care. The present nationwide, retrospective, observational study involved 233 general practitioners. Each general practitioner completed an electronic questionnaire to provide information on the clinical profile, treatment strategies, and resources consumed to care for their patients with AF. Of the 295,906 patients screened, representative of the Italian population, 6,036 (2.04%) had AF: 20.2% paroxysmal, 24.3% persistent, and 55.5% permanent AF. AF occurred in 0.16% of patients aged 16 to 50 years, 9.0% of those aged 76 to 85 years, and 10.7% of those aged ≥85 years. AF was symptomatic despite therapy in 74.6% of patients and was associated with heart disease in 75%. Among the patients with AF, 24.8% had heart failure, 26.8% renal failure, 18% stroke/transient ischemic attack, and 29.3% had ≥3 co-morbidities. The rate control treatment strategy was pursued in 55%. Of the 6,036 patients with AF, 46% received anticoagulants. The success rate of catheter ablation of the AF substrate was 50%. In conclusion, in our study, the frequency of AF was 2 times greater than previously reported (approximately 0.90%), rate control was the most pursued treatment strategy, anticoagulants were still underused, and the success rate of AF ablation was lower than reported by referral centers., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Published
2013
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46. [The Flec-SL study].

Author

Zoni Berisso M and Alboni P

Subjects
Humans, Randomized Controlled Trials as Topic, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation drug therapy
Published
2013
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47. Noninvasive prediction of sudden death and sustained ventricular tachycardia after acute myocardial infarction using a neural network algorithm.

Author

Zoni-Berisso M, Molini D, Viani S, Mela GS, and Delfino L

Subjects
Aged, Electrocardiography, Ambulatory, Female, Humans, Male, Middle Aged, Signal Processing, Computer-Assisted, Survival Analysis, Tachycardia, Ventricular etiology, Tachycardia, Ventricular mortality, Algorithms, Death, Sudden, Cardiac etiology, Myocardial Infarction complications, Neural Networks, Computer, Tachycardia, Ventricular diagnosis
Abstract

Background: The early and accurate noninvasive identification of postinfarction patients at risk of sudden death and sustained ventricular tachycardia (arrhythmic events) still remains an unsolved problem. The aim of the present study was to identify the combination of clinical and laboratory noninvasive variables, easy to obtain in most patients, that best predicts the occurrence of arrhythmic events after an acute myocardial infarction., Methods: Four hundred and four consecutive patients with acute myocardial infarction were enrolled and followed for a median period of 21.4 months. In each patient, 61 clinical and laboratory noninvasive variables were collected before hospital discharge and used for the prediction of arrhythmic events using an artificial neural network., Results: During follow-up, 13 (3.2%) patients died suddenly and 11(2.5%) had sustained ventricular tachycardia. The neural network showed that the combination best predicting arrhythmic events included: left ventricular failure during coronary care stay, ventricular dyskinesis, late potentials, number of ventricular premature depolarizations/hour, nonsustained ventricular tachycardia, left ventricular ejection fraction, bundle branch block and digoxin therapy at discharge. The neural network algorithm allowed identification of a small high-risk patient subgroup (12% of the study population) with an arrhythmic event rate of 46%. The sensitivity and specificity of the test were 96 and 93% respectively., Conclusions: These results suggest that, in postinfarction patients, it is possible to predict early and accurately arrhythmic events by noninvasive variables easily obtainable in most patients. Patients identified as being at risk are candidates for prophylactic antiarrhythmic therapy.

Published
2001

48. [The guidelines of the ANMCO-SIC-AIAC on the appropriate use of the methods of permanent cardiac electric stimulation. Associazione Nazionale Medici Cardiologi Ospedalieri-Società Italiana di Cardiologia-Associazione Italiana di Aritmologia e Cardiostimolazione].

Author

Zoni Berisso M, Bongiorni MG, Della Bella P, Proclemer A, and Viani S

Subjects
Adolescent, Adult, Arrhythmias, Cardiac classification, Arrhythmias, Cardiac therapy, Cardiac Pacing, Artificial methods, Cardiology, Child, Defibrillators, Implantable standards, Humans, Italy, Pacemaker, Artificial standards, Societies, Medical, Terminology as Topic, Cardiac Pacing, Artificial standards
Published
2000

49. [The clinical significance and therapy of supraventricular tachyarrhythmias that complicate the acute and subacute phases of a myocardial infarct].

Author

Zoni Berisso M and Vecchio C

Subjects
Electrocardiography, Humans, Incidence, Myocardial Infarction mortality, Recurrence, Tachycardia, Supraventricular drug therapy, Tachycardia, Supraventricular epidemiology, Tachycardia, Supraventricular mortality, Myocardial Infarction complications, Tachycardia, Supraventricular etiology
Published
1992

50. Frequency, characteristics and significance of supraventricular tachyarrhythmias detected by 24-hour electrocardiographic recording in the late hospital phase of acute myocardial infarction.

Author

Zoni Berisso M, Carratino L, Ferroni A, Mela GS, Mazzotta G, and Vecchio C

Subjects
Adult, Age Factors, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Monitoring, Physiologic, Myocardial Infarction complications, Myocardial Infarction mortality, Recurrence, Risk Factors, Survival Analysis, Tachycardia, Supraventricular etiology, Tachycardia, Supraventricular physiopathology, Electrocardiography, Myocardial Infarction physiopathology, Tachycardia, Supraventricular epidemiology
Abstract

The incidence, characteristics and clinical significance of supraventricular tachyarrhythmias occurring in the late hospital phase of acute myocardial infarction (AMI) were assessed in 209 consecutive patients. Arrhythmias were quantified by 24-hour electrocardiographic recording 16 +/- 3 days after AMI, and were classified according to the degree of complexity in 5 classes. Class 0 = less than 5 premature beats/hr; class 1 = between 5 and 100/hr; class 2 = greater than 100/hr or repetitive premature beats; class 3 = atrial-junctional tachycardia; class 4 = atrial flutter-fibrillation. Supraventricular tachyarrhythmias classes 1 to 2 always occurred in the absence of symptoms in 86 patients (41%); supraventricular tachyarrhythmias classes 3 to 4 (paroxysmal, self-limiting, brief) occurred in 27 patients (13%), symptomatically in 6. The presence of supraventricular tachyarrhythmias classes 2 to 3 was related to age over 55 years and complex ventricular tachyarrhythmias (greater than 20 premature beats/hr, ventricular tachycardia) (both p less than 0.05). Increasing complexity of supraventricular tachyarrhythmias was significantly associated with presence and entity of cardiac enlargement and left ventricular dysfunction (both p less than 0.01). Patients with class 4 showed the most severe cardiac deterioration. During the 2 years after AMI, patients with classes 2, 3 and 4 had a higher incidence of acute pulmonary edema, New York Heart Association functional classes III to IV for congestive heart failure (both p less than 0.005) and a greater need of digitalis and diuretics (p = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1990
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