14 results on '"Viani S"'
Search Results
2. Feasibility of carbon dioxide insufflation and impact on epicardial approach utilization for ventricular tachycardia ablation in a midvolume referral center.
- Author
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Zucchelli G, Parollo M, Di Cori A, Mazzocchetti L, Segreti L, Grifoni G, Torre M, Sbragi S, De Lucia R, Barletta V, Canu A, Viani S, and Bongiorni MG
- Subjects
- Humans, Male, Female, Middle Aged, Prospective Studies, Referral and Consultation, Treatment Outcome, Follow-Up Studies, Retrospective Studies, Tachycardia, Ventricular surgery, Tachycardia, Ventricular physiopathology, Insufflation methods, Feasibility Studies, Carbon Dioxide administration & dosage, Catheter Ablation methods, Pericardium surgery
- Abstract
Background: Epicardial access is often crucial for successful ventricular tachycardia (VT) ablation, but it is often burdened by significant procedural risk. Intentional coronary vein exit and intrapericardial CO
2 insufflation (EpiCO2 ) can facilitate subxiphoid pericardial access., Objective: This prospective study aimed to assess procedural feasibility, safety, and impact of the introduction of intrapericardial CO2 insufflation for epicardial access in a referral center for VT ablation., Methods: All consecutive patients treated with epicardial VT ablation between November 2022 and January 2024 with the EpiCO2 technique at Pisa University Hospital were prospectively enrolled and compared in terms of feasibility, efficiency, and safety with a local retrospective cohort of patients treated with subxiphoid dry puncture between July 2018 and October 2022., Results: Twenty-two consecutive patients (90.9% male; mean age, 54.3 years) underwent VT ablation with EpiCO2 during the study period. Epicardial access was achieved in all patients; median time from coronary sinus (CS) cannulation to epicardial access was 33 minutes. Intentional vein exit was successful in all cases, whereas CO2 insufflation was not feasible in 1 patient. There were no major complications and no significant bleeding. Since EpiCO2 introduction, epicardial approach utilization increased from 17.8% to 40% of all VT procedures. Comparison with 20 standard dry approach epicardial ablations showed no significant differences in terms of total procedural duration (322.5 [interquartile range, 296.75-363.75] minutes vs 359 [interquartile range, 323-409] minutes; P = .08)., Conclusion: In our single-center experience, EpiCO2 was feasible and safe and led to significant increase in procedural volume without affecting total procedural time compared with standard dry puncture., Competing Interests: Disclosures The authors have no conflicts to disclose., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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3. Lipomatous metaplasia as the most reliable computed tomography predictor for functional substrate localization in scar-related ventricular tachycardia.
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Parollo M, Mazzocchetti L, Di Cori A, Segreti L, De Lucia R, Grifoni G, Barletta V, Faggioni L, Aquaro GD, Neri E, Canu A, Viani S, Soldati E, Berruezo A, and Zucchelli G
- Subjects
- Humans, Cicatrix complications, Cicatrix diagnosis, Tomography, X-Ray Computed, Metaplasia, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular etiology, Catheter Ablation
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- 2023
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4. Longevity of model 3501 subcutaneous implantable cardioverter-defibrillator leads in clinical practice.
- Author
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Viani S, Migliore F, Ottaviano L, Biffi M, Ammendola E, Ricciardi G, Francia P, D'Onofrio A, Bisignani G, Russo AD, De Filippo P, Solimene F, Scalone A, Caravati F, Rordorf R, Calvi VI, Botto GL, and Bongiorni MG
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- Defibrillators, Implantable
- Published
- 2022
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5. Time to therapy delivery and effectiveness of the subcutaneous implantable cardioverter-defibrillator.
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Diemberger I, Migliore F, Ricciardi G, Ottaviano L, Tavoletta V, Francia P, Viani S, Capucci A, de Filippo P, Nigro G, Caravati F, Palmisano P, Ziacchi M, Lovecchio M, Valsecchi S, Bongiorni MG, and Biffi M
- Subjects
- Adult, Age Factors, Analysis of Variance, Cohort Studies, Defibrillators, Implantable, Female, Humans, Italy, Male, Middle Aged, Multivariate Analysis, Retrospective Studies, Risk Assessment, Severity of Illness Index, Sex Factors, Survival Rate, Treatment Outcome, Ventricular Fibrillation mortality, Ventricular Fibrillation physiopathology, Electric Countershock methods, Electric Countershock mortality, Electrocardiography methods, Time-to-Treatment, Ventricular Fibrillation diagnostic imaging, Ventricular Fibrillation therapy
- Abstract
Background: At the time of subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation, successful termination of ventricular fibrillation (VF) is confirmed. A previous study reported cases of prolonged time to therapy during defibrillation testing., Objectives: We sought to evaluate the time to therapy, identify possible predictors of delay, and investigate the impact of delayed therapy on VF conversion., Methods: We analyzed consecutive patients with S-ICDs who underwent initial conversion testing at a shock energy of 65 J in 53 Italian centers., Results: We analyzed 570 patients (467 [82%] male; mean age 48 ± 15 years; mean body mass index 25 ± 6 kg/m
2 ; mean ejection fraction 47% ± 17%). General anesthesia was used in 165 (29%) of patients, with sub- or intermuscular positioning of the generator in (422; 74%). Cardioversion was successful at 65 J in 557 (97.7%) of patients. In 12 patients (2.1%) the shock did not convert VF, and in 1 patient the shock was not delivered because of noise from entrapped subcutaneous air. All failures were successfully managed by reprogramming or repositioning the device. The mean time to therapy was 15 ± 3 seconds, and it exceeded 18 seconds in 51 patients (9%). Independent predictors of delayed therapy (18 seconds) were ejection fraction (odds ratio [OR] 0.98; 95% confidence interval [CI] 0.96-0.99; P = .016) and a 2× gain programmed (OR 3.66; 95% CI 1.44-9.30; P = .006). Effectiveness at 65 J was not associated with time to therapy (OR 1.13; 95% CI 0.97-1.32; P = .122)., Conclusion: In this analysis of a large population of patients with S-ICDs, delayed therapy during defibrillation testing occurred less frequently than previously reported and had no effect on VF conversion success. Delayed therapies seemed more common when a vector with a 2× gain was programmed., (Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)- Published
- 2019
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6. Use and outcomes of subcutaneous implantable cardioverter-defibrillator (ICD) after transvenous ICD extraction: An analysis of current clinical practice and a comparison with transvenous ICD reimplantation.
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Viani S, Migliore F, Tola G, Pisanò ECL, Russo AD, Luzzi G, Sartori P, Piro A, Rordorf R, Forleo GB, Rago A, Segreti L, Bertaglia E, Biffi M, Lovecchio M, Valsecchi S, Diemberger I, and Bongiorni MG
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- Echocardiography, Electrocardiography, Female, Humans, Italy, Male, Middle Aged, Registries, Retreatment, Retrospective Studies, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable adverse effects, Device Removal, Electrodes, Implanted adverse effects, Practice Patterns, Physicians'
- Abstract
Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) does not require the insertion of any leads into the cardiovascular system., Objective: The aims of the study were to describe current practice and to measure outcomes associated with S-ICD or standard single-chamber transvenous ICD (TV-ICD) use after TV-ICD explantation., Methods: We analyzed all consecutive patients who underwent transvenous extraction of an ICD and subsequent implantation of an S-ICD or a single-chamber TV-ICD at 12 Italian centers from 2011 to 2017., Results: A total of 229 patients were extracted and subsequently reimplanted with an S-ICD (90; 39%) or a single-chamber TV-ICD (139; 61%). S-ICD implantation increased from 9% in 2011 to 85% in 2017 (P < .001). Patients reimplanted with an S-ICD were younger (53 ± 13 years vs 60 ± 18 years; P = .011) and more frequently had undergone extraction owing to infection (73% vs 52%; P < .001). The rates of complications at follow-up were comparable between groups (hazard ratio 0.97; 95% confidence interval 0.49-1.92; P = .940). No lead failures, systemic infections, or system-related deaths occurred in the S-ICD group. In the TV-ICD group, 1 lead fracture occurred and 2 systemic infections were reported, resulting in death in 1 case. In the S-ICD group, the rate of complications was lower when the generator was positioned in a sub- or intermuscular pocket (hazard ratio 0.21; 95% confidence interval 0.05-0.87; P = .048)., Conclusion: Our results show an increasing use of S-ICD over the years in patients undergoing TV-ICD explantation. An S-ICD is preferably adopted in young patients, mostly in the case of infection. The complication rate was comparable between groups and decreased when a sub- or intermuscular S-ICD generator position was adopted., (Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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7. Subcutaneous implantable cardioverter defibrillator in patients with arrhythmogenic right ventricular cardiomyopathy: Results from an Italian multicenter registry.
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Migliore F, Viani S, Bongiorni MG, Zorzi A, Silvetti MS, Francia P, D'Onofrio A, De Franceschi P, Sala S, Donzelli S, Ricciardi G, Menardi E, Giammaria M, La Greca C, Bauce B, Rigato I, Iliceto S, Bertaglia E, Diemberger I, and Corrado D
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- Adolescent, Adult, Aged, Arrhythmogenic Right Ventricular Dysplasia diagnosis, Child, Electrocardiography methods, Electrocardiography trends, Female, Follow-Up Studies, Humans, Italy epidemiology, Male, Middle Aged, Young Adult, Arrhythmogenic Right Ventricular Dysplasia physiopathology, Arrhythmogenic Right Ventricular Dysplasia therapy, Defibrillators, Implantable trends, Registries, Subcutaneous Tissue
- Abstract
Background: Despite expanding indication of the subcutaneous implantable cardioverter defibrillator (S-ICD) in clinical practice, limited data exists on safety and efficacy of S-ICD in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. The aim of this multicenter study was to evaluate the safety and efficacy of S-ICD in ARVC patients., Methods: The study population included 44 consecutive patients with definite ARVC diagnosis according to the 2010 ITF criteria (57% male, mean age 37 ± 17 years [range 10-75 years]) who received an S-ICD. Eighteen (41%) patients were implanted for secondary prevention., Results: At implant, all inducible patients (34/44) had conversion of ventricular fibrillation at 65 J. No early complications occurred. During a median follow-up of 12 months (7-19), 3 (6.8%) patients experienced complications requiring surgical revision. No local or systemic device-related infections were observed. Six patients (14%) received a total of 61 appropriate and successful shocks on ventricular arrhythmias. Six (14%) patients experienced 8 inappropriate shocks for oversensing of cardiac signal (4 cases) and non-cardiac signal (4 cases) with one patient requiring device explantation. No patients had the device explanted due to the need for antitachycardia pacing., Conclusions: The study shows that S-ICD provides safe and effective therapy for termination of both induced and spontaneous malignant ventricular tachyarrhythmias with high energy shocks in ARVC patients, but the risk of inappropriate shocks and complications needing surgical revision should be considered., (Copyright © 2019. Published by Elsevier B.V.)
- Published
- 2019
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8. Performance and clinical comparison between left ventricular quadripolar and bipolar leads in cardiac resynchronization therapy: Observational research.
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Ziacchi M, Zucchelli G, Ricciardi D, Morani G, De Ruvo E, Calzolari V, Viani S, Calabrese V, Tomasi L, Calò L, De Mattia L, Bongiorni MG, Boriani G, and Biffi M
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- Aged, Equipment Design, Female, Follow-Up Studies, Heart Failure physiopathology, Humans, Male, Retrospective Studies, Time Factors, Treatment Outcome, Cardiac Resynchronization Therapy methods, Electrodes, Implanted, Heart Failure therapy, Heart Ventricles physiopathology, Ventricular Remodeling physiology
- Abstract
Aim: To evaluate Attain Performa (Medtronic, Dublin, Ireland) quadripolar lead performance in clinical practice and, secondarily, to compare its long term clinical outcomes vs bipolar leads for left ventricular (LV) pacing., Methods and Results: We retrospectively analyzed clinical, procedural and follow-up data of 215 patients implanted with a quadripolar lead. One hundred and twenty one patients implanted with bipolar lead were selected to compare long-term clinical outcomes. The quadripolar lead was implanted in the target vein in 196 patients (91%) without acute dislodgements. In 50% of patients the chosen final pacing configuration at implant would not have been available with bipolar leads. A dedicated quadripolar pacing vector was chosen more frequently when the LV tip location was apical than otherwise (65.6% vs 42.7%, p=0.003). After a median follow-up of 14 months, the LV pacing threshold was less than 2.5V at 0.4ms in 98 patients (90%) with a safety margin between phrenic nerve and LV pacing threshold >3V in 97 patients (89%). We observed a slight trend toward a lower risk of heart failure worsening and a lower incidence of ventricular arrhythmias and pulmonary congestion in patients implanted with quadripolar leads compared with the control group., Conclusion: Quadripolar leads improve the management of phrenic nerve stimulation at no trade-off with pacing threshold and lead stability. Quadripolar leads seems to be associated with a lower incidence of VT/VF and pulmonary congestion, when compared with bipolar leads, but further investigations are necessary to confirm that this positive effect is associated with better LV reverse remodeling., (Copyright © 2018 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)
- Published
- 2018
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9. Effectiveness of subcutaneous implantable cardioverter-defibrillator testing in patients with hypertrophic cardiomyopathy.
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Maurizi N, Tanini I, Olivotto I, Amendola E, Limongelli G, Losi MA, Allocca G, Perego GB, Pieragnoli P, Ricciardi G, De Filippo P, Ferrari P, Quarta G, Viani S, Rapacciuolo A, Bongiorni MG, and Cecchi F
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- Adolescent, Adult, Aged, Cardiomyopathy, Hypertrophic complications, Death, Sudden, Cardiac etiology, Equipment Safety, Female, Follow-Up Studies, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Ventricular Fibrillation complications, Ventricular Fibrillation therapy, Young Adult, Cardiomyopathy, Hypertrophic therapy, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Electric Countershock instrumentation
- Abstract
Background: Subcutaneous ICD (S-ICD) is a promising option for Hypertrophic Cardiomyopathy (HCM) patients at risk of Sudden Cardiac Death (SCD). However, its effectiveness in terminating ventricular arrhythmias in HCM is yet unresolved., Methods: Consecutive HCM patients referred for S-ICD implantation were prospectively enrolled. Patients underwent one or two attempts of VF induction by the programmer. Successful conversion was defined as any 65J shock that terminated VF (not requiring rescue shocks). Clinical and instrumental parameters were analyzed to study predictors of conversion failure., Results: Fifty HCM patients (34 males, 40±16years) with a mean BMI of 25.2±4.4kg/m2 were evaluated. Mean ESC SCD risk of was 6.5±3.9% and maximal LV wall thickness (LVMWT) was 26±6mm. In 2/50 patients no arrhythmias were inducible, while in 7 (14%) only sustained ventricular tachycardia was induced and cardioverted. In the remaining 41 (82%) patients, 73 VF episodes were induced (1 episode in 14 and >1 in 27 patients). Of these, 4 (6%) spontaneously converted. In 68/69 (98%) the S-ICD successfully cardioverted, but failed in 1 (2%) patient, who needed rescue defibrillation. This patient was severely obese (BMI 36) and LVMWT of 25mm. VF was re-induced and successfully converted by the 80J reversed polarity S-ICD., Conclusions: Acute DT at 65J at the implant showed the effectiveness of S-ICD in the recognition and termination of VT/VF in all HCM patients except one. Extreme LVH did not affect the performance of the device, whereas severe obesity was likely responsible for the single 65J failure., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
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10. Subcutaneous Implantable Defibrillator in an acromegalic pregnant woman for secondary prevention of sudden cardiac death: When (2) technologies save (2) lives.
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Viani S, Zucchelli G, Paperini L, Soldati E, Segreti L, Di Cori A, Menichetti F, Coluccia G, Andreini D, Branchitta G, and Bongiorni MG
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- Acromegaly complications, Acromegaly diagnostic imaging, Adult, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Cardiovascular diagnostic imaging, Secondary Prevention trends, Acromegaly therapy, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable trends, Human Growth Hormone metabolism, Pregnancy Complications, Cardiovascular prevention & control, Secondary Prevention methods
- Published
- 2016
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11. Incessant accelerated idioventricular rhythm in pregnancy: An unusual long lasting case.
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Zucchelli G, Soldati E, Segreti L, Di Cori A, Viani S, Menichetti F, Coluccia G, Branchitta G, Andreini D, Taponeco F, and Bongiorni MG
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- Adult, Electrocardiography trends, Female, Heart Rate physiology, Humans, Pregnancy, Time Factors, Accelerated Idioventricular Rhythm diagnosis, Accelerated Idioventricular Rhythm physiopathology, Pregnancy Complications, Cardiovascular diagnosis, Pregnancy Complications, Cardiovascular physiopathology
- Published
- 2016
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12. Transvenous extraction profile of Riata leads: procedural outcomes and technical complexity of mechanical removal.
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Bongiorni MG, Di Cori A, Segreti L, Zucchelli G, Viani S, Paperini L, De Lucia R, Levorato D, Boem A, and Soldati E
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- Aged, Equipment Design instrumentation, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, United States, Defibrillators, Implantable adverse effects, Device Removal statistics & numerical data, Electrodes, Implanted adverse effects, Equipment Design adverse effects, Equipment Failure statistics & numerical data, Medical Device Recalls
- Abstract
Background: Riata (RT) and Sprint Fidelis (SF) leads were recalled by the United States Food and Drug Administration because of an increased rate of failure mainly due to conductor fracture or insulation abrasion. According to lead design and type of failure, extraction complexity may be different, potentially affecting procedural outcomes and indications., Objective: The purpose of this study was to assess the extraction profile of RT leads with and without cable externalization in comparison to SF leads., Methods: From January 1997 to April 2014, all consecutive RT and SF leads extracted transvenously were analyzed. Among 661 consecutive patients with 705 ventricular implantable cardioverter-defibrillator (ICD) leads extracted, 194 patients with 134 RT leads (RT group) and 61 SF leads (SF group) were identified. Removal indications often were infective (64%), and extracted leads had a prevalence of dual-coil design (89%). Baseline patients and lead characteristics were comparable between groups., Results: Success rate was high in both groups (97.8% RT vs 100% SF) without major complications. Mechanical dilation was comparable between groups, but RT leads often required larger sheaths (11.7 ± 1.4 vs 11.3 ± 1.4), a more frequent crossover to the internal transjugular approach (14% vs 3%), and a longer procedural time (23 ± 33 minutes vs 12 ± 16 minutes). Implantation time (odds ratio 4.84, 95% confidence interval 1.05-22.2, P = .042) and RT leads (odds ratio 1.04, 95% confidence interval 1.02-1.06, P <.001) were independent predictors of the internal transjugular approach., Conclusion: Extraction of RT leads is feasible and effective. However, extraction of RT leads is more complex than that of SF leads. Lack of coil backfilling and cable externalization in RT group may account for these differences., (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
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13. Major predictors of fibrous adherences in transvenous implantable cardioverter-defibrillator lead extraction.
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Segreti L, Di Cori A, Soldati E, Zucchelli G, Viani S, Paperini L, De Lucia R, Coluccia G, Valsecchi S, and Bongiorni MG
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- Aged, Aged, 80 and over, Analysis of Variance, Cohort Studies, Device Removal statistics & numerical data, Electrodes, Implanted adverse effects, Female, Follow-Up Studies, Heart Failure diagnosis, Heart Failure mortality, Heart Failure therapy, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Survival Rate, Tissue Adhesions, Treatment Outcome, Defibrillators, Implantable adverse effects, Device Removal methods, Fibrosis pathology, Jugular Veins
- Abstract
Background: Percutaneous removal of implantable cardioverter-defibrillator (ICD) leads is a difficult procedure because of the consequence of massive fibrous tissue growth along the lead., Objective: The purpose of this study was to describe the occurrence and location of fibrous adherences in ICD lead extraction and to identify potential predictors among patient and lead characteristics., Methods: We studied 637 consecutive patients who underwent transvenous extraction of 678 ICD leads from 1997 to 2013., Results: Procedural success rate was 99%, without major complications. Areas of adherence were found in the subclavian vein (78%), innominate vein (65%), superior vena cava (66%), and heart (73%). Dwell-time, passive fixation, and dual-coil lead design were independently associated with adherences. Dual-coil lead design was associated with adherences in the innominate vein and superior vena cava, whereas coil treatment (eg, expandable polytetrafluoroethylene-coated or medical adhesive back-filled strategies) prevented adherences. Passive fixation mechanism was associated with adherences in the heart., Conclusion: ICD leads, after long dwell-time, are affected by fibrous adherences uniformly distributed along the lead course. Lead features represent major predictors of the phenomenon. Careful lead selection is recommended at the time of implantation to prevent adherences. In addition, lead-related risk stratification is mandatory before a transvenous extraction procedure., (Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
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14. Short-term extraction profile of cardiac pacing leads with hybrid silicone-polyurethane insulator: a pilot study.
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Di Cori A, Bongiorni MG, Zucchelli G, Lilli A, Coluccia G, Fabiani I, Segreti L, Paperini L, Viani S, and Soldati E
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- Equipment Design, Female, Humans, Male, Middle Aged, Pilot Projects, Polyurethanes, Silicones, Time Factors, Device Removal methods, Electrodes, Implanted, Pacemaker, Artificial
- Published
- 2013
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