31 results on '"Champagne J"'
Search Results
2. Complications associated with revision of Sprint Fidelis leads: report from the Canadian Heart Rhythm Society Device Advisory Committee.
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Parkash R, Crystal E, Bashir J, Simpson C, Birnie D, Sterns L, Exner D, Thibault B, Connors S, Healey JS, Champagne J, Cameron D, Mangat I, Verma A, Wolfe K, Essebag V, Kus T, Ayala-Paredes F, Davies T, and Sanatani S
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- 2010
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3. Systematic assessment of patients with unexplained cardiac arrest: Cardiac Arrest Survivors With Preserved Ejection Fraction Registry (CASPER).
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Krahn AD, Healey JS, Chauhan V, Birnie DH, Simpson CS, Champagne J, Gardner M, Sanatani S, Exner DV, Klein GJ, Yee R, Skanes AC, Gula LJ, Gollob MH, Krahn, Andrew D, Healey, Jeffrey S, Chauhan, Vijay, Birnie, David H, Simpson, Christopher S, and Champagne, Jean
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- 2009
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4. Fetomaternal hemorrhage during external cephalic version.
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Boucher M, Marquette GP, Varin J, Champagne J, and Bujold E
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- 2008
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5. Effect of amiodarone and sotalol on ventricular defibrillation threshold: the optimal pharmacological therapy in cardioverter defibrillator patients (OPTIC) trial.
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Hohnloser SH, Dorian P, Roberts R, Gent M, Israel CW, Fain E, Champagne J, and Connolly SJ
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- 2006
6. Reactive hemophagocytic syndrome presenting as a component of multiple organ dysfunction syndrome.
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Gauvin, F, Toledano, B, Champagne, J, and Lacroix, J
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- 2000
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7. N-acetylcysteine in pig liver transplantation from non-heart-beating donors
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Manika, A., Trinh, T., Lagace, G., Dugas, M.A., Proulx, F., Lepage, G., Champagne, J., Lavoie, J.C., Cousineau, J., Russo, P., Chartrand, C., and Yandza, T.
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- 1999
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8. Axis II comorbidity and developmental adversity in bulimia nervosa.
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STEIGER, HOWARD, JABALPURWALA, SHEILA, CHAMPAGNE, JOSEE, Steiger, H, Jabalpurwala, S, and Champagne, J
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- 1996
9. Effect of High-dose Folic Acid Supplementation in Pregnancy on Preeclampsia (FACT): Double-blind, Phase III, Randomized Controlled, International, Multicenter Trial.
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Wen, S. W., White, R. R., Rybak, N., Gaudet, L. M., Robson, S., Hague, W., Simms-Stewart, D., Carroli, G., Smith, G., Fraser, W. D., Wells, G., Davidge, S. T., Kingdom, J., Coyle, D., Fergusson, D., Corsi, D. J., Champagne, J., Sabri, E., Ramsay, T., and Mol, B. W. J.
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- 2019
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10. Obesity and metabolic syndrome are independent risk factors for atrial fibrillation after coronary artery bypass graft surgery.
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Echahidi N, Mohty D, Pibarot P, Després J, O'Hara G, Champagne J, Philippon F, Daleau P, Voisine P, and Mathieu P
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- 2007
11. #305 Management of persistent platelet transfusion refractoriness (PTR) using plasma exchange with immunoabsorption (IA).
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Champagne, M., Moghrabi, A., Champagne, J., David, M., Demers, J., Rivard, G. E., and Hume, H.
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- 1999
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12. #304 Cord blood banking for potential use in a pediatric population.
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Champagne, M., Moghrabi, A., Vachon, M. F., Roy, G., Gauthier, R., Champagne, J., David, M., Demers, J., Hume, H., and Rivard, G. E.
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- 1999
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13. Characteristics of Patients with Spontaneous Versus Drug-Induced Brugada Electrocardiogram: Sub-Analysis From the SABRUS.
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Milman A, Sabbag A, Conte G, Postema PG, Andorin A, Gourraud JB, Sacher F, Mabo P, Kim SH, Maeda S, Takahashi Y, Kamakura T, Aiba T, Juang JJ, Michowitz Y, Leshem E, Mizusawa Y, Arbelo E, Huang Z, Denjoy I, Giustetto C, Wijeyeratne YD, Mazzanti A, Brugada R, Casado-Arroyo R, Champagne J, Calo L, Sarquella-Brugada G, Tfelt-Hansen J, Priori SG, Takagi M, Veltmann C, Delise P, Corrado D, Behr ER, Gaita F, Yan GX, Brugada J, Leenhardt A, Wilde AAM, Brugada P, Kusano KF, Hirao K, Nam GB, Probst V, and Belhassen B
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- Humans, Death, Sudden, Cardiac, Electrocardiography, Ventricular Fibrillation, Brugada Syndrome chemically induced, Brugada Syndrome diagnosis
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- 2023
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14. DREAM-ICD-II Study.
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Steinberg C, Dognin N, Sodhi A, Champagne C, Staples JA, Champagne J, Laksman ZW, Sarrazin JF, Bennett MT, Plourde B, Deyell MW, Andrade JG, Roy K, Yeung-Lai-Wah JA, Hawkins NM, Mondésert B, Blier L, Nault I, O'Hara G, Krahn AD, Philippon F, and Chakrabarti S
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- Canada, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac etiology, Death, Sudden, Cardiac prevention & control, Humans, Primary Prevention methods, Retrospective Studies, Risk Factors, Time Factors, Defibrillators, Implantable adverse effects
- Abstract
Background: Regulatory authorities of most industrialized countries recommend 6 months of private driving restriction after implantation of a secondary prevention implantable cardioverter-defibrillator (ICD). These driving restrictions result in significant inconvenience and social implications. This study aimed to assess the incidence rate of appropriate device therapies in contemporary recipients of a secondary prevention ICD., Methods: This retrospective study at 3 Canadian tertiary care centers enrolled consecutive patients with new secondary prevention ICD implants between 2016 and 2020., Results: For a median of 760 days (324, 1190 days), 721 patients were followed up. The risk of recurrent ventricular arrhythmia was highest during the first 3 months after device insertion (34.4%) and decreased over time (10.6% between 3 and 6 months, 11.7% between 6 and 12 months). The corresponding incidence rate per 100 patient-days was 0.48 (95% CI, 0.35-0.64) at 90 days, 0.28 (95% CI, 0.17-0.45) at 180 days, and 0.21 (95% CI, 0.13-0.33) between 181 and 365 days after ICD insertion ( P <0.001). The cumulative incidence of arrhythmic syncope resulting in sudden cardiac incapacitation was 1.8% within the first 90 days and subsequently dropped to 0.4% between 91 and 180 days ( P <0.001) after ICD insertion., Conclusions: The incidence rate of appropriate therapies resulting in sudden cardiac incapacitation in contemporary recipients of a secondary prevention ICD is much lower than previously reported and declines significantly after the first 3 months. Lowering driving restrictions to 3 months after the index cardiac event seems safe, and revision of existing guidelines should be considered in countries still adhering to a 6-month period. Existing restrictions for private driving after implantation of a secondary prevention ICD should be reconsidered.
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- 2022
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15. Repeat Atrial Fibrillation Ablation Procedures in the CIRCA-DOSE Study.
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Cheung CC, Deyell MW, Macle L, Verma A, Champagne J, Leong-Sit P, Novak P, Badra-Verdu M, Sapp J, Khairy P, and Andrade JG
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- Action Potentials, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Canada, Heart Rate, Humans, Pulmonary Veins physiopathology, Recurrence, Reoperation, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation adverse effects, Cryosurgery adverse effects, Pulmonary Veins surgery
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- 2020
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16. Short-Term Oral Anticoagulation Versus Antiplatelet Therapy Following Transcatheter Left Atrial Appendage Closure.
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Asmarats L, O'Hara G, Champagne J, Paradis JM, Bernier M, O'Connor K, Beaudoin J, Junquera L, Del Val D, Muntané-Carol G, Côté M, and Rodés-Cabau J
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- Administration, Oral, Aged, Aged, 80 and over, Anticoagulants adverse effects, Antithrombin III, Atrial Appendage diagnostic imaging, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Biomarkers blood, Blood Coagulation drug effects, Drug Administration Schedule, Female, Fibrinolytic Agents adverse effects, Heart Rate, Humans, Male, Peptide Fragments blood, Peptide Hydrolases blood, Platelet Aggregation Inhibitors adverse effects, Prospective Studies, Prothrombin, Risk Assessment, Risk Factors, Thrombosis blood, Thrombosis diagnostic imaging, Thrombosis etiology, Time Factors, Treatment Outcome, Anticoagulants administration & dosage, Atrial Appendage physiopathology, Atrial Fibrillation therapy, Atrial Function, Left, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Fibrinolytic Agents administration & dosage, Platelet Aggregation Inhibitors administration & dosage, Thrombosis prevention & control
- Abstract
Background: The impact of antithrombotic therapy on coagulation system activation after left atrial appendage closure (LAAC) remains unknown. This study sought to compare changes in coagulation markers associated with short-term oral anticoagulation (OAC) versus antiplatelet therapy (APT) following LAAC., Methods: Prospective study including 78 atrial fibrillation patients undergoing LAAC with the Watchman device. F1+2 (prothrombin fragment 1+2) and TAT (thrombin-antithrombin III) were assessed immediately before the procedure, and at 7, 30, and 180 days after LAAC., Results: Forty-eight patients were discharged on APT (dual: 31, single: 17) and 30 on OAC (direct anticoagulants: 26, vitamin K antagonists: 4), with no differences in baseline-procedural characteristics between groups except for higher spontaneous echocardiography contrast in the OAC group. OAC significantly reduced coagulation activation within 7 days post-LAAC compared with APT (23% [95% CI, 5%-41%] versus 82% [95% CI, 54%-111%] increase for F1+2, P =0.007; 52% [95% CI, 15%-89%] versus 183% [95% CI, 118%-248%] increase for TAT, P =0.048), with all patients in both groups progressively returning to baseline values at 30 and 180 days. Spontaneous echocardiography contrast pre-LAAC was associated with an enhanced activation of the coagulation system post-LAAC (144 [48-192] versus 52 [24-111] nmol/L, P =0.062 for F1+2; 299 [254-390] versus 78 [19-240] ng/mL, P =0.002 for TAT). Device-related thrombosis occurred in 5 patients (6.4%), and all of them were receiving APT at the time of transesophageal echocardiography (10.2% versus 0% if OAC at the time of transesophageal echocardiography, P =0.151). Patients with device thrombosis exhibited a greater coagulation activation 7 days post-LAAC ( P =0.038 and P =0.108 for F1+2 and TAT, respectively)., Conclusions: OAC (versus APT) was associated with a significant attenuation of coagulation system activation post-LAAC. Spontaneous echocardiography contrast pre-LAAC associated with enhanced coagulation activation post-LAAC, which in turn increased the risk of device thrombosis. These results highlight the urgent need for randomized trials comparing OAC versus APT post-LAAC.
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- 2020
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17. Cryoballoon or Radiofrequency Ablation for Atrial Fibrillation Assessed by Continuous Monitoring: A Randomized Clinical Trial.
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Andrade JG, Champagne J, Dubuc M, Deyell MW, Verma A, Macle L, Leong-Sit P, Novak P, Badra-Verdu M, Sapp J, Mangat I, Khoo C, Steinberg C, Bennett MT, Tang ASL, and Khairy P
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- Aged, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation physiopathology, Female, Fluoroscopy, Humans, Longitudinal Studies, Male, Middle Aged, Treatment Outcome, Atrial Fibrillation surgery, Catheter Ablation, Cryosurgery
- Abstract
Background: Advanced generation ablation technologies have been developed to achieve more effective pulmonary vein isolation (PVI) and minimize arrhythmia recurrence after atrial fibrillation (AF) ablation., Methods: We randomly assigned 346 patients with drug-refractory paroxysmal AF to contact force-guided radiofrequency ablation (CF-RF; n=115), 4-minute cryoballoon ablation (Cryo-4; n=115), or 2-minute cryoballoon ablation (Cryo-2; n=116). Follow-up was 12 months. The primary outcome was time to first documented recurrence of symptomatic or asymptomatic atrial tachyarrhythmia (AF, atrial flutter, or atrial tachycardia) between days 91 and 365 after ablation or a repeat ablation procedure at any time. Secondary end points included freedom from symptomatic arrhythmia and AF burden. All patients received an implantable loop recorder., Results: One-year freedom from atrial tachyarrhythmia defined by continuous rhythm monitoring was 53.9%, 52.2%, and 51.7% with CF-RF, Cryo-4, and Cryo-2, respectively ( P =0.87). One-year freedom from symptomatic atrial tachyarrhythmia defined by continuous rhythm monitoring was 79.1%, 78.2%, and 73.3% with CF-RF, Cryo-4, and Cryo-2, respectively ( P =0.26). Compared with the monitoring period before ablation, AF burden was reduced by a median of 99.3% (interquartile range, 67.8%-100.0%) with CF-RF, 99.9% (interquartile range, 65.3%-100.0%) with Cryo-4, and 98.4% (interquartile range, 56.2%-100.0%) with Cryo-2 ( P =0.36). Serious adverse events occurred in 3 patients (2.6%) in the CF-RF group, 6 patients (5.3%) in the Cryo-4 group, and 7 patients (6.0%) in the Cryo-2 group, with no significant difference between groups ( P =0.24). The CF-RF group had a significantly longer procedure duration but significantly shorter fluoroscopy exposure ( P <0.001 vs cryoballoon groups)., Conclusions: In this multicenter, randomized, single-blinded trial, CF-RF and 2 different regimens of cryoballoon ablation resulted in no difference in 1-year efficacy, which was 53% by time to first recurrence but >98% burden reduction as assessed by continuous cardiac rhythm monitoring., Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01913522.
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- 2019
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18. Gray Zone Lymphoma Arising in the Neck of a Teenager With a Germline Mutation in TP53.
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Gatineau-Sailliant S, Turcotte K, Quintal MC, Turpin S, Champagne J, Petrella T, Roussy M, Cellot S, and Bouron-Dal Soglio D
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- Adolescent, Combined Modality Therapy, Female, Humans, Lymphoma, B-Cell genetics, Lymphoma, B-Cell therapy, Prognosis, Germ-Line Mutation, Lymphoma, B-Cell pathology, Neck pathology, Palatine Tonsil pathology, Tumor Suppressor Protein p53 genetics
- Abstract
Gray zone lymphoma is an aggressive disease for which appropriate management is still debated. We report a 15-year-old girl with a cervical mass, an enlarged ipsilateral tonsil, and anemia. Both sites showed hypermetabolism on F18-FG positron emission tomography/CT. Surgical resection was diagnostic of Epstein-Barr virus-negative gray zone lymphoma cervical and tonsillar involvement. No abnormality was found in cytogenetic analysis on tumor cells. However, exome sequencing in peripheral blood DNA revealed a germline mutation in TP53. Complete response was achieved after surgery and 6 cycles of rituximab with dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin regimen.
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- 2019
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19. Age of First Arrhythmic Event in Brugada Syndrome: Data From the SABRUS (Survey on Arrhythmic Events in Brugada Syndrome) in 678 Patients.
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Milman A, Andorin A, Gourraud JB, Sacher F, Mabo P, Kim SH, Maeda S, Takahashi Y, Kamakura T, Aiba T, Conte G, Juang JJM, Leshem E, Rahkovich M, Hochstadt A, Mizusawa Y, Postema PG, Arbelo E, Huang Z, Denjoy I, Giustetto C, Wijeyeratne YD, Napolitano C, Michowitz Y, Brugada R, Casado-Arroyo R, Champagne J, Calo L, Sarquella-Brugada G, Tfelt-Hansen J, Priori SG, Takagi M, Veltmann C, Delise P, Corrado D, Behr ER, Gaita F, Yan GX, Brugada J, Leenhardt A, Wilde AAM, Brugada P, Kusano KF, Hirao K, Nam GB, Probst V, and Belhassen B
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- Adolescent, Adult, Age of Onset, Aged, Female, Humans, Male, Middle Aged, Prognosis, Brugada Syndrome physiopathology, Brugada Syndrome therapy, Defibrillators, Implantable
- Abstract
Background: Data on the age at first arrhythmic event (AE) in Brugada syndrome are from limited patient cohorts. The aim of this study is 2-fold: (1) to define the age at first AE in a large cohort of patients with Brugada syndrome, and (2) to assess the influence of the mode of AE documentation, sex, and ethnicity on the age at first AE., Methods and Results: A survey of 23 centers from 10 Western and 4 Asian countries gathered data from 678 patients with Brugada syndrome (91.3% men) with first AE documented at time of aborted cardiac arrest (group A, n=426) or after prophylactic implantable cardioverter-defibrillator implantation (group B, n=252). The vast majority (94.2%) of the patients were 16 to 70 years old at the time of AE, whereas pediatric (<16 years) and elderly patients (>70 years) comprised 4.3% and 1.5%, respectively. Peak AE rate occurred between 38 and 48 years (mean, 41.9±14.8; range, 0.27-84 years). Group A patients were younger than in Group B by a mean of 6.7 years (46.1±13.2 versus 39.4±15.0 years; P <0.001). In adult patients (≥16 years), women experienced AE 6.5 years later than men ( P =0.003). Whites and Asians exhibited their AE at the same median age (43 years)., Conclusions: SABRUS (Survey on Arrhythmic Events in Brugada Syndrome) presents the first analysis on the age distribution of AE in Brugada syndrome, suggesting 2 age cutoffs (16 and 70 years) that might be important for decision-making. It also allows gaining insights on the influence of mode of arrhythmia documentation, patient sex, and ethnic origin on the age at AE., (© 2017 American Heart Association, Inc.)
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- 2017
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20. Genetic Testing in the Evaluation of Unexplained Cardiac Arrest: From the CASPER (Cardiac Arrest Survivors With Preserved Ejection Fraction Registry).
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Mellor G, Laksman ZWM, Tadros R, Roberts JD, Gerull B, Simpson CS, Klein GJ, Champagne J, Talajic M, Gardner M, Steinberg C, Arbour L, Birnie DH, Angaran P, Leather R, Sanatani S, Chauhan VS, Seifer C, Healey JS, and Krahn AD
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- Adult, Calcium Channels, L-Type genetics, Cardiomyopathies genetics, Cardiomyopathies pathology, Channelopathies genetics, Channelopathies pathology, Coronary Vessels metabolism, Electrocardiography, Female, Heart Arrest genetics, Humans, Male, Middle Aged, NAV1.5 Voltage-Gated Sodium Channel genetics, Odds Ratio, Phenotype, Ryanodine Receptor Calcium Release Channel genetics, Survivors, Ventricular Function, Left genetics, Genetic Testing, Heart Arrest pathology, Registries
- Abstract
Background: Unexplained cardiac arrest may be because of an inherited arrhythmia syndrome. The role of genetic testing in cardiac arrest survivors without a definite clinical phenotype is unclear., Methods and Results: The CASPER (Cardiac Arrest Survivors with Preserved Ejection Fraction Registry) is a large registry of cardiac arrest survivors where initial assessment reveals normal coronary arteries, left ventricular function, and resting ECG. Of 375 cardiac arrest survivors in CASPER from 2006 to 2015, 174 underwent genetic testing. Patients were classified as phenotype-positive (n=72) or phenotype-negative (n=102). Genetic testing was performed at treating physicians' discretion in line with contemporary guidelines and availability. All genetic variants identified from original laboratory reports were reassessed by the investigators in line with modern criteria. Pathogenic variants were identified in 29 (17%) patients (60% channelopathy-associated and 40% cardiomyopathy-associated genes) and 70 variants of unknown significance were identified in 32 (18%) patients. Prior syncope (odds ratio, 4.0; 95% confidence interval, 1.6-9.7) and a family history of sudden death (odds ratio, 3.2; 95% confidence interval, 1.1-9.4) were independently associated with the presence of a pathogenic variant. In phenotype-negative patients, broad multiphenotype genetic testing led to higher yields (21% versus 8%; P =0.04) but was associated with more variants of unknown significance (55% versus 5%; P <0.01)., Conclusions: Genetic testing identifies a pathogenic variant in a significant proportion of unexplained cardiac arrest survivors. Prior syncope and family history of sudden death are predictors of a positive genetic test. Both arrhythmia and cardiomyopathy genes are implicated. Broad, multiphenotype testing revealed the highest frequency of pathogenic variants in phenotype-negative patients., Clinical Trial Registration: https://www.clinicaltrials.gov. Unique Identifier: NCT00292032., (© 2017 American Heart Association, Inc.)
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- 2017
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21. Cardiac Abnormalities in First-Degree Relatives of Unexplained Cardiac Arrest Victims: A Report From the Cardiac Arrest Survivors With Preserved Ejection Fraction Registry.
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Steinberg C, Padfield GJ, Champagne J, Sanatani S, Angaran P, Andrade JG, Roberts JD, Healey JS, Chauhan VS, Birnie DH, Janzen M, Gerull B, Klein GJ, Leather R, Simpson CS, Seifer C, Talajic M, Gardner M, and Krahn AD
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- Adult, Anti-Arrhythmia Agents administration & dosage, Canada, Death, Sudden, Cardiac, Diagnostic Imaging, Electrocardiography, Epinephrine administration & dosage, Exercise Test, Female, Genetic Testing, Heart Arrest diagnosis, Heart Defects, Congenital diagnosis, Humans, Male, Middle Aged, Mutation, Phenotype, Procainamide administration & dosage, Prospective Studies, Registries, Survivors, Heart Arrest genetics, Heart Defects, Congenital genetics
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Background: Unexplained cardiac arrest (UCA) may be explained by inherited arrhythmia syndromes. The Cardiac Arrest Survivors With Preserved Ejection Fraction Registry prospectively assessed first-degree relatives of UCA or sudden unexplained death victims to screen for cardiac abnormalities., Methods and Results: Around 398 first-degree family members (186 UCA, 212 sudden unexplained death victims' relatives; mean age, 44±17 years) underwent extensive cardiac workup, including ECG, signal averaged ECG, exercise testing, cardiac imaging, Holter-monitoring, and selective provocative drug testing with epinephrine or procainamide. Genetic testing was performed when a mutation was identified in the UCA survivor or when the diagnostic workup revealed a phenotype suggestive of a specific inherited arrhythmia syndrome. The diagnostic strength was classified as definite, probable, or possible based on previously published definitions. Cardiac abnormalities were detected in 120 of 398 patients (30.2%) with 67 of 398 having a definite or probable diagnosis (17%), including Long-QT syndrome (13%), catecholaminergic polymorphic ventricular tachycardia (4%), arrhythmogenic right ventricular cardiomyopathy (4%), and Brugada syndrome (3%). The detection yield was similar for family members of UCA and sudden unexplained death victims (31% versus 27%; P=0.59). Genetic testing was performed more often in family members of UCA patients (29% versus 20%; P=0.03). Disease-causing mutations were identified in 20 of 398 relatives (5%). The most common pathogenic mutations were RyR2 (2%), SCN5A (1%), and KNCQ1 (0.8%)., Conclusions: Cardiac screening revealed abnormalities in 30% of first-degree relatives of UCA or sudden unexplained death victims, with a clear working diagnosis in 17%. Long-QT, arrhythmogenic right ventricular cardiomyopathy, and catecholaminergic polymorphic ventricular tachycardia were the most common diagnoses. Systematic cascade screening and genetic testing in asymptomatic individuals will lead to preventive lifestyle and medical interventions with potential to prevent sudden cardiac death., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00292032., (© 2016 American Heart Association, Inc.)
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- 2016
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22. Response to Letter Regarding Article, "Outcome of Apparently Unexplained Cardiac Arrest: Results From Investigation and Follow-Up of the Prospective Cardiac Arrest Survivors With Preserved Ejection Fraction Registry".
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Herman AR, Cheung C, Gerull B, Simpson CS, Birnie DH, Klein GJ, Champagne J, Healey JS, Gibbs K, Talajic M, Gardner M, Bennett MT, Steinberg C, Janzen M, Gollob MH, Angaran P, Yee R, Leather R, Chakrabarti S, Sanatani S, Chauhan VS, and Krahn AD
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- Female, Humans, Male, Defibrillators, Implantable, Electrocardiography, Heart Arrest diagnosis, Registries, Stroke Volume physiology
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- 2016
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23. Programmed Ventricular Stimulation for Risk Stratification in the Brugada Syndrome: A Pooled Analysis.
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Sroubek J, Probst V, Mazzanti A, Delise P, Hevia JC, Ohkubo K, Zorzi A, Champagne J, Kostopoulou A, Yin X, Napolitano C, Milan DJ, Wilde A, Sacher F, Borggrefe M, Ellinor PT, Theodorakis G, Nault I, Corrado D, Watanabe I, Antzelevitch C, Allocca G, Priori SG, and Lubitz SA
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- Defibrillators, Implantable standards, Humans, Observational Studies as Topic, Prospective Studies, Risk Assessment, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular etiology, Ventricular Fibrillation diagnosis, Ventricular Fibrillation etiology, Brugada Syndrome diagnosis, Brugada Syndrome therapy, Defibrillators, Implantable adverse effects
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Background: The role of programmed ventricular stimulation in identifying patients with Brugada syndrome at the highest risk for sudden death is uncertain., Methods and Results: We performed a systematic review and pooled analysis of prospective, observational studies of patients with Brugada syndrome without a history of sudden cardiac arrest who underwent programmed ventricular stimulation. We estimated incidence rates and relative hazards of cardiac arrest or implantable cardioverter-defibrillator shock. We analyzed individual-level data from 8 studies comprising 1312 patients who experienced 65 cardiac events (median follow-up, 38.3 months). A total of 527 patients were induced into arrhythmias with up to triple extrastimuli. Induction was associated with cardiac events during follow-up (hazard ratio, 2.66; 95% confidence interval [CI], 1.44-4.92, P<0.001), with the greatest risk observed among those induced with single or double extrastimuli. Annual event rates varied substantially by syncope history, presence of spontaneous type 1 ECG pattern, and arrhythmia induction. The lowest risk occurred in individuals without syncope and with drug-induced type 1 patterns (0.23%, 95% CI, 0.05-0.68 for no induced arrhythmia with up to double extrastimuli; 0.45%, 95% CI, 0.01-2.49 for induced arrhythmia), and the highest risk occurred in individuals with syncope and spontaneous type 1 patterns (2.55%, 95% CI, 1.58-3.89 for no induced arrhythmia; 5.60%, 95% CI, 2.98-9.58 for induced arrhythmia)., Conclusions: In patients with Brugada syndrome, arrhythmias induced with programmed ventricular stimulation are associated with future ventricular arrhythmia risk. Induction with fewer extrastimuli is associated with higher risk. However, clinical risk factors are important determinants of arrhythmia risk, and lack of induction does not necessarily portend low ventricular arrhythmia risk, particularly in patients with high-risk clinical features., (© 2016 American Heart Association, Inc.)
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- 2016
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24. Outcome of Apparently Unexplained Cardiac Arrest: Results From Investigation and Follow-Up of the Prospective Cardiac Arrest Survivors With Preserved Ejection Fraction Registry.
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Herman AR, Cheung C, Gerull B, Simpson CS, Birnie DH, Klein GJ, Champagne J, Healey JS, Gibbs K, Talajic M, Gardner M, Bennett MT, Steinberg C, Janzen M, Gollob MH, Angaran P, Yee R, Leather R, Chakrabarti S, Sanatani S, Chauhan VS, and Krahn AD
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- Adolescent, Adult, Aged, Aged, 80 and over, Canada epidemiology, Diagnosis, Differential, Female, Follow-Up Studies, Heart Arrest mortality, Heart Arrest therapy, Humans, Male, Middle Aged, Retrospective Studies, Survival Rate trends, Time Factors, Young Adult, Defibrillators, Implantable, Electrocardiography, Heart Arrest diagnosis, Registries, Stroke Volume physiology
- Abstract
Background: The Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER) enrolls patients with apparently unexplained cardiac arrest and no evident cardiac disease to identify the pathogenesis of cardiac arrest through systematic clinical testing. Exercise testing, drug provocation, advanced cardiac imaging, and genetic testing may be useful when a cause is not apparent., Methods and Results: The first 200 survivors of unexplained cardiac arrest from 14 centers across Canada were evaluated to determine the results of investigation and follow-up (age, 48.6±14.7 years, 41% female). Patients were free of evidence of coronary artery disease, left ventricular dysfunction, or evident repolarization syndromes. Advanced testing determined a diagnosis in 34% of patients at baseline, with a diagnosis emerging during follow-up in 7% of patients. Of those who were diagnosed, 28 (35%) had an underlying structural condition and 53 (65%) had a primary electric disease. During a mean follow-up of 3.15±2.34 years, 23% of patients had either a shock or an appropriate antitachycardia pacing from their implantable cardioverter defibrillator, or both. The implantable cardioverter defibrillator appropriate intervention rate was 8.4% at 1 year and 18.1% at 3 years, with no clear difference between diagnosed and undiagnosed subjects, or between those diagnosed with a primary electric versus structural pathogenesis., Conclusions: Obtaining a diagnosis in previously unexplained cardiac arrest patients requires systematic clinical testing and regular follow-up to unmask the cause. Nearly half of apparently unexplained cardiac arrest patients ultimately received a diagnosis, allowing for improved treatment and family screening. A substantial proportion of patients received appropriate implantable cardioverter defibrillator therapy during medium-term follow-up., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00292032., (© 2016 American Heart Association, Inc.)
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- 2016
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25. Evaluation of genes encoding for the transient outward current (Ito) identifies the KCND2 gene as a cause of J-wave syndrome associated with sudden cardiac death.
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Perrin MJ, Adler A, Green S, Al-Zoughool F, Doroshenko P, Orr N, Uppal S, Healey JS, Birnie D, Sanatani S, Gardner M, Champagne J, Simpson C, Ahmad K, van den Berg MP, Chauhan V, Backx PH, van Tintelen JP, Krahn AD, and Gollob MH
- Subjects
- Action Potentials, Adult, Amino Acid Sequence, Animals, Base Sequence, DNA Mutational Analysis, Female, Genotype, HEK293 Cells, Heart Ventricles physiopathology, Heterozygote, Humans, Male, Middle Aged, Molecular Sequence Data, Mutation, Missense, Phenotype, Shal Potassium Channels metabolism, Brugada Syndrome complications, Brugada Syndrome genetics, Death, Sudden, Cardiac etiology, Shal Potassium Channels genetics
- Abstract
Background: J-wave ECG patterns are associated with an increased risk of sudden arrhythmic death, and experimental evidence supports a transient outward current (I(to))-mediated mechanism of J-wave formation. This study aimed to determine the frequency of genetic mutations in genes encoding the I(to) in patients with J waves on ECG., Methods and Results: Comprehensive mutational analysis was performed on I(to)-encoding KCNA4, KCND2, and KCND3 genes, as well as the previously described J-wave-associated KCNJ8 gene, in 51 unrelated patients with ECG evidence defining a J-wave syndrome. Only patients with a resuscitated cardiac arrest or type 1 Brugada ECG pattern were included for analysis. A rare genetic mutation of the KCND2 gene, p.D612N, was identified in a single patient. Co-expression of mutant and wild-type KCND2 with KChIP2 in HEK293 cells demonstrated a gain-of-function phenotype, including an increase in peak I(to) density of 48% (P<0.05) in the heterozygous state. Using computer modeling, this increase in Ito resulted in loss of the epicardial action potential dome, predicting an increased ventricular transmural Ito gradient. The previously described KCNJ8-S422L mutation was not identified in this cohort of patients with ECG evidence of J-wave syndrome., Conclusions: These findings are the first to implicate the KCND2 gene as a novel cause of J-wave syndrome associated with sudden cardiac arrest. However, genetic defects in I(to)-encoding genes seem to be an uncommon cause of sudden cardiac arrest in patients with apparent J-wave syndromes., (© 2014 American Heart Association, Inc.)
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- 2014
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26. Effects of sex on the incidence of cardiac tamponade after catheter ablation of atrial fibrillation: results from a worldwide survey in 34 943 atrial fibrillation ablation procedures.
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Michowitz Y, Rahkovich M, Oral H, Zado ES, Tilz R, John S, Denis A, Di Biase L, Winkle RA, Mikhaylov EN, Ruskin JN, Yao Y, Josephson ME, Tanner H, Miller JM, Champagne J, Della Bella P, Kumagai K, Defaye P, Luria D, Lebedev DS, Natale A, Jais P, Hindricks G, Kuck KH, Marchlinski FE, Morady F, and Belhassen B
- Subjects
- Adult, Age Distribution, Aged, Aged, 80 and over, Cardiac Tamponade etiology, Data Collection, Female, Global Health, Humans, Incidence, Male, Middle Aged, Postoperative Complications, Sex Distribution, Sex Factors, Survival Rate trends, Young Adult, Atrial Fibrillation surgery, Cardiac Tamponade epidemiology, Catheter Ablation adverse effects
- Abstract
Background: Cardiac tamponade is the most dramatic complication observed during atrial fibrillation (AF) ablation and the leading cause of procedure-related mortality. Female sex is a known risk factor for complications during AF ablation; however, it is unknown whether women have a higher risk of tamponade., Methods and Results: A systematic Medline search was used to locate academic electrophysiological centers that reported cases of tamponade occurring during AF ablation. Centers were asked to provide information on cases of acute tamponade according to sex and their mode of management including any case of related mortality. Nineteen electrophysiological centers provided information on 34 943 ablation procedures involving 25 261 (72%) men. Overall, 289 (0.9%) cases of tamponade were reported: 120 (1.24%) in women and 169 (0.67%) in men (odds ratio, 1.83; P<0.001). There was a reciprocal association between center volume and the occurrence of tamponade with substantially lower risk in high-volume centers. Most cases of tamponade occurred during catheter manipulation or ablation; women tended to develop more tamponades during transseptal catheterization. No sex difference in the mode of management was observed. However, 16% cases of tamponade required surgery with lower rates in high-volume centers. Three cases of tamponade (1%) culminated in death., Conclusions: Tamponade during AF ablation procedures is relatively rare. Women have an ≈2-fold higher risk for developing this complication. The risk of tamponade among women decreases substantially in high-volume centers. Surgical backup and acute management skills for treating tamponade are important in centers performing AF ablation.
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- 2014
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27. Selective complex fractionated atrial electrograms targeting for atrial fibrillation study (SELECT AF): a multicenter, randomized trial.
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Verma A, Sanders P, Champagne J, Macle L, Nair GM, Calkins H, and Wilber DJ
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- Aged, Atrial Fibrillation physiopathology, Canada, Electrocardiography, Ambulatory, Female, Heart Atria physiopathology, Heart Atria surgery, Heart Conduction System physiopathology, Heart Conduction System surgery, Humans, Illinois, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Pulmonary Veins physiopathology, Pulmonary Veins surgery, Recurrence, Reoperation, South Australia, Time Factors, Treatment Outcome, Atrial Fibrillation diagnosis, Atrial Fibrillation surgery, Catheter Ablation methods, Electrophysiologic Techniques, Cardiac
- Abstract
Background: This study compared generalized complex fractionated atrial electrograms (CFAE) ablation versus a selective CFAE ablation strategy targeting areas of continuous electric activity., Methods and Results: Subjects with symptomatic, persistent/high-burden paroxysmal atrial fibrillation (AF) were enrolled at 6 centers (n=86) and randomized to 1 of 2 arms. For group I, all CFAE regions with an interval confidence level >7 were ablated followed by pulmonary vein isolation (PVI). For group II, only CFAE sites with continuous electric activity were ablated followed by PVI. For PVI, all 4 PV antra were isolated with confirmed entrance block. Subjects were followed for 1 year with a visit, ECG, and 48-hour Holter every 3 months. Symptoms were confirmed by loop recording. The primary end point was freedom from arrhythmia >30 seconds at 1 year. For both group I and II, CFAE ablation prolonged AF cycle length (25±33 versus 23±33 ms; P=0.78) and resulted in similar rates of AF termination (37% versus 28%; P=0.42). Radiofrequency duration during CFAE ablation was significantly less in group II (23±20 versus 38±20 minutes; P=0.002). At 1-year follow-up, freedom from AF/atrial flutter/atrial tachycardia recurrence was significantly higher in group I versus group II after 1 procedure (50% versus 28%; P=0.03). There were also significantly fewer repeat procedures in group I (13% versus 36%; P=0.021)., Conclusions: Continuous electric activity ablation+PVI result in a similar incidence of acute AF termination with significantly less radiofrequency time. However, incidence of repeat procedures and long-term recurrence of AF/atrial flutter/atrial tachycardia are significantly lower using generalized CFAE ablation+PVI. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00926783.
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- 2014
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28. Lymphomatoid granulomatosis: a unique complication of Crohn disease and its treatment in pediatrics.
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Destombe S, Bouron-DalSoglio D, Rougemont AL, Fournet JC, Ovetchkine P, Champagne J, and Deslandres C
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- Adolescent, Crohn Disease pathology, Female, Humans, Lung pathology, Lymphomatoid Granulomatosis pathology, Crohn Disease complications, Lymphomatoid Granulomatosis etiology
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- 2010
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29. A randomized controlled trial of the efficacy and safety of electroanatomic circumferential pulmonary vein ablation supplemented by ablation of complex fractionated atrial electrograms versus potential-guided pulmonary vein antrum isolation guided by intracardiac ultrasound.
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Khaykin Y, Skanes A, Champagne J, Themistoclakis S, Gula L, Rossillo A, Bonso A, Raviele A, Morillo CA, Verma A, Wulffhart Z, Martin DO, and Natale A
- Subjects
- Atrial Fibrillation diagnostic imaging, Atrial Fibrillation physiopathology, Chi-Square Distribution, Combined Modality Therapy, Echocardiography methods, Electrocardiography, Female, Heart Atria surgery, Humans, Male, Middle Aged, Pulmonary Veins diagnostic imaging, Quality of Life, Safety, Treatment Outcome, Ultrasonography, Interventional, Atrial Fibrillation surgery, Catheter Ablation, Pulmonary Veins surgery, Surgery, Computer-Assisted methods
- Abstract
Background: The study was conducted to compare relative safety and efficacy of pulmonary vein antrum isolation (PVAI) using intracardiac echocardiographic guidance and circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF) using radiofrequency energy., Methods and Results: Sixty patients (81% men; 81% paroxysmal; age, 56+/-8 years) failing 2+/-1 antiarrhythmic drugs were randomly assigned to undergo CPVA (n=30) or PVAI (n=30) at 5 centers between December 2004 and October 2007. CPVA patients had circular lesions placed at least 1 cm outside of the veins. Ipsilateral veins were ablated en block with the end point of disappearance of potentials within the circular lesion. Left atrial roof line and mitral isthmus line were ablated without verification of block. For patients in AF postablation or with AF induced with programmed stimulation, complex fractionated electrograms were mapped and ablated to the end point of AF termination or disappearance of complex fractionated electrograms. PVAI did not include complex fractionated electrogram ablation. Esophageal temperature was monitored and kept within 2 degrees C of baseline or under 39 degrees C. Success was defined as absence of atrial tachyarrhythmias (AF/AT) off antiarrhythmic drugs. There was no difference between CPVA and PVAI regarding to baseline variables, catheter used, duration of the procedure, or RF delivery. Fluoroscopy time was longer with PVAI (54+/-17 minutes versus 77+/-18 minutes, P=0.0001). No significant complications occurred in either arm. PVAI was more likely to achieve control of AF/AT off antiarrhythmic drugs (57% versus 27%, P=0.02) at 2+/-1 years of follow-up., Conclusions: A single PVAI procedure is more likely to result in freedom from AF/AT off antiarrhythmic drugs than CPVA supplemented by complex fractionated electrogram ablation in select patients.
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- 2009
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30. Second induction in pediatric patients with recurrent acute lymphoid leukemia using DFCI-ALL protocols.
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Dalle JH, Moghrabi A, Rousseau P, Leclerc JM, Barrette S, Bernstein ML, Champagne J, David M, Demers J, Duval M, Hume H, Meyer P, and Champagne MA
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- Adolescent, Asparaginase administration & dosage, Child, Child, Preschool, Cytarabine administration & dosage, Doxorubicin administration & dosage, Female, Humans, Infant, Male, Methotrexate administration & dosage, Prednisone administration & dosage, Recurrence, Retrospective Studies, Stem Cell Transplantation, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Vincristine administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology
- Abstract
Between 15% and 30% of children with acute lymphoblastic leukemia (ALL) experience disease recurrence. With the possible exception of patients presenting with late isolated extramedullary relapse, induction of second complete remission (CR) is employed as a stepping stone to allogeneic hematopoietic stem cell transplantation (HSCT). The authors report their institutional experience in the management of children with recurrent ALL using the Dana Farber Cancer Institute (DFCI) ALL protocol in patients treated initially with that same protocol. Successful reinduction was followed by allogeneic HSCT when possible. Between April 1986 and May 2003, 34 patients with recurrent ALL, treated at initial diagnosis with DFCI-ALL protocol therapy, were given the same protocol as repeat induction chemotherapy. The median age was 4.6 years at diagnosis and 7.1 years at recurrence. Median duration of CR1 was 30.3 months. Second CR was obtained in 29 (85%) patients. Twenty went on to allogeneic HSCT; 10 of them currently remain in CR. Two additional patients treated with chemotherapy without HSCT are also in continuous CR2. Overall, 13 (38%) of the 34 patients are alive with a median follow-up of 105 months. There were no toxic deaths due to the reinduction therapy. One child died of cardiac failure after autologous HSCT. The treatment of children with recurrent ALL using the DFCI-ALL protocol induction regimen after initial use of the same protocol is associated with a high rate of second CR with no excess toxicity. However, the overall prognosis in these patients remains unsatisfactory and needs to be improved.
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- 2005
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31. Primary non-Hodgkin lymphoma of the extrahepatic biliary tract and gallbladder in a child.
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Gravel J, Lallier M, Garel L, Brochu P, Champagne J, and Alvarez F
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- Abdomen diagnostic imaging, Biliary Tract Neoplasms pathology, Child, Preschool, Diagnosis, Differential, Gallbladder Neoplasms pathology, Humans, Lymphoma, Non-Hodgkin pathology, Male, Tomography, X-Ray Computed, Ultrasonography, Biliary Tract Neoplasms diagnosis, Gallbladder Neoplasms diagnosis, Lymphoma, Non-Hodgkin diagnosis
- Published
- 2001
- Full Text
- View/download PDF
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