14 results on '"Martínez-Sande L"'
Search Results
2. Electrical storm in patients with prophylactic defibrillator implantation
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Rodríguez-Mañero M, González-Cambeiro C, Moreno-Arribas J, Expósito-García V, Sánchez-Gómez JM, González-Torres L, Arce-León Á, Arguedas-Jiménez H, Gaztañaga L, Salvador-Montañés O, Iglesias-Bravo JA, Huerta AA, Fernández-Armenta J, Arias MÁ, and Martínez-Sande L
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Sudden cardiac death ,Electrical storm ,Myocardiopathy ,Spain ,animal diseases ,Implantable cardioverter-defibrillator - Abstract
Introduction: Little is known about the prevalence of electrical storm, baseline characteristics and mortality implications of patients with implantable cardioverter defibrillator in primary prevention versus those patients without electrical storm. We sought to assess the prevalence, baseline risk profile and survival significance of electrical storm in patients with implantable defibrillator for primary prevention. Methods: Retrospective multicenter study performed in 15 Spanish hospitals. Consecutives patients referred for desfibrillator implantation, with or without left ventricular lead (at least those performed in 2010 and 2011), were included. Results: Over all 1,174 patients, 34 (2,9%) presented an electrical storm, mainly due to ventricular tachycardia (82.4%). There were no significant baseline differences between groups, with similar punctuation in the mortality risk scores (SHOCKED, MADIT and FADES). A clear trigger was identified in 47% of the events. During the study period (38 +/- 21 months), long-term total mortality (58.8% versus 14.4%, p < 0.001) and cardiac mortality (52.9% versus 8.6%, p < 0.001) were both increased among electrical storm patients. Rate of inappropriate desfibrillator intervention was also higher (14.7 versus 8.6%, p < 0.001). Conclusions: In the present study of patients with desfibrillator implantation for primary prevention, prevalence of electrical storm was 2.9%. There were no baseline differences in the cardiovascular risk profile versus those without electrical storm. However, all cause mortality and cardiovascular mortality was increased in these patients versus control desfibrillator patients without electrical storm, as was the rate of inappropriate desfibrillator intervention. (C) 2015 Instituto Nacional de Cardiologia Ignacio Chavez. Published by Masson Doyma Mexico S.A. All rights reserved.
- Published
- 2016
3. Plasma FABP4 levels are associated with left atrial fat volume in persistent atrial fibrillation and predict recurrence after catheter ablation.
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Lopez-Canoa JN, Baluja A, Couselo-Seijas M, Naveira AB, Gonzalez-Melchor L, Rozados A, Martínez-Sande L, García-Seara J, Fernandez-Lopez XA, Fernandez AL, Gonzalez-Juanatey JR, Eiras S, and Rodriguez-Mañero M
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- Adipose Tissue diagnostic imaging, Aged, Atrial Fibrillation pathology, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Organ Size, Predictive Value of Tests, Recurrence, Tomography, X-Ray Computed, Adipokines blood, Adipose Tissue pathology, Atrial Fibrillation blood, Atrial Fibrillation surgery, Catheter Ablation, Fatty Acid-Binding Proteins blood, Heart Atria
- Abstract
Background: Imaging techniques have shown the association between left atrial adipose tissue (LAAT) volume and atrial fibrillation (AF) risk., Purpose: To analyze 1) adipokines in peripheral and atrial plasma from patients undergoing AF ablation; 2) its association with LAAT volume measured by multislice CT and 3) its predictive value for AF recurrence., Methods: Seventy consecutive patients undergoing AF catheter ablation were screened. Blood samples were extracted from the left atrium and peripheral vein before catheter ablation. Multiplex fluorimetric immunoassay, enzyme-linked immunoassay and Western blot techniques were used for analyzing some adipokines, fatty acid binding protein 4 (FABP4), and leptin and perilipin analysis, respectively. Patients were followed up with clinical visits until one year after ablation. Generalized additive regression (GAM) was used for determining the best indicator of LAAT volume. Logistic regression analysis determined the best predictor of AF recurrence after persistent AF catheter ablation., Results: Our results showed 1) differences in the levels of FABP4 between peripheral and left atrial blood samples. 2) persistent AF patients had higher LAAT volume than those with paroxysmal AF (5.12 ± 2.76 vs. 3.82 ± 1.81 mL; p < 0.036). FABP4 was the best adipokine associated with LAAT in persistent AF (p < 0.01) 3) and predictive value for AF recurrence after catheter ablation (AUC-ROC 0.883 with 95% CI 0.739-1.028)., Conclusions: Plasma FABP4 levels, which were associated with LAAT volume in persistent AF, can be predictors of recurrence after catheter ablation. Whether persistent AF patients require more intensive management and monitoring according to FABP4 deserves further investigation., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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4. Ablation of Inappropriate Sinus Tachycardia: A Systematic Review of the Literature.
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Rodríguez-Mañero M, Kreidieh B, Al Rifai M, Ibarra-Cortez S, Schurmann P, Álvarez PA, Fernández-López XA, García-Seara J, Martínez-Sande L, González-Juanatey JR, and Valderrábano M
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- Adult, Anti-Arrhythmia Agents therapeutic use, Body Surface Potential Mapping, Catheter Ablation methods, Electrocardiography, Electrocardiography, Ambulatory, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pacemaker, Artificial standards, Pericardium anatomy & histology, Phrenic Nerve physiopathology, Recurrence, Sinoatrial Node physiopathology, Tachycardia, Sinus drug therapy, Tachycardia, Sinus physiopathology, Treatment Outcome, Catheter Ablation adverse effects, Electrophysiologic Techniques, Cardiac instrumentation, Tachycardia, Sinus therapy
- Abstract
Objectives: The goal of this study was to describe short- and long-term outcomes in all patients referred for inappropriate sinus tachycardia ablation, along with the potential complications of the intervention., Background: Sinus node (SN) ablation/modification has been proposed for patients refractory to pharmacological therapy. However, available data derive from limited series., Methods: The electronic databases MEDLINE, Embase, CINAHL, Cochrane, and Scopus were systematically searched (January 1, 1995-December 31, 2015). Studies were screened according to predefined inclusion and exclusion criteria., Results: A total of 153 patients were included. Their mean age was 35.18 ± 10.02 years, and 139 (90.8%) were female. All patients had failed to respond to maximum tolerated doses of pharmacological therapy (3.5 ± 2.4 drugs). Mean baseline heart rates averaged 101.3 ± 16.4 beats/min according to electrocardiography and 104.5 ± 13.5 beats/min according to 24-h Holter monitoring. Two electrophysiological strategies were used, SN ablation and SN modification, with the latter being used more. Procedural acute success (using variably defined pre-determined endpoints) was 88.9%. Consistently, all groups reported high-output pacing from the ablation catheter to confirm absence of phrenic nerve stimulation before radiofrequency delivery. Need of pericardial access varied between 0% and 76.9%. Thirteen patients (8.5%) experienced severe procedural complications, and 15 patients (9.8%) required implantation of a pacemaker. At a mean follow-up interval of 28.1 ± 12.6 months, 86.4% of patients demonstrated successful outcomes. The symptomatic recurrence rate was 19.6%, and 29.8% of patients continued to receive antiarrhythmic drug therapy after procedural intervention., Conclusions: Inappropriate sinus tachycardia ablation/modification achieves acute success in the vast majority of patients. Complications are fairly common and diverse. However, symptomatic relief decreases substantially over longer follow-up periods, with a corresponding high recurrence rate., (Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2017
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5. Comparative Evaluation of Four Risk Scores for Predicting Mortality in Patients With Implantable Cardioverter-defibrillator for Primary Prevention.
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Rodríguez-Mañero M, Abu Assi E, Sánchez-Gómez JM, Fernández-Armenta J, Díaz-Infante E, García-Bolao I, Benezet-Mazuecos J, Andrés Lahuerta A, Expósito-García V, Bertomeu-González V, Arce-León Á, Barrio-López MT, Peinado R, Martínez-Sande L, and Arias MA
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- Age Factors, Aged, Aged, 80 and over, Atrial Fibrillation epidemiology, Cause of Death, Creatinine blood, Death, Sudden, Cardiac etiology, Diabetes Mellitus epidemiology, Electric Countershock, Female, Heart Diseases complications, Heart Diseases epidemiology, Humans, Male, Middle Aged, Primary Prevention, Proportional Hazards Models, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic epidemiology, Retrospective Studies, Risk Assessment, Smoking epidemiology, Spain epidemiology, Stroke Volume, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Heart Diseases therapy, Mortality
- Abstract
Introduction and Objectives: Several clinical risk scores have been developed to identify patients at high risk of all-cause mortality despite implantation of an implantable cardioverter-defibrillator. We aimed to examine and compare the predictive capacity of 4 simple scoring systems (MADIT-II, FADES, PACE and SHOCKED) for predicting mortality after defibrillator implantation for primary prevention of sudden cardiac death in a Mediterranean country., Methods: A multicenter retrospective study was performed in 15 Spanish hospitals. Consecutive patients referred for defibrillator implantation between January 2010 and December 2011 were included., Results: A total of 916 patients with ischemic and nonischemic heart disease were included (mean age, 62 ± 11 years, 81.4% male). Over 33.4 ± 12.9 months, 113 (12.3%) patients died (cardiovascular origin in 86 [9.4%] patients). At 12, 24, 36, and 48 months, mortality rates were 4.5%, 7.6%, 10.8%, and 12.3% respectively. All the risk scores showed a stepwise increase in the risk of death throughout the scoring system of each of the scores and all 4 scores identified patients at greater risk of mortality. The scores were significantly associated with all-cause mortality throughout the follow-up period. PACE displayed the lowest c-index value regardless of whether the population had heart disease of ischemic (c-statistic = 0.61) or nonischemic origin (c-statistic = 0.61), whereas MADIT-II (c-statistic = 0.67 and 0.65 in ischemic and nonischemic cardiomyopathy, respectively), SHOCKED (c-statistic = 0.68 and 0.66, respectively), and FADES (c-statistic = 0.66 and 0.60) provided similar c-statistic values (P ≥ .09)., Conclusions: In this nontrial-based cohort of Mediterranean patients, the 4 evaluated risk scores showed a significant stepwise increase in the risk of death. Among the currently available risk scores, MADIT-II, FADES, and SHOCKED provide slightly better performance than PACE., (Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
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6. Monomorphic ventricular tachycardia in patients with Brugada syndrome: A multicenter retrospective study.
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Rodríguez-Mañero M, Sacher F, de Asmundis C, Maury P, Lambiase PD, Sarkozy A, Probst V, Gandjbakhch E, Castro-Hevia J, Saenen J, Fukushima Kusano K, Rollin A, Arbelo E, Valderrábano M, Arias MA, Mosquera-Pérez I, Schilling R, Chierchia GB, García-Bolao I, García-Seara J, Hernandez-Ojeda J, Kamakura T, Martínez-Sande L, González-Juanatey JR, Haïssaguerre M, Brugada J, and Brugada P
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- Brugada Syndrome physiopathology, Brugada Syndrome therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Tachycardia, Ventricular etiology, Tachycardia, Ventricular therapy, Brugada Syndrome complications, Defibrillators, Implantable, Electrocardiography, Heart Conduction System physiopathology, Tachycardia, Ventricular physiopathology
- Abstract
Background: Isolated cases of monomorphic ventricular tachycardia (MVT) in patients with Brugada syndrome (BrS) have been reported., Objective: We aimed to describe the incidence and characteristics of MVT in a cohort of patients with BrS who had received an implantable cardioverter-defibrillator (ICD)., Methods: Data from 834 patients with BrS implanted with an ICD in 15 tertiary hospitals between 1993 and 2014 were included., Results: The mean age of enrolled patients was 45.3 ± 13.9 years; 200 patients (24%) were women. During a mean follow-up of 69.4 ± 54.3 months, 114 patients (13.7%) experienced at least 1 appropriate ICD intervention, with MVT recorded in 35 patients (4.2%) (sensitive to antitachycardia pacing in 15 [42.8%]). Only QRS width was an independent predictor of MVT in the overall population. Specifically, 6 (17.1%) patients presented with right ventricular outflow tract tachycardia (successfully ablated from the endocardium in 4 and epicardial and endocardial ablation in 1), 2 patients with MVT arising from the left ventricle (1 successfully ablated in the supra lateral mitral annulus), and 2 (5.7%) patients with bundle branch reentry ventricular tachycardia. Significant structural heart disease was ruled out by echocardiography and/or cardiac magnetic resonance imaging., Conclusion: In this retrospective study, 4.2% of patients with BrS implanted with an ICD presented with MVT confirmed as arising from the right ventricular outflow tract tachycardia in 6, patients with MVT arising from the left ventricle in 2, and patients with bundle branch reentry ventricular tachycardia in 2. Endocardial and/or epicardial ablation was successful in 80% of these cases. These data imply that the occurrence of MVT should not rule out the possibility of BrS. This finding may also be relevant for ICD model selection and programming., (Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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7. Risk of pacemaker implantation after uneventful successful cavotricuspid isthmus radiofrequency ablation in patients with common atrial flutter.
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Rodríguez-Mañero M, González-Melchor L, Ballesteros G, Raposeiras-Roubín S, García-Seara J, López XA, Cambeiro CG, Alcalde O, García-Bolao I, Martínez-Sande L, and González-Juanatey JR
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- Aged, Electrocardiography, Electrophysiologic Techniques, Cardiac, Female, Humans, Male, Retrospective Studies, Spain, Treatment Outcome, Atrial Flutter surgery, Catheter Ablation methods, Heart Conduction System surgery, Pacemaker, Artificial
- Abstract
Introduction: Little is known about the risk of pacemaker implantation after common atrial flutter ablation in the long-term., Methods: We retrospectively reviewed the electrophysiology laboratory database at two Spanish University Hospitals from 1998 to 2012 to identify patients who had undergone successful ablation for cavotricuspid dependent atrial flutter. Cox regression analysis was used to examine the risk of pacemaker implantation., Results: A total of 298 patients were considered eligible for inclusion. The mean age of the enrolled patients was 65.7±11. During 57.7±42.8 months, 30 patients (10.1%) underwent pacemaker implantation. In the stepwise multivariate models only heart rate at the time of the ablation (OR: 0.96; 95% CI: 0.93-0.98; p<0.0001) and intraventricular conduction disturbances in the baseline ECG (OR: 3.87; 95% CI: 1.54-9.70; p=0.004) were independents predictors of the need of pacemaker implantation. A heart rate of ≤65 bpm was identified as the optimal cut-off value to predict the need of pacemaker implantation in the follow-up (sensitivity: 79%, specificity: 74%) by ROC curve analyses., Conclusion: This is the first study of an association between the slow conducting common atrial flutter and subsequent risk of pacemaker implantation. In light of these findings, assessing it prior to ablation can be helpful for the risk stratification of sinus node disease or atrioventricular conduction disease requiring a pacemaker implantation in patients with persistent atrial flutter., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
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- 2016
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8. Is safe to discontinue anticoagulation after successful ablation of atrial flutter?
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Raposeiras-Roubín S, García-Seara J, Cabanas-Grandío P, Abu-Assi E, Rodríguez-Mañero M, Fernández-López JA, Martínez-Sande L, and González-Juanatey JR
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- Atrial Flutter complications, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Stroke etiology, Time Factors, Anticoagulants therapeutic use, Atrial Flutter surgery, Catheter Ablation methods, Postoperative Care methods, Stroke prevention & control, Withholding Treatment
- Published
- 2015
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9. Comparison between CHA2DS2-VASc and the new R2CHADS2 and ATRIA scores at predicting thromboembolic event in non-anticoagulated and anticoagulated patients with non-valvular atrial fibrillation.
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Abumuaileq RR, Abu-Assi E, López-López A, Raposeiras-Roubin S, Rodríguez-Mañero M, Martínez-Sande L, García-Seara J, Fernandez-López XA, Peña-Gil C, and González-Juanatey JR
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- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies, Thromboembolism prevention & control, Anticoagulants therapeutic use, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Risk Assessment methods, Thromboembolism etiology
- Abstract
Background: Accurate risk stratification is considered the first and most important step in the management of patients with non-valvular atrial fibrillation (NVAF). We compared the performance of the widely used CHA2DS2-VASc and the recently developed R2CHADS2 and ATRIA scores, for predicting thromboembolic (TE) event in either non-anticoagulated or anticoagulated patients with NVAF., Methods: The non-anticoagulated cohort was comprised of 154 patients, whereas 911 patients formed the cohort of patients on vitamin-K-antagonist. The scores were computed using the criteria mentioned in their developmental cohorts. Measures of performance for the risk scores were evaluated at predicting TE event., Results: In the non-anticoagulated cohort, 9 TE events occurred during 11 ± 2.7 months. CHA2DS2-VASc showed significant association with TE occurrence: hazard ratio (HR) = 1.58 (95 % confidence interval [95 % IC] 1.01-2.46), but R2CHADS2 and ATRIA did not (HR = 1.23 (95 % CI 0.86-1.77) and 1.20 (95 % CI 0.93-1.56), respectively. In the anticoagulated cohort, after 10 ± 3 months of follow up, 18 TE events were developed. In that cohort, the three scores showed similar association with TE risk: HR = 1.49 (95 % CI 1.13-1.97), 1.41 (95 % CI 1.13-1.77) and 1.37 (95 % CI 1.12-1.66) for CHA2DS2-VASc, R2CHADS2 and ATRIA, respectively. In both cohorts, no TE event occurred in patients classified in the low risk category according to CHA2DS2-VASc or R2CHADS2., Conclusions: In this study of NVAF patients, CHA2DS2-VASc has better association with TE events than the new R2CHADS2 and ATRIA risk scores in the non-anticoagulated cohort. CHA2DS2-VASc and R2CHADS2 can identify patients at truly low risk regardless of the anticoagulation status.
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- 2015
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10. Renal function assessment in atrial fibrillation: Usefulness of chronic kidney disease epidemiology collaboration vs re-expressed 4 variable modification of diet in renal disease.
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Abumuaileq RR, Abu-Assi E, López-López A, Raposeiras-Roubin S, Rodríguez-Mañero M, Martínez-Sande L, García-Seara FJ, Fernandez-López XA, and González-Juanatey JR
- Abstract
Aim: To compare the performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial fibrillation., Methods: We studied 911 consecutive patients with non-valvular atrial fibrillation on vitamin-K antagonist. The performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial fibrillation with respect to either a composite endpoint of major bleeding, thromboembolic events and all-cause mortality or each individual component of the composite endpoint was assessed using continuous and categorical ≥ 60, 59-30, and < 30 mL/min per 1.73 m(2) estimated glomerular filtration rate., Results: During 10 ± 3 mo, the composite endpoint occurred in 98 (10.8%) patients: 30 patients developed major bleeding, 18 had thromboembolic events, and 60 died. The new equation provided lower prevalence of renal dysfunction < 60 mL/min per 1.73 m(2) (32.9%), compared with the re-expressed equation (34.1%). Estimated glomerular filtration rate from both equations was independent predictor of composite endpoint (HR = 0.98 and 0.97 for the re-expressed and the new equation, respectively; P < 0.0001) and all-cause mortality (HR = 0.98 for both equations, P < 0.01). Strong association with thromboembolic events was observed only when estimated glomerular filtration rate was < 30 mL/min per 1.73 m(2): HR is 5.1 for the re-expressed equation, and HR = 5.0 for the new equation. No significant association with major bleeding was observed for both equations., Conclusion: The new equation reduced the prevalence of renal dysfunction. Both equations performed similarly in predicting major adverse outcomes.
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- 2015
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11. Analyses of inappropriate shocks in a Spanish ICD primary prevention population: Predictors and prognoses.
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Fernández-Cisnal A, Arce-León Á, Arana-Rueda E, Rodríguez-Mañero M, González-Cambeiro C, Moreno-Arribas J, Gaztañaga L, Castillo Poyo R, Cabanas-Grandío P, Arias MA, Andrés de la Huerta A, Sánchez Gómez JM, Martínez-Sande L, and Pedrote A
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- Age Factors, Aged, Atrial Fibrillation epidemiology, Cardiac Resynchronization Therapy statistics & numerical data, Equipment Failure Analysis statistics & numerical data, Female, Follow-Up Studies, Humans, Male, Middle Aged, Primary Prevention methods, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Spain epidemiology, Treatment Outcome, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable adverse effects, Defibrillators, Implantable standards, Electric Countershock adverse effects, Electric Countershock methods, Tachycardia, Ventricular therapy
- Abstract
Background: ICDs have been demonstrated to be highly effective in the primary prevention of sudden death, but inappropriate shocks (IS) occur frequently and represent one of the most important adverse effects of ICDs. The aim of this study was to analyze IS and identify the clinical predictors and prognostic implications of ISs in a real-world primary prevention ICD population., Methods: This multicenter retrospective study was performed in 13 centers with experience in the field of ICD implantation (at least 30 per year) and ICD follow-up in Spain. All consecutive patients who underwent ICD implantation for primary prevention between January 2008 and May 2014 were included., Results: One-thousand-sixteen patients were included, and 4 (0.39%) were lost to follow-up. Two-hundred-seventeen (21.4%) patients suffered from shock; 69 (6.8%) of these patients experienced IS, and 154 (15.4%) experienced appropriate shocks (AS). Age (<65 years, hazard ratio (HR) 2.588 [95% CI 1.282-5.225]; p=0.008), history of atrial fibrillation (HR 2.252 [95% CI 1.230-4.115]; p=0.009), non-ischemic myocardiopathy (HR 2.258 [95% CI 1.090-4.479]; p=0.028), and cardiac resynchronization therapy (HR 0.385 [95% CI 0.200-0.740]; p=0.004) were identified as IS predictors in a multivariate analysis. IS was not associated with rehospitalization due to heart failure, myocardial infarction, cardiovascular mortality or all-cause mortality., Conclusions: This analysis of our national registry identified the independent IS predictors of age, atrial fibrillation history and cardiac resynchronization therapy and suggests that ISs are not linked to poorer clinical endpoints., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
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- 2015
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12. Two-Year Follow-up in Atrial Fibrillation Patients Referred for Catheter Ablation of the Atrioventricular Node.
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Rodríguez-Mañero M, Pujol Salvador C, Martínez-Sande L, de Asmundis C, Chierchia GB, Macías Gallego A, A Fernández-López X, José Gavira-Gómez J, García-Seara J, Calvo N, Brugada P, González-Juanatey JR, and García-Bolao I
- Abstract
Introduction: At the present time there is still concern regarding the long-term deleterious effects of right ventricular apical pacing in patients referred for auriculoventricular node ablation (AVNA). Furthermore, scarce information is available regarding differences in the follow up according to the baseline cardiopathy and predictors associated with a worse outcome., Methods: 104 consecutives patients referred for AVNA were retrospectively analyzed. Patients included were seen in the outpatient clinic at 6, 12 and 24 months post ablation (mean follow-up 24 ± 2 months). An echocardiogram two years after the procedure was obtained in 68 patients. Three categories were done according to the change in the left ventricular function (LVEF) (increase, decrease or absence of change, defined as less than 10% variation in either LVEF)., Results: After two years of follow up there was a decrease in the rate of hospital admission (from 0.9 admission/year to 0.35, p<0.001), an increase in the functional status in at least one NYHA class in 58 patients, and an increase in the global LVEF (from 48.9% to 54,1%; p<0.001). Valvular replacement and LVEF less than 50% were independently associated with a decrease in the LVEF. Regarding safety issues, one patient who presented a polymorphic ventricular tachycardia (Torsade de pointes) 60 minutes after the ablation., Conclusions: AVNA results in a decrease in hospital admission rates and an improvement in functional status. Baseline LVEF < 50% and mitral valvulopathy were multivariate predictor of LVEF decline, hence, it is our belief that, in this particular population, the "ablate and pace" strategy is not the most suitable option, and or maybe a biventricular pacemaker should be implanted or an AF ablation reconsidered." Finally, although it is a safe procedure and rate of complications were low, there is a potential risk of fatal complications.
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- 2014
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13. Predictive value of thromboembolic risk scores before an atrial fibrillation ablation procedure: time for a consensus?
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Rodríguez-Mañero M, Martínez-Sande L, and González-Juanatey JR
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- Female, Humans, Male, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Catheter Ablation statistics & numerical data, Echocardiography, Transesophageal statistics & numerical data, Thromboembolism diagnostic imaging, Thromboembolism epidemiology
- Published
- 2013
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14. [Left ventricular structure and (systolic and diastolic) function in hypertensive patients without atherosclerotic coronaropathy].
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González-Juanatey JR, García-Acuña JM, Amaro Cendón A, Iglesias Carreño C, Pose Reino A, Martínez Sande L, and Gil de la Peña M
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- Aged, Analysis of Variance, Coronary Angiography, Diastole, Echocardiography methods, Echocardiography statistics & numerical data, Electrocardiography statistics & numerical data, Female, Heart Ventricles diagnostic imaging, Heart Ventricles physiopathology, Humans, Hypertension diagnosis, Male, Middle Aged, Myocardial Ischemia diagnosis, Myocardial Ischemia physiopathology, Systole, Coronary Artery Disease, Hypertension physiopathology, Ventricular Function, Left
- Abstract
Introduction and Objectives: Electrocardiographic (ECG) ST-T segment abnormalities in hypertensive patients are traditionally associated with hypertrophy and/or ischaemia and a higher cardiovascular risk. Hypertensive patients with typical or non-typical chest discomfort and a normal coronarographic study underwent an echocardiographic and Doppler study in order to assess left ventricular structure and (systolic and diastolic) function., Material and Methods: Hypertensive patients with ST-T changes were classified as follows: Control group (CG) was made up of 12 hypertensive patients (6 women, 6 men, mean age 59.6 +/- 7.4 years) with normal ECG; Group A (GA), 10 patients (6 women, 4 men, mean age 63.1 +/- 6.8 years) with ECG image of strain; Group B (GB) (9 women and 8 men, mean age 61.3 +/- 10.1 years) with other ST-T alterations. We assessed by echocardiographic and transmitral flow Doppler study left ventricular structure and (systolic and diastolic) function., Results: Interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and mass index were significantly higher in the GA and GB than in the CG, without differences between GA and GB groups. No differences in left ventricular systolic function parameters were observed between the groups. In comparison with the CG, the GA and GB showed significant differences in E wave deceleration velocity and deceleration time, A wave deceleration time and isovolumetric relaxation time. Between GA and GB differences were observed in A wave deceleration time and isovolumetric relaxation time., Conclusions: In hypertensive patients without atherosclerotic coronaropathy, ST-T changes identify a group with greater left ventricular mass and worse left ventricular diastolic function. The patients with a ST-T strain pattern showed the impaired diastolic function.
- Published
- 1996
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