14 results on '"Stabile, G."'
Search Results
2. The stricter criteria for Class I CRT indication suggested by the 2016 ESC Guidelines reliably exclude patients with a worse prognosis in comparison with the 2013 ESC indication criteria.
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Bertaglia E, Reggiani A, Palmisano P, D'Onofrio A, De Simone A, Caico SI, Pecora D, Arena G, Marini M, Ricciardi G, Badolati S, Spotti A, Solimene F, Ferraro A, Migliore F, Botto GL, Malacrida M, and Stabile G
- Subjects
- Aged, Cardiac Resynchronization Therapy methods, Cardiology methods, Cohort Studies, Europe epidemiology, Female, Follow-Up Studies, Heart Diseases epidemiology, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Cardiac Resynchronization Therapy standards, Cardiology standards, Heart Diseases diagnosis, Heart Diseases therapy, Practice Guidelines as Topic standards, Societies, Medical standards
- Abstract
Background: The European Society of Cardiology (ESC) Guidelines published in 2016 modified indications for cardiac resynchronization therapy (CRT) in comparison with the 2013 ESC Guidelines. The aim of this analysis was to evaluate the impact of the stricter criteria suggested by the 2016 ESC Guidelines on patient outcome in a real-world population., Methods: We collected data on 930 consecutive patients with complete outcome information who had undergone CRT implantation from 2011 to 2013 from the CRT-MORE registry. Patients were classified according to 2013 (Reference) and 2016 (Current) ESC Guidelines. The primary end-point of the study was death from any cause and heart failure hospitalization., Results: According to the Reference Guidelines, 650 (69.9%) patients met Class I indications, 190 (20.4%) Class IIa, 39 (4.2%) Class IIb and 51 (5.5%) Class III. According to the Current Guidelines, 563 (60.5%) patients met Class I indications, 145 (15.6%) Class IIa, 108 (11.6%) Class IIb and 114 (12.3%) Class III. On comparing the Reference and Current Guidelines, the 538 patients who confirmed their Class I indication had a better outcome in terms of freedom from the combined end-point of heart failure (HF) hospitalization or death from any cause (hazard ratio (HR) of 0.64; 95% CI 0.42 to 0.99; p = 0.0436) when compared to the 112 patients who lost their class I indication (84 moved to class IIb and 28 moved to class III)., Conclusions: The stricter criteria for Class I CRT indication suggested by the 2016 ESC Guidelines excluded about 20% of patients with a worse prognosis., Clinical Trial Registration: CRT MORE: Cardiac Resynchronization Therapy Modular Registry URL: http://clinicaltrials.gov/Identifier:NCT01573091., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
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3. Efficacy of cryoballoon ablation in patients with paroxysmal atrial fibrillation without time to pulmonary vein isolation assessment.
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Stabile G, Tondo C, Curnis A, Lunati M, Manfrin M, Molon G, Sciarra L, Mantica M, Iacopino S, Arena G, Landolina M, Arestia A, and Verlato R
- Subjects
- Aged, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Catheter Ablation methods, Cryosurgery methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation trends, Cryosurgery trends, Pulmonary Veins surgery
- Abstract
Background: Real-time visualization of the electrical activity of the pulmonary veins (PV) is not always possible in the setting of atrial fibrillation (AF) cryoballoon ablation. We investigated the relation between the effective documentation of time to PV isolation and the clinical outcome in a cohort of patients with paroxysmal AF who underwent cryoballoon ablation., Methods: One thousand forty two consecutive patients were enrolled. An inner lumen mapping catheter was typically used to visualize real-time electrical activity inside the PVs., Results: Time to PV isolation was documented in all targeted PVs in 391 patients (Group 1), in 651 patients it was not possible to record PV potentials and assess time to PV isolation in at least one PV (Group 2). In Group 1 a longer procedure duration and ablation time were observed, while a longer fluoroscopy time was observed in Group 2. After a mean follow-up of 14 ± 11 months, 209/1042 (20%) patients had an atrial arrhythmia recurrence (20.2% in Group 1, 19.9% in Group 2, p = 0.25). Complications occurred in 54/1042 (5.2%) patients without any difference among the two study groups., Conclusion: In our retrospective analysis, in about two thirds of patients undergoing cryoballoon ablation it was not possible to acutely assess time to PV isolation in all PVs. However, one-year freedom from clinically symptomatic atrial tachyarrhythmia was similar to that of patients in which time to PV isolation was documented in all targeted veins., Clinical Trial Registration: clinicaltrials.gov (NCT01007474)., (Copyright © 2018. Published by Elsevier B.V.)
- Published
- 2018
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4. NOACs and atrial fibrillation: Incidence and predictors of left atrial thrombus in the real world.
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Bertaglia E, Anselmino M, Zorzi A, Russo V, Toso E, Peruzza F, Rapacciuolo A, Migliore F, Gaita F, Cucchini U, De Divitiis M, Iliceto S, and Stabile G
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- Administration, Oral, Aged, Atrial Fibrillation epidemiology, Cohort Studies, Echocardiography, Transesophageal trends, Female, Heart Diseases diagnostic imaging, Heart Diseases drug therapy, Heart Diseases epidemiology, Humans, Incidence, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Thrombosis epidemiology, Anticoagulants administration & dosage, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation drug therapy, Heart Atria diagnostic imaging, Thrombosis diagnostic imaging, Thrombosis drug therapy
- Abstract
Aims: Despite optimal oral anticoagulation with vitamin K antagonist, left atrial (LA) thrombus could be detected in the left appendage (LAA) in >2% of patients with atrial fibrillation (AF) and CHA
2 DS2 -VASc score≥1 but few data are available for patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We evaluated the occurrence and predictors of LA thrombi by means of transesophageal echocardiography (TOE) in consecutive patients with non-valvular AF who received for at least 3weeks Apixaban, Dabigatran, or Rivaroxaban., Methods: This study included 414 consecutive patients (male 252, 60.6%, mean age 67.3years) referred to our Centers for catheter ablation of AF (n=220, 53.1%) or scheduled electrical cardioversion (n=194, 46.9%). Patients were on Dabigatran (n=160), Rivaroxaban (n=150) or Apixaban (n=104). TOE was performed in all cases within 12h prior to ablation or cardioversion., Results: Preprocedural TOE revealed LA thrombus in 15/414 patients (3.6%), all located in the LAA (Apixaban 3/104 2.9%, Dabigatran 5/160 3.1%, and Rivaroxaban 7/150 4.7%, p=0.69). Of these, 14 patients had persistent AF. Patients with LAA thrombus had a mean CHA2 DS2 -VASc score of 3 (3-4). Higher CHA2 DS2 -VASc score (p=0.02), but not the type of NOAC, significantly predicted the presence of LA thrombus., Conclusion: The incidence of LAA thrombus in a cohort of patients anticoagulated with NOACs is low but not negligible, in any case similar among the 3 drugs. Preprocedural TOE should be considered in patients with a CHA2 DS2 -VASc score>3., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)- Published
- 2017
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5. Left atrial appendage thrombi relate to easily accessible clinical parameters in patients undergoing atrial fibrillation transcatheter ablation: A multicenter study.
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Anselmino M, Garberoglio L, Gili S, Bertaglia E, Stabile G, Marazzi R, Themistoclakis S, Solimene F, Frea S, Grosso Marra W, Morello M, Scaglione M, De Ponti R, and Gaita F
- Subjects
- Adult, Aged, Atrial Appendage diagnostic imaging, Atrial Fibrillation diagnostic imaging, Cohort Studies, Echocardiography, Transesophageal methods, Female, Heart Diseases diagnostic imaging, Heart Diseases epidemiology, Heart Diseases surgery, Humans, Male, Middle Aged, Thrombosis diagnostic imaging, Atrial Appendage surgery, Atrial Fibrillation epidemiology, Atrial Fibrillation surgery, Catheter Ablation methods, Thrombosis epidemiology, Thrombosis surgery
- Abstract
Background: Transesophageal echocardiography (TEE) is routinely performed before atrial fibrillation (AF) transcatheter ablation to exclude the presence of left atrial (LA) or LA appendage (LAA) thrombi. The aim of the study is to evaluate if easily accessible clinical parameters may relate to the presence of LA or LAA thrombi to identify patients who could potentially avoid TEE., Methods and Results: Between January 2012 and September 2014, data from 1539 consecutive patients undergoing TEE, as a work-up before AF transcatheter ablation, in six large volume centers were collected. Baseline clinical features, CHA
2 DS2 -VASc score, transthoracic echocardiography and presence of thrombi at TEE were recorded. Exclusion criteria were valvular, hypertrophic or dilated cardiomyopathy, previous heart surgery or an ejection fraction ≤35%. Mean age was 59.6±10.4years, 1215 (78.9%) were males; 951 (62.9%) presented in sinus rhythm (SR) on admission, 324 (21.1%) had undergone at least one previous ablation and 900 (58.5%) had CHA2 DS2 -VASc score 0-1. Thrombi were encountered in 12 patients (0.8%). SR at TEE independently related to the absence of thrombi (OR 5.15, 95% CI 1.38-19.02, p=0.015); in addition to this, no patient with a CHA2 DS2 -VASc score 0-1 and SR on admission presented thrombi at TEE (specificity 100%, p=0.011)., Conclusion: In a selected population of patients referred for AF ablation, LA/LAA thrombi prevalence is low. No patients in SR with CHA2 DS2 -VASc score 0-1 presented LAA thrombi at TEE, identifying a significant subset of patients who could potentially safely be spared from pre-procedural TEE., (Copyright © 2017 Elsevier B.V. All rights reserved.)- Published
- 2017
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6. Magnitude of QRS duration reduction after biventricular pacing identifies responders to cardiac resynchronization therapy.
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Coppola G, Ciaramitaro G, Stabile G, DOnofrio A, Palmisano P, Carità P, Mascioli G, Pecora D, De Simone A, Marini M, Rapacciuolo A, Savarese G, Maglia G, Pepi P, Padeletti L, Pierantozzi A, Arena G, Giovannini T, Caico SI, Nugara C, Ajello L, Malacrida M, and Corrado E
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- Aged, Cardiac Resynchronization Therapy mortality, Cardiovascular Diseases mortality, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Survival Rate trends, Cardiac Resynchronization Therapy methods, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases therapy, Heart Rate physiology, Ventricular Remodeling physiology
- Abstract
Background: Several studies have investigated the association between native QRS duration (QRSd) or QRS narrowing and response to biventricular pacing. However, their results have been conflicting. The aim of our study was to determine the association between the relative change in QRS narrowing index (QI) and clinical outcome and prognosis in patients who undergo cardiac resynchronization therapy (CRT) implantation., Methods and Results: We included 311 patients in whom a CRT device was implanted in accordance with current guidelines for CRT. On implantation, the native QRS, the QRSd and the QI during CRT were measured. After 6months, 220 (71%) patients showed a 10% reduction in LVESV. The median [25th-75th] QI was 14.3% [7.2-21.4] and was significantly related to reverse remodeling (r=+0.22; 95%CI: 0.11-0.32, p=0.0001). The cut-off value of QI that best predicted LV reverse remodeling after 6months of CRT was 12.5% (sensitivity=63.6%, specificity=57.1%, area under the curve=0.633, p=0.0002). The time to the event death or cardiovascular hospitalization was significantly longer among patients with QI>12.5% (log-rank test, p=0.0155), with a hazard ratio (HR) of 0.3 [95%CI: 0.11-0.78]. In the multivariate regression model adjusted for baseline parameters, a 10% increment in QI (HR=0.61[0.44-0.83], p=0.002) remained significantly associated with CRT response., Conclusions: Patients with a larger decrease in QRSd after CRT initiation showed greater echocardiographic reverse remodeling and better outcome from death or cardiovascular hospitalization. QI is an easy-to-measure variable that could be used to predict CRT response at the time of pacing site selection or pacing configuration programming., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
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7. Use of remote monitoring in the management of ICD end-of-life: Data from the DECODE registry.
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Campana A, Giofrè F, Stabile G, Iori M, La Rosa C, Tomasi C, Calzolari V, Miracapillo G, Notarstefano P, Carinci V, Calò L, Ferretti C, Manzo M, Malacrida M, and Biffi M
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Female, Follow-Up Studies, Heart Diseases physiopathology, Heart Diseases therapy, Humans, Male, Middle Aged, Prospective Studies, Defibrillators, Implantable, Disease Management, Registries, Remote Sensing Technology methods, Statistics as Topic methods, Terminal Care methods
- Published
- 2016
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8. Electrical remodeling after cardiac resynchronization therapy and its relationship with the anatomical remodeling.
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D'Onofrio A, Iuliano A, De Simone A, Pecora D, Rapacciuolo A, Ricciardi G, Marini M, Pepi P, Caico SI, Palmisano P, Giovannini T, Arena G, Maglia G, Ospizio R, Botto GL, Bertaglia E, and Stabile G
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- Aged, Female, Follow-Up Studies, Heart Failure physiopathology, Humans, Male, Atrial Remodeling physiology, Cardiac Resynchronization Therapy trends, Heart Failure diagnosis, Heart Failure therapy, Ventricular Remodeling physiology
- Published
- 2016
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9. Trends in fluoroscopy time during radiofrequency catheter ablation of supraventricular tachycardias.
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Solimene F, Donnici G, Shopova G, Nappi F, Cannizzaro E, Chiariello P, De Simone A, and Stabile G
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- Catheter Ablation adverse effects, Fluoroscopy adverse effects, Follow-Up Studies, Humans, Tachycardia, Supraventricular diagnosis, Time Factors, Catheter Ablation trends, Fluoroscopy trends, Monitoring, Intraoperative trends, Tachycardia, Supraventricular surgery
- Published
- 2016
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10. Transesophageal echocardiograpy in patients with persistent atrial fibrillation undergoing electrical cardioversion on new oral anticoagulants: A multi center registry.
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Stabile G, Russo V, Rapacciuolo A, De Divitiis M, De Simone A, Solimene F, D'Onofrio A, Iuliano A, Maresca G, Esposito F, La Rocca V, Schillaci V, De Crescenzo I, Losi MA, and Librera M
- Subjects
- Administration, Oral, Aged, Female, Heart Atria, Humans, Male, Middle Aged, Thrombosis diagnostic imaging, Thrombosis therapy, Anticoagulants administration & dosage, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation therapy, Echocardiography, Transesophageal, Electric Countershock methods, Registries
- Published
- 2015
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11. Feasibility and safety of a cardiologist-only approach to sedation for DFT testing.
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Iuliano A, Librera MT, De Simone A, La Rocca V, Solimene F, Napolitano G, Stabile E, and Stabile G
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- Aged, Anesthetics, Intravenous administration & dosage, Conscious Sedation adverse effects, Electric Countershock adverse effects, Feasibility Studies, Female, Humans, Male, Midazolam administration & dosage, Middle Aged, Cardiology methods, Conscious Sedation methods, Defibrillators, Implantable adverse effects, Electric Countershock methods, Physician's Role
- Published
- 2015
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12. Geometrical characteristics of interventricular electrical delay.
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Stabile G, D'Onofrio A, Reggiani A, De Simone A, Rapacciuolo A, Parisi Q, Pecora D, Orsida D, Giovannini T, Accogli M, Iuliano A, Botto G, Bertaglia E, Malacrida M, and Padeletti L
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- Aged, Aged, 80 and over, Cardiac Resynchronization Therapy methods, Female, Humans, Male, Middle Aged, Bundle-Branch Block physiopathology, Bundle-Branch Block therapy, Cardiac Resynchronization Therapy standards, Heart Rate physiology, Pacemaker, Artificial standards
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- 2014
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13. Prevalence of patent foramen ovale in atrial fibrillation patients with history of cerebral ischemia: a stand-alone additional risk?
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Zoppo F, Stabile G, Pappone A, Avella A, Pecora D, Corò L, Zingarini G, Verlato R, Castro A, and Bertaglia E
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- Adult, Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Prevalence, Registries, Risk Factors, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Brain Ischemia diagnosis, Brain Ischemia epidemiology, Foramen Ovale, Patent diagnosis, Foramen Ovale, Patent epidemiology
- Published
- 2014
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14. Documentation of pulmonary vein isolation improves long term efficacy of persistent atrial fibrillation catheter ablation.
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Bertaglia E, Stabile G, Senatore G, Pratola C, Verlato R, Lowe M, Raatikainen P, Lamberti F, and Turco P
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- Adult, Aged, Atrial Fibrillation diagnosis, Documentation, Electrocardiography, Ambulatory, Female, Follow-Up Studies, Heart Atria surgery, Humans, Interviews as Topic, Logistic Models, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Prospective Studies, Recurrence, Treatment Outcome, Young Adult, Atrial Fibrillation surgery, Catheter Ablation methods, Pulmonary Veins surgery
- Abstract
Background: The aim of this study was to investigate the efficacy of catheter ablation in the treatment of persistent atrial fibrillation (AF) and the predictors of arrhythmia recurrence., Methods: Absence of atrial tachyarrhythmia (AT) recurrence during a mid-term follow-up was correlated with several clinical and procedural characteristics in a population of 82 patients aged 20-70 years who had experienced at least one documented relapse of persistent AF during a single trial of antiarrhythmic drug therapy. Electrophysiological success of ablation was declared when all identified PVs were isolated (confirmation of entry and exit block). Patients were followed for a maximum of 24 months after the blanking period with outpatient visits, ECG recordings, 24-hour Holter monitoring, and weekly transtelephonic monitoring for 30s., Results: Electrophysiological success was documented in 38/82 (46.3%) patients. During a mean follow-up of 24.7 ± 4.2 months, 69/82 (84.1%) patients presented at least one episode of AT after the 2 month blanking period. According to univariate and multivariate logistic regression analyses, only an electrophysiologically successful ablation significantly correlated with the absence of documented AT relapse (OR 5.32, 95% CL 1.02-27.72; p=.0472)., Conclusions: Mid-term outcome of a single procedure of catheter ablation without the adjunction of antiarrhythmic drug therapy is poor in patients with persistent AF. Documented PV isolation is useful to increase the success rate of circumferential PV ablation even in persistent AF patients., (Copyright © 2013. Published by Elsevier Ireland Ltd.)
- Published
- 2014
- Full Text
- View/download PDF
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