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1. Performance of a multisensor implantable defibrillator algorithm for HF monitoring in presence of comorbidities

Author: V E Santobuono, V Tavoletta, M Manzo, L Calo', M Bertini, L Santini, G Savarese, A Dello Russo, M Viscusi, C Lavalle, C Amellone, R Calvanese, S Valsecchi, and S Favale
Subjects: General Engineering, General Earth and Planetary Sciences, Cardiology and Cardiovascular Medicine, General Environmental Science
Abstract: Background Cardiovascular and non-cardiovascular comorbidities are common in heart failure (HF) patients and impact disease severity and prognosis. Select modern implantable defibrillators (ICDs) are equipped with multisensor algorithms for HF monitoring. The HeartLogic index combines multiple ICD-based sensor data (heart rate, heart sounds, thoracic impedance, respiration, activity), and the associated alert has proved to be a sensitive and timely predictor of impending HF decompensation in cardiac resynchronization therapy (CRT-D) patients The algorithm was developed using data from CRT-D patients; the performance in non-CRT ICD patients and the impact of selected comorbidities on performance requires further study. Methods The HeartLogic feature was activated in 568 ICD patients (410 with CRT) from 26 centers. The median follow-up was 25 months [25th–75th percentile: 15–35]. Results During follow-up, 97 hospitalizations were reported (53 cardiovascular) and 55 patients died. We recorded 1200 HeartLogic alerts (0.71 alerts/patient-year) in 370 patients. Overall, the time IN the alert state was 13% of the total observation period. The rate of cardiovascular hospitalizations or death was 0.48/patient-year (95% CI: 0.37–0.60) with the HeartLogic IN alert state and 0.04/patient-year (95% CI: 0.03–0.05) OUT of alert state, with an incidence rate ratio of 13.35 (95% CI: 8.83–20.51, p13% was associated with the occurrence of the combined endpoint of cardiovascular hospitalization or death (HR: 2.54, 95% CI: 1.61–4.01, p Conclusions The burden of HeartLogic alerts appears similar between CRT and non-CRT patients, while patients with AF and CKD seem more exposed to alerts. Nonetheless, the ability of the HeartLogic algorithm to identify patients during periods of significantly increased risk of clinical events is confirmed regardless of the type of device, the presence of AF, or CKD. Funding Acknowledgement Type of funding sources: None.
Published: 2022
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2. Predictors of heart failure events detected by a multisensor implantable defibrillator algorithm

Author: V Santobuono, V Tavoletta, M Manzo, L Calo’, M Bertini, L Santini, G Savarese, A Dello Russo, M Viscusi, C Lavalle, C Amellone, C La Greca, S Valsecchi, and S Favale
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Funding Acknowledgements Type of funding sources: None. Background Cardiovascular and non-cardiovascular comorbidities are common in heart failure (HF) patients and determine disease severity and prognosis. Select modern implantable defibrillators (ICDs) are equipped with multisensor algorithms for HF monitoring. The HeartLogic index combines multiple ICD-based sensor data (heart rate, heart sounds, thoracic impedance, respiration, activity), and the associated alert has proved to be a sensitive and timely predictor of impending HF decompensation in cardiac resynchronization therapy (CRT) patients. Purpose This analysis aims to investigate the performance of the algorithm in non-CRT patients, as well as in relation to the presence of comorbidities. Methods The HeartLogic feature was activated in 568 ICD patients (410 with CRT) from 26 centers. The median follow-up was 25 months [25th–75th percentile: 15-35]. Results We recorded 1200 HeartLogic alerts (0.71 alerts per patient-year) in 370 patients. Among patient characteristics, atrial fibrillation (AF) at implantation (HR: 1.62, 95%CI: 1.27-2.07, p Conclusions The burden of HeartLogic alerts appears similar between CRT and non-CRT patients, while patients with AF and CKD seem more exposed to alerts. ICD-measured thoracic impedance is sensitive to the fluid overload that characterizes kidney disease, as well as the first and third heart sound amplitudes seem sensitive to the reduced ventricular efficiency during AF. Nonetheless, ICD sensors seem to equally contribute to the HeartLogic alerts in all patient subgroups.
Published: 2022
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3. Biosensors in cardiology. T-CARE project: a preliminary study on an innovative wearable telemonitoring system

Author: F Amati, VE Santobuono, N Bozza, M Latorre, R Memeo, and S Favale
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): REGIONE PUGLIA Introduction The demographic trend evolution and the modification of health needs highlight the requirement for a novel organization of the healthcare system. Telemedicine allows the assistance of patients remotely, breaking down geographical barriers. Purpose The aim of the present study was to assess the validity of a novel wearable system to monitor EKG, heart rate and pulse oximetry in patients with chronic cardiac diseases. The equippement included a T-shirt with electrodes and a band with a photopletimosgraphic sensor, connected to a tiny dock station (Figure 1, panel A). Methods We enrolled 38 patients admitted to the coronary care unit at our hospital in Italy, 71% male, mean age 67 years, mean EF 45%. The main characteristics of the sample are listed in Table 1. The system was entirely automatic. Health parameters recording started as soon as patients wore T-shirt and band. Data were transmitted by Bluetooth technology to an external control unit. Recordings could be stored or could be checked in real time from a control room. Data were compared to measurements obtained by traditional monitoring system (telemetry). Results The devices tested in this study showed a satisfying level of reliability in monitoring heart rate, pulse oximetry, QT interval, QRS complex duration, and onset of arrhythmic events. Indeed, the difference between traditional monitoring system and the new wearable equipment in acquiring health parameters was not statistically significant (Figure 1, panel B). However, alerts produced by arrhythmias different from atrial fibrillation were not completely reliable. Conclusions The most important aspect of this new equipment was the need of minimal patient’s interaction. This system was not inferior to traditional telemetry in recording health parameters.
Published: 2022
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4. C64 UNMASKING THE PREVALENCE OF AMYLOID CARDIOMYOPATHY IN THE REAL WORLD: RESULTS FROM PHASE 2 OF AC–TIVE STUDY, AN ITALIAN NATIONWIDE SURVEY

Author: M Merlo, L Pagura, A Porcari, M Cameli, G Vergaro, B Musumeci, E Biagini, M Canepa, L Crotti, M Imazio, C Forleo, F Cappelli, S Favale, G Di Bella, F Dore, F Girardi, D Tomasoni, R Pavasini, V Rella, G Palmiero, M Caiazza, M Albanese, A Igoren Guarrucci, G Branzi, A Caponetti, G Saturi, G La Malfa, A Merlo, A Andreis, F Bruno, F Longo, M Rossi, G Varra‘, R Saro, L Di Ienno, G De Carli, E Giacomin, V Spini, G Limongelli, C Autore, I Olivotto, L Badano, G Parati, S Perlini, M Metra, M Emdin, C Rapezzi, and G Sinagra
Subjects: Cardiology and Cardiovascular Medicine
Abstract: Background Clinicians need to identify patients with amyloid cardiomyopathy (AC) at an early stage, due to the availability of disease–modifying therapies. Some echocardiographic findings may rise the suspicion of AC, also in patients with mild or no symptoms, addressing second level diagnostic tests. Aim To investigate the prevalence of AC in consecutive patients ≥55 years undergoing clinically indicated, routine transthoracic echocardiogram in Italy and presenting echocardiographic signs suggestive of AC. Methods This is a prospective multicentric study conducted in Italy. It comprises two phases: 1) a recording phase consisting in a national survey on prevalence of possible echocardiographic red flags of AC in consecutive unselected patients ≥55 years undergoing routine echocardiogram (previously published) and 2) an AC diagnostic phase involving a diagnostic work–up for AC to investigate AC prevalence among patients with at least one echocardiographic red flag (herein presented). Patients that in Phase 1 presented an “AC suggestive” echocardiogram (i.e., at least one red flag of AC in hypertrophic, non–dilated left ventricles with preserved ejection fraction) underwent clinical evaluation, blood and urine tests and scintigraphy with bone tracer. Diagnosis of transthyretin related–AC (ATTR–AC) was made in presence of grade 2–3 Perugini uptake at scintigraphy and absence of monoclonal protein. The study was registered at ClinicalTrials.gov (#NCT04738266). Results Of the 5315 screened echocardiograms, 381 exams (7.2%) were classified as “AC suggestive” and proceeded to Phase 2. 217 patients completed Phase 2 investigations. Main reasons for the 164 non–entering patients into Phase 2 were death (n = 49) and refusal to participate (n = 66). A final diagnosis of AC was made in 62 patients with an estimated prevalence of 28,6% (95% CI: 22,5%–34,7%). ATTR–AC was diagnosed in 51 and AL–AC in 11 patients, ascertaining a prevalence of 23,5% (95% CI: 17,8%–29,2%) and 5,1% (95% CI: 2,2%–8,0%), respectively. Conclusion Among a cohort of consecutive unselected patients ≥55 years with echocardiographic findings suggestive of AC, the prevalence of AC ranged from 23% up to 35%. Although ATTR–AC was predominant, AL–AC was diagnosed in a significant number of cases. Echocardiography has a fundamental role in screening patients, raising the suspicion of disease and orienting diagnostic work–up for AC.
Published: 2022
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5. Multimodality imaging in the evaluation of left ventricle myocardial deformation determined by edema and scar in acute myocarditis

Author: G Angelini, M Bonanni, VL Paiocchi, LA Leo, S Schlossbauer, E Pasotti, G Pedrazzini, M Valgimigli, S Favale, C Forleo, AG Pavon, and F Faletra
Subjects: Radiology, Nuclear Medicine and imaging, cardiovascular diseases, General Medicine, Cardiology and Cardiovascular Medicine
Abstract: Funding Acknowledgements Type of funding sources: None. INTRODUCTION acute myocarditis (aMY) is characterized by the presence of edema and myocardial scar detected by cardiovascular magnetic resonance (CMR). Aim of our study is to investigate the diagnostic value of two-dimensional (2D) speckle tracking echocardiography and Cardiovascular Magnetic Resonance (CMR) feature tracking (FT) in detecting edema and myocardial scar in aMY. METHODS all consecutive patients with clinically suspected aMY were enrolled in our study. Inclusion criteria were: 1) new ECG abnormalities 2) myocardial cytolysis markers and 3) absence of angiographically detectable coronary artery disease. Exclusion criteria included poor cine image quality caused by respiratory motion and arrhythmia. All patients underwent transthoracic echocardiography and cardiac function was evaluated by a comprehensive assessment of LV function, including 2D speckle-tracking echocardiography (2D STE). CMR was performed in all patients in a 3T scanner. Extension of edema and myocardial scar were respectively evaluated on T2 mapping and on Late Gadolinium Enhancement sequences considering numbers of segments involved according to 17-segment model (AHA). FT analysis of the left ventricle (LV) was performed using the Tissue Tracking Module to obtain LV strain data. RESULTS 52 patients were included in the study, mean age was 36± 17 years, three patients were female (6%). Mean LVEF was 56,2 ± 7,2 % and mean end diastolic volume index (EDVi) was 62,52 ± 19,02 ml/m2. 10 patients (19,2%) had impaired EF with mean values of 44,6 ± 6,15%. aMY was confirmed in all patients with the presence of myocardial edema and subepicardial late gadolinium enhancement (LGE). Inferior segments were involved in 28 patients (53,8%), lateral segment in 19 patients (36,5%), septal segments in 7 patients (13,5%) and anterior segments in 15 patients (28,8%). 2D STE LV GLS was -16.41± 5,47% while CMR-FT LV GLS was -19,07 ± 4,65%, showing a good agreement between the two methods (r = 0,5; p < 0,001). The univariate analysis showed a significant correlation between 2D STE LV GLS and CMR-FT LV GLS with the extension of myocardial edema assessed by CMR (r= 0,43; p= 0,002 and r = 0.47; p = 0,002 respectively). The univariate analysis did not show a significant correlation between 2D STE LV and the extension of myocardial scar assessed by CMR (r= 0.2; p= 0.155) while a significant correlation was found between CMR-FT LV GLS and myocardial scar (r = 0.4; p = 0.01). CONCLUSIONS in patients with aMY, good correlation was found between CMR-FT and 2D STE in the evaluation of GLS. 2D STE LV GLS and CMR-FT LV GLS proved to have a good correlation with the extension of myocardial edema, while only CMR-FT LV GLS proved to be associated with myocardial scar extension.
Published: 2022
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6. Irreversible Dilated Cardiomyopathy After Abuse of Anabolic Androgenic Steroids: A Case Report and Literature Review

Author: C Caiati, S Favale, P Pollice, ME Lepera, and G Angelini
Subjects: medicine.medical_specialty, Cardiotoxicity, biology, Anabolism, Athletes, business.industry, Dilated cardiomyopathy, General Medicine, urologic and male genital diseases, medicine.disease, biology.organism_classification, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Trenbolone, Internal medicine, medicine, 030212 general & internal medicine, business, 030217 neurology & neurosurgery, Stanozolol, Testosterone, medicine.drug, Hormone
Abstract: Numerous athletes make use of anabolic-androgenic steroids (AASs), the synthetic derivatives of the male hormone testosterone
Published: 2019
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7. Saturday, 25 August 2012

Author: A. Welz, B. V. Antwerp, A Di Cori, A. Hager, P. Hatzigiannis, R. De Lucia, C. Yu, A. Apor, M. Niemann, R. Sampognaro, M. Fiuza, M. G. Charlot, N. Cortez Dias, A. Nagae, A. Maciag, T. Sato, M. Valgimigli, D. Levorato, S. Herrmann, T. Kimura, M. Luedde, V. Tzamou, M. Iwabuchi, C. Rickers, J. Sobierajski, J. Vecera, C. Vlachopoulos, K. Goscinska-Bis, S. Goldsmith, H. Ueno, J. Sosna, G. Malerba, W. Li, H. W. Lee, K. Bogaard, K. Yamada, A. Mateo-Martinez, J. Navarova, M. Zeman, K. Dimopoulos, M. P. Lopez Lereu, E. Pelissero, B. Gersak, J. M. Tolosana, S Manzano Fernandez, P. Mertens, J. J. M. Takkenberg, J. W. Kim, R.T. van Domburg, G. P. Diller, H. M. Yang, F. Gustafsson, P. G. Golzio, G. S. Hwang, J. Brugada, S. Stoerk, J. Hess, Y. Cavusoglu, L. Segreti, M. E. Trucco, C. Jacoby, I. Bafakis, T. Isshiuki, L. Pulpon, S. Pires, L. Paperini, A. Cremonesi, H. Baumgartner, C. Tsioufis, M. Valdes-Chavarri, S. Schaefer, M. Totzeck, A. Bochenek, F. Saia, P. Carrilho-Ferreira, M. Khatib, E. M. W. J. Utens, G. Zucchelli, R. Jenni, E. Gencer, N. Carter, A. Kovacs, C. Linde, V. Monivas, A. Marzocchi, L. Baerfacker, L. Mont, R. Weber, F. J. Enguita, T. L. Bergemann, M. Chudzik, A. Chernyavskiy, D. Dragulescu, S. Orwat, B. J. Choi, P. Opic, C. Torp-Pedersen, F. Gaita, V. A. W. M. Umans, A. Lopez-Cuenca, S. B. Christensen, E. C. Bertolino, D. Tousoulis, F. Weidemann, H. H. Kramer, J. Greenslade, J Cosin Sales, M. Gonzalez Estecha, W. Grosso Marra, T. Katsimichas, J. Hoerer, S. Mingo, M. Hochadel, M. A. Castel, M. S. Lattarulo, E. Y. Yun, K. Fattouch, H. S. Lim, A. Uebing, T. Ulus, J. Radosinska, A. Castro Beiras, J. Peteiro, M. Koren, C. Prados, A. Nunes, C. Rammos, C. Thomopoulos, T. Kameyama, F. Borgia, I. Voges, J. L. Looi, L. Cullen, C. Campo, J. Bis, S. Shiva, H. Kato, N. Frey, E. Andrikou, G. H. Gislason, J. Ruvira, A. Kasiakogias, S. Robalo Martins, A. M. Zimmer, M. H. Yacoub, M. Nobuyoshi, U. Zeymer, K. Hanazawa, F. J. Broullon, B. Petracci, K. Hu, A. Petrescu, A. M. Maceira Gonzalez, K. Harada, L. Swan, C. Felix, H. Inoue, T. Haraguchi, N. Cortez-Dias, S. Bisetti, P. Mitkowski, C. Daubert, H. J. Heuvelman, M. R. Gold, G. P. Kimman, O. Gaemperli, H. C. Lee, Y. Takasawa, V. Monivas Palomero, A. C. Andrade, S. Maddock, W. Budts, M. Penicka, F. J. Ten Cate, M. Czajkowski, C. D. Nguyen, K. Kaitani, K. Kintis, S. Castrovinci, D. Liu, T. Benova, K. W. Seo, B. A. Herzog, A. Ionac, C. Jorge, M. Iacoviello, S. Kuramitsu, Y. Nakagawa, K. U. Mert, A. Manari, S. Brili, R. Alonso-Gonzalez, A. J. Six, J. S. Mcghie, A. Goedecke, M. Kelm, F. C. Tanner, F. Marin, C. I. Santos De Sousa, L. Kober, M. Frigerio, D. Adam, B. E. Backus, U. Hendgen-Cotta, A. Belo, D. Couto Mallon, M. Dewor, M. Madsen, J. H. Shin, M. H. Yoon, L. Maiz, P. Lancellotti, A. Nunes Diogo, G. Ertl, R. Pietura, A. Mornos, M. Than, C. Andersson, C. Izumi, E. Liodakis, N. van Boven, Y. Y. Lam, T. Hansen, W. Roell, T. J. Hong, P. Luedicke, M. Sanchez-Martinez, L. Ruiz Bautista, E. N. Oechslin, T. Klaas, M. T. Martinez, W. A. Helbing, J. L. Januzzi, S. Parra-Pallares, A. Romanov, B. Sax, D. Prokhorova, P. Guastaroba, D. Silva, A. Karaskov, P. Kolkhof, B. Bouzas Zubeldia, T. Rassaf, M. Costa, C. Viczenczova, V. Antoncecchi, A. Kempny, J. Bartunek, I. Kardys, J. H. Ahn, C. Hart, A. Berruezo, C. Vittori, W. Vletter, M. Shigekiyo, S. Knob, V. Marangelli, R. Borras, A E Van Den Bosch, S. Y. Choi, E. Arbelo, G. Lazaros, T. Arita, G. Suchan, T. Nakadate, D. Van Der Linde, E. Pokushalov, K. Ando, J. Neutel, P. Biaggi, C. Mornos, R. Corti, M. Landolina, B. Merkely, B. Malecka, H. J. Hippe, S. J. Tahk, J. Aguilar, G. Piovaccari, M. Lutz, D. Rizopoulos, N. Alvarez Garcia, M. Cipriani, T. Kumamoto, S. Kubota, M. Sitges, B. K. Fleischmann, G. Caccamo, D. Tsiachris, M. A. Russ, F. Mutlu, A. Menozzi, J. C. Choi, J. V. Monmeneu, J. C. Yanez Wonenburger, N. Tribulova, C. Forleo, M. Vinci, J. W. Roos-Hesselink, O. Bodea, T. Domei, P. W. Lee, A. Puzzovivo, M. Heikenwaelder, F. Ferraris, C. Stefanadis, M. Kempa, M. Vanderheyden, A. Birdane, J. A. A. E. Cuypers, I. Andrikou, G. Casella, P. Stock, S. Favale, B. Bijnens, A. Kretschmer, J. Bernhagen, M. A. Cavero Gibanel, S. Datta, M. E. Menting, S. Viani, T. Heuft, M. Cikes, A. J. J. C. Bogers, J. Estornell, M. Pham, A. Nadir, F. J. Pinto, M. Hyodo, D. Flessas, C. Chrysohoou, O. Dewald, B. Ren, K. Wustmann, J. C. Burnett, T. Noto, G. Ruvolo, M. Witsenburg, E. Soldati, G. D. Duerr, L. Alonso Pulpon, J. H. Oh, A. Zabek, B. Albrecht-Kuepper, V. Antonakis, M. B. Nielsen, T. Huttl, B. Bacova, A. Piorkowski, I. Z. Cabrita, A. Fanelli, M. A. Weber, J. Segovia, A. I. Romero-Aniorte, J. H. Choi, V. Dosenko, C. Wackerl, J. H. Ruiter, H. Yokoi, S. Ghio, V. Knezl, F. Monitillo, M. Morello, M. Jerosch-Herold, M. L. Geleijnse, A. Bouzas Mosquera, R. Fabregas Casal, H. Mudra, J. Gruenenfelder, U. Floegel, L. Petrescu, M. A. Gatzoulis, S. Shizuta, J. Brachmann, M. G. Bongiorni, M. Pringsheim, J. Mueller, A. Nagy, R. Giron, W. T. Abraham, Y. Takabatake, F. Toyota, D. Martinez Ruiz, M. Lunati, S. Vargiu, L E De Groot De Laat, V. Shabanov, L. Lioni, R. Kast, D. Bettex, K. S. Cha, J. L. Diago, D. Cozma, H. Lieu, M. Giakoumis, E. Orenes-Pinero, G. Murana, A. Kutarski, A.P.J. van Dijk, G. Speziale, A. Boem, L. M. Belotti, B. Igual, A. M. S. Olsen, and H. Lue
Subjects: business.industry, Medicine, Ancient history, Cardiology and Cardiovascular Medicine, business
Published: 2012
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8. Abstracts

Author: O. Barthelemy, J. Silvain, D. Brieger, A. Bellemain-Appaix, G. Cayla, F. Beygui, R. Lancar, J. P. Collet, A. Mercadier, G. Montalescot, K. S. Cha, Y. H. Nam, J. H. Kim, S. Y. Park, T. H. Park, M. H. Kim, Y. D. Kim, H. C. Lee, M. S. Ahn, T. J. Hong, R. Blanco, F. Blanco, J. Szarfer, A. Garcia Escudero, G. Gigena, J. Gagliardi, A. Rodriguez, R. Sarmiento, S. Affatatto, M. Riccitelli, A. Petris, M. D. Datcu, C. Pop, M. Radoi, C. Arsenescu-Georgescu, I. Petrescu, L. Petrescu, L. Serban, E. Nechita, G. Tatu-Chitoiu, M. Dorobantu, I. Benedek, E. Craiu, C. Sinescu, D. D. Ionescu, C. Ginghina, B. Minescu, A. Izzo, P. Mantovani, L. Tomasi, L. Dall'oglio, S. Bonatti, R. Rosiello, M. Romano, F. Agostini, R. Zanini, Z. Y. Zhao, Y. J. Wu, J. J. Li, Y. J. Yany, H. Y. Qian, Y. D. Tang, A. T. Timoteo, A. Toste, A. Lousinha, R. Ramos, J. A. Oliveira, M. L. Ferreira, R. C. Ferreira, C. Cabades, J. L. Diez Gil, P. Aguar, D. Sanmiguel, A. Lopez-March, R. Marmol, L. Guerra, V. Girbes, J. Ferrando, A. Rincon De Arellano, L. Patricio, M. Blondal, T. Ainla, T. Marandi, J. Eha, M. M. Oliveira, M. N. Silva, P. S. Cunha, J. Feliciano, S. Silva, J. Kanovsky, P. Kala, J. Parenica, M. Poloczek, K. Prymusova, L. Kubkova, J. Spinar, D. Olinic, C. Homorodean, M. Ober, M. Olinic, C. Andrioaia, A. Condac, M. Masmoudi, B. Berdaoui, S. Labidi, C. Tapia Ballesteros, C. Hernandez Luis, M. G. Sandin, J. M. Vegas, R. Andion, N. Martinez, I. A. Gonzalez, M. Alvarado, I. J. Amat, J. A. San Roman, M. J. Garcia Gonzalez, E. Arroyo Ucar, C. Hernandez Garcia, M. Dorta Martin, F. Marrero Rodriguez, R. Dragu, M. Kapeliovich, H. Hammerman, D. Silva, N. Cortez-Dias, C. Jorge, J. Silva Marques, P. Carilho Ferreira, S. Robalo Martins, M. Almeida Ribeiro, C. Calisto, M. Fiuza, M. G. Lopes, P. Milicevic, M. Panic, I. Stankovic, D. Milicevic, T. Kalezic, S. Kafedzic, I. Ilic, M. Cerovic, B. Putnikovic, A. Neskovic, D. Rott, D. Leibowitz, Z. Monhart, J. Reissigova, H. Grunfeldova, P. Jansky, B. Valente, I. Villanueva Benito, I. Solla, E. Paredes, O. Diaz Castro, F. Calvo, J. A. Baz, A. Iniguez, A. Aleksova, R. Gerloni, R. Belfiore, C. Carriere, G. Barbati, E. Fabris, F. Possa, D. Nait, M. Milo, G. Sinagra, N. Marques, J. Mimoso, V. Gomes, R. M. Agra Bermejo, E. A. A. Emad Abu Assi, S. R. R. Sergio Raposeiras Roubin, P. C. G. Pilar Cabanas Grandio, C. P. G. Carlos Pena Gil, J. M. G. A. Jose Maria Garcia Acuna, J. R. G. J. Jose Ramon Gonzalez Juanatey, M. J. Daly, P. Scott, C. G. Owens, A. Tomlin, B. Smith, A. A. J. Adgey, L. R. Alvarez-Contreras, U. Juarez, A. Altamirano, A. Arias, A. Alvarez-San Gabriel, H. Gonzalez-Pacheco, C. Martinez-Sanchez, M. Rahnavardi, M. Keshtkar-Jahromi, H. Vakili, S. Gholamin, S. M. Razavi, T. Gilis-Januszewski, K.- P. Mellwig, M. Wiemer, J. Gilis-Januszewski, A. Peterschroeder, J. Koerfer, D. Horstkotte, M. Vrsalovic, B. Getaldic, N. Vrkic, H. Pintaric, S. Khan, B. Wasan, L. Moretti, P. Grossi, S. Silenzi, M. Testa, L. Candelori, L. N. Clementi, M. Forlini, L. Lando, M. L. Pezzuoli, P. Corradetti, G. Leurent, P. Y. Pennec, E. Filippi, B. Moquet, J. P. Hacot, P. Druelles, A. Rialan, G. Rouault, I. Coudert, H. Le Breton, S. Gevaert, F. Tromp, E. Vandecasteele, F. De Somer, Y. Van Belleghem, S. Bouchez, F. Martens, I. Herck, M. De Pauw, O. Ludka, M. Sepsi, R. Miklik, L. Dusek, D. Tomcikova, J. M. Garcia-Acuna, P. Aguiar-Souto, S. Raposeiras Roubin, R. Agra-Bermejo, M. Jacquet, E. Abu-Assi, J. R. Gonzalez-Juanatey, A. Ibatov, R. Labrova, R. Karlik, P. Lokaj, Q. She, S. B. Deng, S. H. Huang, L. J. Gu, J. I. A. N. Rong, Z. K. Wu, Y. Li, J. Zhang, L. Parascan, A. Campanile, L. Spinelli, G. Santulli, M. Ciccarelli, S. De Gennaro, E. Assante Di Panzillo, B. Trimarco, G. Iaccarino, E. Bobescu, G. Datcu, D. Dobreanu, B. Doka, J.- C. Charniot, C. Cosson, J. P. Albertini, R. Bittar, P. Giral, C. Cherfils, E. Guillerm, D. Bonnefont-Rousselot, A. Rusali, L. Cojocaru, I. Parepa, T. Koizumi, S. Iida, J. Sato, T. Kikutani, T. 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China, F. Corbetti, S. Iliceto, L. L. Stazhadze, E. A. Spiridonova, N. A. Bulanova, A. A. Ermolaev, L. Savic, I. Mrdovic, G. Krljanac, J. Perunicic, M. Asanin, R. Lasica, M. Matic, Z. Vasiljevic, M. Ostojic, M. Tichy, C. Andrys, A. Conti, C. Poggioni, G. Viviani, F. Bulletti, V. Boni, M. Luzzi, S. Vicidomini, M. Donati, B. Del Taglia, R. Pini, O. Sousa, R. Fontes-Carvalho, D. Caeiro, N. Dias Ferreira, G. Silva, E. Pereira, J. Ribeiro, A. Albuquerque, V. Gama Ribeiro, M. Murai, Y. Takeda, T. Shinmyo, J. Tanigawa, H. Hazui, T. Nakakohji, Y. Ohishi, M. Hoshiga, T. Ishihara, T. Hanafusa, J. Belohlavek, V. Rohn, J. Kunstyr, M. Lips, M. Semrad, F. Mlejnsky, J. Tosovsky, A. Linhart, J. Lindner, Z. Sablik, A. Samborska-Sablik, J. Drozdz, W. Gaszynski, M. M. Izquierdo-Gomez, R. Juarez-Prera, G. Blanco-Palacios, R. Lakhdar, M. Drissa, B. Jedaida, H. Drissa, F. Sampaio, H.- T. Hsin, J.- H. Huang, K.- M. Chiu, Z.- S. Chen, P.- C. Lin, L.- Y. Chen, S.- H. Chu, I. Efthimiadis, P. Skendros, A. Sarantopoulos, P. Boura, A. M. Van Der Laan, P. A. Van Der Vleuten, M. Klees, J. G. P. Tijssen, B. E. Backus, A. J. Six, J. H. Kelder, A. Mosterd, E. G. Mast, T. P. Mast, R. Braam, R. Tio, R. Veldkamp, P. A. Doevendans, N. Paarup Dridi, L. Holmvang, T. Engstroem, S. Rekik, J. Brunet, F. X. Hager, G. Bayet, L. Meille, J. M. Quatre, J. Sainsous, P.- H. Chu, C.- H. Tang, N. Pogosova, I. E. Koltunov, I. D. Sapunova, V. A. Vigodin, R. Uhliar, A. Schmidt, B. Brockmeyer, A. Suzuki, Y. Eki, H. Higuchi, A. Yukawa, R. Yamauchi, Y. Sato, Y. Endo, J. Salazar Mendigucha Garcia, S. Homs Vila, A. Cequier Fillat, R. Andion Ogando, M. Sandin Fuentes, J. M. Vegas Valle, I. A. Gonzalez Garcia, I. A. Duro Aguado, A. J. Palomino Doza, I. Gomez Salvador, J. A. San Roman Calvar, T. M. Mamarasulov, L. Todorovic, Z. C. H. Cherneva, S. D. Denchev, K. Heltai, A. Boytsov, N. N. Nikulina, D. Zanna, V. Marangelli, C. Caiati, R. Picon Heras, M. J. Loureiro, I. Urazovskaya, D. Vinogradova, E. Vasilieva, A. Shpektor, E. Conti, M. B. Musumeci, F. M. Lauri, E. Dito, M. De Giusti, A. Lallo, D. Fusco, M. Davoli, M. Volpe, C. Autore, H. Gamra, Z. Dridi, M. Hassine, F. Addad, I. Gherissi, A. Reda, M. Mahjoub, S. Bouraoui, M. Abdennadher, F. Betbout, P. M. F. P. Mota, J. D. Silva, R. Jankovic Tomasevic, V. Djordjevic, D. Djordjevic Radojkovic, A. Scafa Udriste, A. Fruntelata, E. Gainoiu, S. Bogdan, D. Zamfir, C. Teodorescu, M. Guran, D. Constantinescu, A. Konopka, M. Banaszewski, I. Wojtkowska, J. Stepinska, J. V. Vidergold, I. V. Osipova, T. V. Tavrovskaya, J. V. Galkina, A. V. Timofeev, R. I. Vorobyov, E. N. Vorobyova, L. Matos, A. C. C. Carvalho, W. Oliveira, F. Cintra, D. Poyares, M. Andersen, R. Martins, S. Tufik, P. Ostadal, J. Brada, S. Horakova, M. Mlcek, V. Hrachovina, O. Kittnar, I. V. Gorudko, I. V. Buko, S. N. Cherenkevich, L. Z. Polonetsky, V. Y. Plotkin, M. A. Timoshina, S. V. Azanchevskaya, N. N. Chromov-Borisov, A. Vorlat, L. Snoep, M. J. Claeys, C. J. Vrints, A. Palazzuoli, M. Caputo, I. Quatrini, A. Calabro, G. Antonelli, M. S. Campagna, B. Franci, R. Nuti, A. Maisel, M. Negrini, T. Minora, P. Marino, R. Seregni, E. Tavlueva, O. Barbarash, L. Barbarash, T. Janota, J. Kudlicka, K. Malik, D. Wichterle, J. Hradec, R. Body, S. D. Carley, G. Mcdowell, M. Nuttall, C. Wibberley, M. France, J. K. Cruickshank, K. Mackway-Jones, M. Leon, C. Cozma, F. Mitu, D. R. Almeida, C. B. Dias, I. Burazor, M. Burazor, M. Krstic, M. Lazovic, M. Vukmanovic, J. Djordjevic, Z. Radovanovic, D. Ilic, P. Bosnjakovic, A. C. Ferreira, P. S. Mateus, P. Fontes, T. Teixeira, G. Conte, A. Menozzi, E. Solinas, M. G. Bolognesi, I. Tadonio, F. Mantovani, A. Cattabiani, L. Vignali, D. Ardissino, O. Tautu, A. Alexandrescu, R. Niculescu, R. Jankovic, N. Bozinovic, C. Santos, F. Costa, G. Cardoso, I. Correia, K. Fountoulaki, S. Kastellanos, E. Voltirakis, A. Kokotos, C. Michalakeas, K. Kontsas, K. Hasioti, E. T. Iliodromitis, M. G. Sandin Fuentes, E. Zatarain Nicolas, N. Martinez Uruena, M. Alvarado Montes De Oca, V. Dytrych, T. Kovarnik, O. Smid, A. Kral, A. G. Aroutunov, S. Intwala, I. Jegere, H. S. H. Shaalan, Z. Pagava, R. Agladze, R. Shakarishvili, N. Sharashidze, L. Gujejiani, G. Saatashvili, T. Z. Katova, V. Kostova, Y. Simova, S. Vukotic, S. Rafajlovski, R. Romanovic, N. Antonijevic, B. Gligic, M. Hutyra, T. Skala, D. Horak, D. Vindis, M. Taborsky, A. Contine, M. Del Pinto, F. Angeli, P. Verdecchia, F. Borgognoni, E. Grikstaite, P. Pantano, G. Ambrosio, C. Cavallini, C. Bonanad, J. Sanchis, V. Bodi, J. Nunez, X. Bosch, M. Heras, M. Pellicer, A. Llacer, L. Adao, M. Oliveira, H. Goncalves, J. Primo, V. Gama, C. Lombardi, M. Metra, S. Bugatti, E. Pasotti, F. Quinzani, M. Adamo, C. Villa, R. Rovetta, A. Manerba, M. Mariani, A. Dushpanova, M. Baroni, E. Cerone, A. Nardelli, J. Gianetti, S. Berti, F. Feliciano, R. Soares, S. Santos, A. Kruger, D. Vondrakova, J. Herget, C. Navarro, N. A. Cromie, J. A. A. Adgey, D. Caeiro Pereira, P. Braga, R. Fontes Carvalho, A. Rodrigues, M. Goncalves, L. Simoes, and K. V. Borisov
Subjects: Cardiology and Cardiovascular Medicine
Published: 2010
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9. Impact of Closed-Loop Stimulation, overdrive pacing, DDDR pacing mode on atrial tachyarrhythmia burden in Brady-Tachy Syndrome A randomized study

Author: G. Altamura, G. Pettinati, B. Castaldi, Critelli G, A. Puglisi, F. Capestro, S. Favale, and L. Pavia
Subjects: Male, Tachycardia, Bradycardia, Randomization, Atrial overdrive pacing, law.invention, Closed loop stimulation, Randomized controlled trial, law, Brady-tachy syndrome, Humans, Medicine, Aged, Atrium (architecture), business.industry, Cardiac Pacing, Artificial, Syndrome, Anesthesia, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Algorithms, Follow-Up Studies
Abstract: Aims Atrial overdrive pacing algorithms increase Atrial Pacing Percentage (APP) to reduce Atrial Tachyarrhythmia (AT) recurrences in patients with Brady-Tachy Syndrome (BTS). This study aimed to compare AT burden and APP in BTS patients treated with conventional DDDR pacing, DDD+ overdrive or Closed-Loop Stimulation (CLS). Methods and results One hundred and forty-nine BTS patients were included (72 male, mean age 74±9), who received a dual chamber pacemaker (Philos DR or Inos 2+CLS, Biotronik GmbH, Berlin, Germany) programmed in DDD at 70min−1. At 1-month follow-up, DDDR, DDD+ or CLS algorithms were activated according to randomization. Follow-up visits for data collection were performed at 4 and 7 months. Non parametric statistical tests (Kruskal–Wallis H-test, Dunn test, Spearman coefficient) were used to analyse not-normally-distributed samples. At 7 months, AT burden was significantly lower in CLS group (20.3±63.1min/day, P
Published: 2003
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10. Clinical implementation of cardiac resynchronization therapy-regional disparities across selected ESC member countries

Author: Amiran Revishvili, Krzysztof Kaczmarek, G Theodorakis, M Lunati, V Zalevsky, Evgeny Pokushalov, Giorgio Corbucci, I Vicini, Béla Merkely, S Favale, V Jovanovic, Robert Hatala, I Zupan, Josef Kautzner, V Calvi, R Vatasescu, Moti Haim, and Eva Goncalvesova
Subjects: Pediatrics, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Population, prevalence, Cardiac resynchronization therapy, cardiac resynchronization therapy, Target population, Annual incidence, Physiology (medical), Internal medicine, medicine, Humans, cardiovascular diseases, Healthcare Disparities, Israel, education, Reimbursement, Heart Failure, education.field_of_study, business.industry, Incidence, General Medicine, Original Articles, medicine.disease, equipment and supplies, Heart Rhythm, Europe, Treatment Outcome, HEART FAILURE, PREVALENCE, Heart failure, cardiovascular system, Russian federation, Cardiology and Cardiovascular Medicine, business, Demography, circulatory and respiratory physiology
Abstract: Background The present analysis aimed to estimate the penetration of cardiac resynchronization therapy (CRT) on the basis of the prevalence and incidence of eligible patients in selected European countries and in Israel. Methods and Results The following countries were considered: Italy, Slovakia, Greece, Israel, Slovenia, Serbia, the Czech Republic, Poland, Romania, Hungary, Ukraine, and the Russian Federation. CRT penetration was defined as the number of patients treated with CRT (CRT patients) divided by the prevalence of patients eligible for CRT. The number of CRT patients was estimated as the sum of CRT implantations in the last 5 years, the European Heart Rhythm Association (EHRA) White Book being used as the source. The prevalence of CRT indications was derived from the literature by applying three epidemiologic models, a synthesis of which indicates that 10% of heart failure (HF) patients are candidates for CRT. HF prevalence was considered to range from 1% to 2% of the general population, resulting in an estimated range of prevalence of CRT indication between 1000 and 2000 patients per million inhabitants. Similarly, the annual incidence of CRT indication, representing the potential target population once CRT has fully penetrated, was estimated as between 100 and 200 individuals per million. The results showed the best CRT penetration in Italy (47–93%), while in some countries it was less than 5% (Romania, Russian Federation, and Ukraine). Conclusion CRT penetration differs markedly among the countries analyzed. The main barriers are the lack of reimbursement for the procedure and insufficient awareness of guidelines by the referring physicians.
Published: 2014

11. May we improve risk stratification for thromboembolic events by combining CHADS2 score with atrial fibrillation presence and duration? Proceedings 16th World Congress in Cardiac Electrophysiology and Cardiac Techniques

Author: G.L. Botto, L. Padeletti, M. Santini, A. Capucci, M. Gulizia, F. Zolezzi, S. Favale, G. Molon, R. Ricci, B. Mariconti, M. Vimercati, G. Corbucci, BIFFI, MAURO, BORIANI, GIUSEPPE, GL.Botto, L.Padeletti, M.Santini, A.Capucci, M.Gulizia, F.Zolezzi, S.Favale, G.Molon, R.Ricci, M.Biffi, B.Mariconti, M.Vimercati, G.Corbucci, and G.Boriani.
Published: 2008

12. May we rely on standard methods fora atrial fibrillation detection?

Author: BORIANI, GIUSEPPE, BIFFI, MAURO, L. Padeletti, M. Santini, A. Capucci, M. Gulizia, F. Zolezzi, S. Favale, G. Molon, R. Ricci, M. Luzi, M. Vimercati, G. Corbucci, G.L. Botto, G.Boriani, L.Padeletti, M.Santini, A.Capucci, M.Gulizia, F.Zolezzi, S.Favale, G.Molon, R.Ricci, M.Biffi, M.Luzi, M.Vimercati, G.Corbucci, and GL.Botto
Subjects: ATRIAL FIBRILLATION
Published: 2008

13. Confronto fra metodi standard per il rilevamento delle fibrillazione atriale e il monitoraggio continuo

Author: BORIANI, GIUSEPPE, BIFFI, MAURO, L. Padeletti, M. Santini, A. Capucci, M.M. Gulizia, F. Zolezzi, S. Favale, G. Molon, R. Ricci, G. Russo, M. Vimercati, G. Corbucci, G. Botto, G.Boriani, L.Padeletti, M.Santini, A.Capucci, MM. Gulizia, F.Zolezzi, S.Favale, G.Molon, R.Ricci, M.Biffi, G.Russo, M.Vimercati, G.Corbucci, and G.Botto
Published: 2008

14. Which Left Ventricular Stimulation Site Is Best for Cardiac Resynchronisation Therapy?

Author: S. Favale, F. Nacci, F. Fino, V. F. Napoli, and E. Spennati
Subjects: medicine.medical_specialty, education.field_of_study, business.industry, Left bundle branch block, Population, Hemodynamics, medicine.disease, Ventricular stimulation, Internal medicine, cardiovascular system, Cardiology, Medicine, In patient, cardiovascular diseases, business, education, Sequence (medicine)
Abstract: In the last few years, cardiac resynchronisation therapy has been proposed as a way of restoring a physiological interventricular and left intraventricular activation sequence in patients with severely symptomatic left ventricular (LV) systolic dysfunction and left bundle branch block (LBBB). In this population haemodynamic and clinical benefits have been confirmed.
Published: 2004
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15. The DAPHNE study: a randomised trial to test the combined role of drugs and a dedicated device to prevent and treat atrial arrhythmias

Author: A. Capucci, G. Botto, G. Molon, A. Spampinato, G. Ferri, S. Favale, A. Proclemer, T. Marotta, BORIANI, GIUSEPPE, A.Capucci, G.Botto, G.Boriani, G.Molon, A.Spampinato, G.Ferri, S.Favale, A.Proclemer, and T.Marotta
Published: 2004

16. Predictors of atrial antitachycardia pacing efficacy from the AT500 Italian Registry

Author: BORIANI, GIUSEPPE, L. Padeletti, G. Botto, A. Galati, P. DellaBella, D. Malfitano, S. favale, A. Grammatico, E. Mazzini, M. Santini, G.Boriani, L.Padeletti, G.Botto, A.Galati, P.DellaBella, D.Malfitano, S.favale, A.Grammatico, E.Mazzini, and M.Santini
Published: 2004

17. Management of Atrial Fibrillation Suppression in AF-HF Comorbidity Therapy (MASCOT) Trial

Author: Antonio Curnis, S. Favale, Giuseppe Arena, Mario Mariani, G. Giannola, A. Puglisi, A. Carboni, M G Bongiorni, E. Hoffmann, Ezio Soldati, and Luigi Padeletti
Subjects: medicine.medical_specialty, business.industry, Diastole, Management of atrial fibrillation, Atrial fibrillation, medicine.disease, Asymptomatic, Framingham Heart Study, Heart failure, Internal medicine, Aortic pressure, Physical therapy, Cardiology, Medicine, medicine.symptom, Risk factor, business
Abstract: Inter- [1,2], intra- [3,4], and atrioventricular [51(AV) dyssynchrony are not new concepts, but only recently have attempts been made to correct these disorders in an effort to treat heart failure (HF). A series of trials [6] has addressed partial or comprehensive cardiac resynchronization in patients with severe HF and evidence of cardiac dyssynchrony. Cardiac resynchronization should improve left ventricular (LV) performance; several trials [7-10] have demonstrated improvement in many hemodynamic parameters (LV and aortic pressure, shortening of mitral diastolic regurgitation, synchronized LV and atrial systole, LV volume, reduced myocardial oxygen consumption) and clinical end-points (quality of life, peak oxygen uptake, functional capacity, reduced number of hospitalizations). The incidence of atrial fibrillation (AF) double every 10 years in adults: there are 2-3 new cases/1000 annually in the age group of 55-64 years and 35 new cases/1000 annually between the age of 85 and 94 years [11-13]. The Framingham study demonstrated that AF is an independent risk factor for mortality with a relative risk of 1.5 for men and 1.9 for women. In patients with HF, the prevalence of AF is directly related to NYHA class: AF is present in 10% of patients in NYHA class II and 40% of patients in NYHA classes III-IV. However, HF morbidity is highly influenced by the coexistence of AF, independently of functional class. Moreover, the presence of symptomatic or asymptomatic AF in patients with LV dysfunction is linked to a poor prognosis and is independently associated with a higher risk of death from all causes and from progressive pump failure [14,15]. The prevalence of AF in most trials [16-22] on HF is shown in Fig. 1.
Published: 2003
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18. Brady-Tachy Syndrome: What Is the Best Pacing Technique To Reduce the Burden of Atrial Fibrillation?

Author: Paolo Azzolini, G. Pettinati, A. Puglisi, P. Dini, G. Altamura, L. Pavia, F. Bacca, S. Favale, F. Capestro, and G. B. Del Giudice
Subjects: medicine.medical_specialty, business.industry, Cardiac arrhythmia, Atrial fibrillation, medicine.disease, Stenosis, Relative risk, Internal medicine, Heart failure, Diabetes mellitus, Cardiology, Medicine, Sinus rhythm, cardiovascular diseases, business, Stroke
Abstract: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with an incidence of 0.4%–1% in the total adult population, 3%–4% in people aged 55–65 years and up to 9%–13% in those older than 70 years [1, 2]. Patients with AF have about two-fold higher risk of death than patients without AF. Above all, AF increases the risk of stroke and thromboembolism: AF is responsible of 20% of strokes, with 5-7-fold higher risk than in patients in sinus rhythm, and the risk ratio is 12–17 when hypertension, heart failure, diabetes and mitral stenosis coexist with AF [3, 4]. Moreover, AF results in electrical remodeling of the heart, which favors the induction and maintenance of the arrhythmia [5].
Published: 2002
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19. Asymptomatic Patients with Brugada Syndrome: Does the Risk of Sudden Death Justify ICD Implantation?

Author: R. Nacci and S. Favale
Subjects: medicine.medical_specialty, Heart disease, business.industry, ST elevation, medicine.disease, Ventricular tachycardia, Sudden death, QRS complex, Anesthesia, Internal medicine, Ventricular fibrillation, cardiovascular system, medicine, Cardiology, Sinus rhythm, cardiovascular diseases, business, Brugada syndrome
Abstract: Brugada syndrome is an arrhythmogenic clinical and electrocardiographic entity consisting of syncope and/or sudden death associated with a typical electrocardiographic pattern in sinus rhythm, characterized by aspects of QRS such as a right bundle-branch block and ST elevation at VI and V3, but with no structural heart disease. Arrhythmias include polymorphous ventricular tachycardia or ventricular fibrillation, which may cease spontaneously [1].
Published: 2002
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20. ICD Patients: What Is the Efficacy of Early Activation of Atrial ATP Therapies in Atrial Fibrillation Termination?

Author: M. Santini, P. A. Ravazzi, G. Altamura, S. Favale, G. Biancalana, and P. L. Padeletti
Subjects: medicine.medical_specialty, business.industry, Atrial fibrillation, medicine.disease, Internal medicine, cardiovascular system, medicine, Cardiology, In patient, cardiovascular diseases, Implant, Early activation, medicine.symptom, business, Atrial tachycardia
Abstract: Atrial fibrillation (AF)/atrial tachycardia (AT) is one of the most common arrhythmias. It has been reported that a relevant percentage of patients implanted with implantable cardioverter defibrillators (ICDs) have atrial tachyarrhythmias at the time of implant [1]. One of the most interesting results of the recently available atrial-ventricular dual-chamber ICD clinical investigations is the significantly high success rate of automatic atrial anti-tachy-pacing (ATP) therapies in AF/AT termination: atrial bursts, ramps and high frequency bursts (50 Hz bursts) successfully terminated 68% of the device-detected atrial episodes [2–4] in patients with an indication for ventricular ICD. In spite of the considerably high AF/AT termination rate, no significant reduction was observed in terms of AF/AT burden or mean duration of AF/AT episodes. A possible explanation of these surprising data may relate to no limit being imposed on the ATP intervention delay from the episode onset.
Published: 2002
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21. Heart rate variability patterns before ventricular tachycardia onset in patients with an implantable cardioverter defibrillator. Participating Investigators of ICD-HRV Italian Study Group

Author: F, Lombardi, A, Porta, M, Marzegalli, S, Favale, M, Santini, A, Vincenti, and A, De Rosa
Subjects: Male, Analysis of Variance, Arrhythmias, Cardiac, Middle Aged, Autonomic Nervous System, Defibrillators, Implantable, Survival Rate, Electrocardiography, Treatment Outcome, Heart Rate, Reference Values, Electrocardiography, Ambulatory, Tachycardia, Ventricular, Humans, Female, Aged, Probability
Abstract: Time- and frequency-domain analysis of heart rate variability (HRV) has been proven effective in describing alteration of autonomic control mechanisms and in identifying patients with increased cardiac and arrhythmic mortality. Patients with implantable cardioverter defibrillators offer the opportunity to evaluate HRV patterns before ventricular tachycardia (VT) and under control conditions. We therefore analyzed time- and frequency-domain parameters of short-term HRV and power-law behavior of RR interval time series at rest, at 15 to 30 minutes, and immediately before VT. In comparison to control conditions, lower values of mean cycle length duration and total power were observed before VT. Spectral analysis indicated that the low- to high-frequency ratio was significantly higher (5.5 +/- 0.6 vs 2.8 +/- 0.3) immediately before VT than during rest. Both findings were consistent with the shift of sympathovagal balance toward sympathetic predominance and reduced vagal tone. Before VT, a more negative value of the scaling exponent beta of the power-frequency relation (-1.57 +/- 0.04 vs -1.33 +/- 0.04) also confirmed the presence of an altered HRV pattern in comparison to controls. Thus, both abnormal autonomic modulation and dynamic patterns of HRV seem to characterize the minutes before arrhythmia onset in these patients.
Published: 2000

22. Immunomicroscopia elettronica per la dimostrazione di anticorpi diretti contro i coronavirus

Author: A. Serafino, S. Favale, P. M. Cereda, A. Cristallo, and M. Battaglia
Published: 1995

23. Poster Session 1

Author: A. Deshmukh, S. S. Sharma, F. G. Gobal, S. S. Singla, P. H. Hebbar, H. P. Paydak, M. Igarashi, H. Tada, Y. Sekiguchi, H. Yamasaki, K. Kuroki, T. Machino, K. Yoshida, K. Aonuma, J. Shavadia, H. Otieno, G. Yonga, A. Jinah, J. F. Qvist, P. H. Soerensen, U. Dixen, M. A. Ramirez-Marrero, B. Perez-Villardon, D. Gaitan-Roman, M. Jimenez-Navarro, J. L. Delgado-Prieto, E. De Teresa-Galvan, M. De Mora-Martin, P. B. Hebbar, W. X. Wei, S. Bardari, M. Zecchin, R. Salame', L. Vitali Serdoz, A. Di Lenarda, N. Guerrini, G. Barbati, G. Sinagra, K. Hanazawa, K. Kaitani, Y. Nakagawa, I. Lenaerts, R. Driesen, N. Hermida, H. Heidbuchel, S. Janssens, J. L. Balligand, K. R. Sipido, R. Willems, R. Sehra, D. Krummen, C. Briggs, S. Narayan, Y. Tanaka, K. Hirao, T. Nakamura, O. Inaba, A. Yagishita, K. Higuchi, H. Hachiya, M. Isobe, E. Kallergis, E. M. Kanoupakis, H. E. Mavrakis, C. A. Goudis, N. E. Maliaraki, P. E. Vardas, K. Kiuchi, C. Piorkowski, S. Kircher, T. Gaspar, N. Watanabe, A. Bollmann, G. Hindricks, K. Wauters, A. Grosse, S. Raffa, M. Brunelli, J. C. Geller, A. P. Maggioni, L. Gonzini, G. Gussoni, G. Vescovo, M. Gulizia, S. Pirelli, G. Mathieu, G. Di Pasquale, R. Salame, S. Magnani, T. Sakamoto, K. Kumagai, E. Fuke, S. Nishiuchi, T. Hayashi, Y. Miki, S. Naito, S. Oshima, I. E. Hof, E. Vonken, B. K. Velthuis, M. Meine, R. N. W. Hauer, K. P. Loh, J. O. Na, C. U. Choi, E. J. Kim, S. W. Rha, C. G. Park, H. S. Seo, D. J. Oh, H. E. Lim, D. Wichterle, V. Bulkova, M. Fiala, J. Chovancik, J. Simek, P. Peichl, R. Cihak, J. Kautzner, A. Glick, S. Viskin, B. Belhassen, A. Navarrete, F. Conte, A. Ishti, D. Sai, M. Moran, Z. Chitovova, H. Ahmed, K. Mares, J. Skoda, L. Sediva, J. Petru, V. Y. Reddy, P. Neuzil, M. Schmidt, U. Dorwarth, A. Leber, M. Wankerl, J. Krieg, F. Straube, S. Reif, E. Hoffmann, E. Mikhaylov, V. Tikhonenko, D. Lebedev, S. Y. Shin, H. S. Yong, J. I. Choi, S. H. Kim, S. Matsuo, T. Yamane, M. Hioki, K. Ito, R. Narui, T. Date, K. Sugimoto, M. Yoshimura, S. Rolf, P. Sommer, R. Batalov, S. Popov, I. Antonchenko, T. Suslova, S. Fichtner, U. Czudnochowsky, H. L. Estner, S. Ammar, T. Reents, C. Jilek, G. Hessling, I. Deisenhofer, E. Pokushalov, A. Romanov, G. Corbucci, S. Artemenko, D. Losik, V. Shabanov, A. Turov, D. Elesin, M. Abramov, P. Sanders, P. Jais, K. Roberts-Thomson, K. Fukumoto, S. Takatsuki, T. Kimura, N. Nishiyama, Y. Aizawa, T. Sato, S. Miyoshi, K. Fukuda, Y. Roux, J. Tenkorang, P. Carroz, J. Schlaepfer, P. Pascale, A. Forclaz, M. Fromer, E. Pruvot, L. Sknouril, R. Nevralova, M. Dorda, J. Januska, R. Santi, C. Geller, K. Nakamura, K. Kasseno, K. Taniguchi, A. Wutzler, M. Huemer, A. Parwani, L. H. Boldt, D. Blaschke, R. Dietz, W. Haverkamp, B. Coutu, R. Malanuk, M. Ait Said, A. Vicentini, S. Schade, K. Ando, A. Rousseauplasse, T. Deering, B. C. Picarra, A. R. Santos, P. Dionisio, P. Semedo, R. Matos, M. Leitao, A. Jacinto, M. Trinca, C. Wan, J. Glad, S. Szymkiewicz, M. Habibovic, H. Versteeg, A. J. M. Pelle, D. A. M. J. Theuns, L. Jordaens, S. S. Pedersen, S. Pakarinen, L. Toivonen, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, S. K. G. Maier, N. Lobitz, S. Paule, J. Becher, G. Mustafa, A. Ibrahim, G. King, B. Foley, B. Wilkoff, R. Freedman, D. Hayes, S. Kalbfleisch, S. Kutalek, R. Schaerf, I. A. Fazal, M. Tynan, C. J. Plummer, J. M. Mccomb, A. Oto, K. Aytemir, H. Yorgun, U. Canpolat, E. B. Kaya, L. Tokgozoglu, G. Kabakci, H. Ozkutlu, S. Greenberg, F. Hamati, R. Styperek, J. Alonso, D. Peress, O. Bolanos, R. Augostini, M. Pelini, S. Zhang, S. Stoycos, S. Witsaman, K. Mowrey, J. Bremer, A. Oza, G. Ciconte, P. Mazzone, G. Paglino, A. Marzi, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, M. Nagashima, M. Goya, Y. Soga, K. Hiroshima, K. Andou, K. Hayashi, Y. An, M. Nobuyoshi, A. Kutarski, B. Malecka, R. Pietura, P. Osmancik, D. Herman, P. Stros, V. Kocka, P. Tousek, H. Linkova, M. Bortnik, E. Occhetta, G. Dell'era, A. Degiovanni, L. Plebani, P. N. Marino, M. V. Gorev, D. G. Alimov, P. Raju, S. Kully, S. Ugni, S. Furniss, G. Lloyd, N. R. Patel, M. W. Richards, C. E. Warren, M. H. Anderson, M. Hero, J. L. Rey, S. Ouali, S. Azzez, S. Kacem, S. Hammas, H. Ben Salem, E. Neffeti, F. Remedi, E. Boughzela, M. B. Kronborg, P. T. Mortensen, S. H. Poulsen, J. C. Nielsen, E. N. Simantirakis, J. E. Kontaraki, E. G. Arkolaki, S. I. Chrysostomakis, E. G. Nyktari, A. P. Patrianakos, R. C. Funck, C. Harink, H. H. Mueller, S. Koelsch, B. Maisch, V. Bolzani, P. Costandi, R. E. Shehada, N. Butala, B. Coppola, M. Taborsky, P. Heinc, M. Fedorco, V. Doupal, A. Di Cori, G. Zucchelli, E. Soldati, L. Segreti, R. De Lucia, S. Viani, L. Paperini, M. G. Bongiorni, K. J. Gutleben, W. Kranig, C. Barr, M. M. Morgenstern, M. Simon, Y. H. Dalal, M. Landolina, A. Pierantozzi, T. Agricola, M. Lunati, E. Pisano', G. Lonardi, G. Bardelli, G. Zucchi, B. Thibault, M. Dubuc, E. Karst, K. Ryu, P. Paiement, M. D. Carlson, T. Farazi, H. Alhous, L. Mont, J. M. Porres, J. Alzueta, X. Beiras, I. Fernandez-Lozano, A. Macias, R. Ruiz, J. Brugada, S. M. Viani, M. Seifert, T. Schau, V. Moeller, J. Meyhoefer, C. Butter, V. Ganiere, V. Niculescu, G. Domenichini, C. Stettler, P. Defaye, H. Burri, M. Stockburger, E. De Teresa, G. Lamas, M. Desaga, C. Koenig, E. Cobo, X. Navarro, U. Wiegand, M. Blich, S. Carasso, M. Suleiman, I. Marai, L. Gepstein, M. Boulos, M. Sasov, B. Liska, P. Margitfalvi, T. Malacky, M. Svetlosak, E. Goncalvesova, R. Hatala, Y. Takaya, T. Noda, Y. Yamada, H. Okamura, K. Satomi, W. Shimizu, N. Aihara, S. Kamakura, A. Proclemer, S. Boveda, H. Oswald, P. Scipione, A. Da Costa, W. Brzozowski, A. Tomaszewski, A. Wysokinski, E. Arbelo, D. Tamborero, B. Vidal, J. M. Tolosana, M. Sitges, M. Matas, G. L. Botto, C. D. Dicandia, M. Mantica, C. La Rosa, A. D' Onofrio, G. Molon, G. Raciti, R. Verlato, P. W. X. Foley, S. Chalil, K. Ratib, R. E. A. Smith, F. Printzen, A. Auricchio, F. Leyva, R. Abu Sham'a, J. Buber, D. Luria, R. Kuperstein, M. Feinberg, H. Granit, M. Eldar, M. Glikson, K. Vondrak, E. Nof, I. Lipchenca, R.- G. Vatasescu, C. Iorgulescu, C. Caldararu, A. Vasile, S. Bogdan, D. Constantinescu, M. Dorobantu, H. Sakaguchi, A. Miyazaki, T. Yamamoto, K. Fujimoto, S. Ono, H. Ohuchi, M. Martinelli, S. Martins, R. Molina, S. Siqueira, S. A. D. Nishioka, G. L. Peixoto, R. Alkmim-Teixeira, R. Costa, M. M. Meine, A. E. Tuinenburg, P. A. Doevendans, J. Denollet, K. Goscinska-Bis, I. Zupan, H. Van Der, F. Anselme, H. Hartog, M. Block, A. Borri, L. Padeletti, M. Toniolo, G. Zanotto, A. Rossi, E. Raytcheva, L. Tomasi, C. Vassanelli, I. Fernandez Lozano, C. Mitroi, J. Toquero Ramos, V. Castro Urda, V. Monivas Palomero, A. Corona Figueroa, L. Ruiz Bautista, L. Alonso Pulpon, A. S. Jadidi, F. Sacher, A. S. Shah, D. Scherr, N. Derval, M. Hocini, M. Haissaguerre, S. Castrejon Castrejon, C. Largo-Aramburu, J. Sachar, E. Gang, A. Estrada, D. Doiny, E. De Miguel, J. L. Merino, N. Trevisi, A. Ricco, F. Petracca, F. Baratto, A. Bisceglie, G. Maccabelli, A. El-Damaty, J. Sapp, J. Warren, P. Macinnis, M. Horacek, B. Dinov, R. Schoenbauer, F. Braunschweig, A. Arya, D. Andreu, A. Berruezo, J. T. Ortiz, E. Silva, T. M. De Caralt, J. Fernandez-Armenta, A. Perez-Silva, M. Ortega, J. L. Lopez-Sendon, F. Regoli, F. Faletra, G. Nucifora, E. Pasotti, T. Moccetti, C. Klersy, M. Casella, A. Dello Russo, M. Moltrasio, M. Zucchetti, G. Fassini, L. Di Biase, A. Natale, C. Tondo, N. Matsuhashi, H. J. Weig, G. Kerst, S. Weretk, P. Seizer, M. P. Gawaz, J. Schreieck, G. Sarquella-Brugada, F. Prada, C. M. Salling, C. Kolb, M. Pytkowski, A. Maciag, M. Farkowski, A. Jankowska, I. Kowalik, A. Kraska, H. Szwed, P. Maury, A. Duparc, P. Mondoly, A. Rollin, R. Pap, M. Kohari, G. Bencsik, A. Makai, L. Saghy, T. Forster, E. Ebrille, M. Scaglione, C. Raimondo, D. Caponi, P. Di Donna, A. Blandino, S. D. L. Delcre, F. Gaita, I. Roca Luque, L. D. S. Dos, N. R. G. Rivas, A. P. D. Pijuan, J. Perez, J. Casaldaliga, D. G. D. Garcia-Dorado, A. M. M. Moya, H. Sato, T. Yagi, T. Yambe, F. Streitner, C. Dietrich, E. Mahl, N. Schoene, C. Veltmann, M. Borggrefe, J. Kuschyk, P. P. Sadarmin, K. C. K. Wong, K. Rajappan, Y. Bashir, T. R. Betts, C. Leclercq, R. Martins, J. C. Daubert, P. Mabo, M. Koide, G. Hamano, T. Taniguchi, M. Yamato, N. Sasaki, K. Hirooka, Y. Ikeda, Y. Yasumura, W. Dichtl, T. Wolber, U. Paoli, S. Bruellmann, T. Berger, M. Stuehlinger, F. Duru, F. Hintringer, E. Kanoupakis, H. Mavrakis, E. Koutalas, I. Saloustros, C. Goudis, G. Chlouverakis, P. Vardas, J. M. Herre, M. Saeed, L. Saberi, S. Neuman, K. Yamaji, M. Iwabuchi, A. Baranchuk, F. Femenia, R. Miranda Hermosilla, J. C. Lopez Diez, J. L. Serra, M. Valentino, E. Retyk, N. Galizio, W. Kwasniewski, A. Filipecki, W. Orszulak, D. Urbanczyk-Swic, M. Trusz - Gluza, O. Piot, B. Degand, A. Donofrio, P. Scanu, A. Quesada, A. Kloppe, D. Mijic, H. Bogossian, M. Zarse, B. Lemke, J. Tyler, G. Comfort, T. F. Deering, A. E. Epstein, S. M. G. Greenberg, D. S. Goldman, J. Rhude, J. P. Majewski, J. Lelakowski, I. Tomala, C. M. Santos, R. S. Miranda, P. J. Sousa, D. M. Cavaco, P. P. Adragao, R. E. Knops, A. A. Wilde, M. Belhameche, J. S. Hermida, E. Dovellini, G. Frohlig, P. Siot, G. Z. Duray, C. W. Israel, J. Brachmann, K. H. Seidl, M. Foresti, F. Birkenhauer, S. H. Hohnloser, C. Ferreira, P. Mateus, H. Ribeiro, S. Carvalho, A. Ferreira, J. Moreira, W. Kadro, H. Rahim, M. Turkmani, M. Abu Lebdeh, A. Altabban, N. Cerrato, S. Rivera, F. Scazzuso, G. Albina, A. Klein, R. Laino, V. Sammartino, A. Giniger, T. Kvantaliani, M. Akhvlediani, M. Namdar, J. Steffel, S. Jetzer, F. Bayrak, G. B. Chierchia, R. Jenni, P. Brugada, Z. Bakos, M. M. Medvedev M, J. C. Jonas Carlsson, F. H. Fredrik Holmqvist, P. P. Pyotr Platonov, T. Nurbaev, M. Pirnazarov, A. Nikishin, P. Aagaard, A. Sahlen, L. Bergfeldt, E. Simeonidou, S. Kastellanos, C. Varounis, C. Michalakeas, C. Koniari, A. Nikolopoulou, M. Anastasiou-Nana, Y. Furukawa, T. Yamada, T. Morita, K. Tanaka, Y. Iwasaki, M. Kawasaki, Y. Kuramoto, M. Fukunami, C. Blanche, N. Tran, F. Rigamonti, M. Zimmermann, E. Okisheva, D. Tsaregorodtsev, V. Sulimov, D. Novikova, T. Popkova, E. Udachkina, Y. Korsakova, A. Volkov, A. Novikov, E. Alexandrova, E. Nasonov, P. Arsenos, K. Gatzoulis, G. Manis, P. Dilaveris, T. Gialernios, E. Kartsagoulis, S. Asimakopoulos, C. Stefanadis, M. Marocolo, O. Barbosa Neto, A. C. Carvalho, S. R. Marques Neto, G. R. Mota, P. R. B. Barbosa, A. Fernandez-Fernandez, S. Manzano Fernandez, F. J. Pastor-Perez, O. Barquero-Perez, R. Goya-Esteban, M. Salar, J. L. Rojo-Alvarez, A. Garcia-Alberola, M. Takigawa, M. Kawamura, T. Aiba, T. Sakaguchi, H. Itoh, M. Horie, T. Igarashi, J. Negishi, N. Toyota, O. Yamada, M. Papavasileiou, F. Cabrera Bueno, M. J. Molina Mora, J. Alzueta Rodriguez, A. Barrera Cordero, E. De Teresa Galvan, A. S. Revishvili, T. Dzhordzhikiya, O. Sopov, G. Simonyan, O. Lyadzhina, E. Fetisova, V. Kalinin, J. C. Balt, R. C. Steggerda, L. V. A. Boersma, M. C. E. F. Wijffels, E. F. D. Wever, J. M. Ten Berg, R. P. Ricci, L. Morichelli, A. D'onofrio, D. Vaccari, L. Calo', G. Buja, N. Rovai, A. Gargaro, J. Sperzel, G. Speca, L. Santini, J. Haarbo, K. Dubin, M. Carlson, A. Garcia Quintana, H. Mendoza-Lemes, L. Garcia Perez, S. Led Ramos, E. Caballero Dorta, M. Matinez De Espronceda, V. Piro Mastracchio, L. Serrano Arriezu, L. Sciarra, M. Marziali, E. Marras, M. Rebecchi, G. Allocca, E. Lioy, P. Delise, V. E. Santobuono, M. Iacoviello, F. Nacci, G. Luzzi, A. Puzzovivo, M. Memeo, F. Quadrini, S. Favale, M. E. Trucco, M. Arce, J. Palazzolo, W. Uribe, R. Maggi, T. Furukawa, F. Croci, A. Solano, M. Brignole, A. Lebreiro, A. Sousa, A. S. Correia, P. Lourenco, S. Oliveira, M. Paiva, J. Freitas, M. J. Maciel, N. Linker, G. Rieger, C. Garutti, N. Edvardsson, R. Salguero Bodes, M. De Riva Silva, A. Fontenla Cerezuela, M. Lopez Gil, E. Mejia Martinez, A. Jurado Roman, S. Garcia Alvarez, F. Arribas Ynsaurriaga, N. R. Petix, A. Del Rosso, V. Guarnaccia, A. Zipoli, F. Rabajoli, G. Foglia Manzillo, C. Tolardo, C. Checchinato, S. Chiaravallotti, M. Santarone, M. T. Spinnler, C. Podoleanu, A. Frigy, D. Dobreanu, C. Ginghina, and E. Carasca
Subjects: Lv function, medicine.medical_specialty, business.industry, Physiology (medical), Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Predictive value, Value (mathematics), Surgery
Abstract: was higher in the NRG (p 0.70 was the more accurate RT-MCE value to predict LV regional recovery with positive predictive value of 70% and negative predictive value of 56% (p
Published: 2011
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24. New insights into pathophysiology, work up and treatment of syncope

Author: P. Palmisano, M. Zaccaria, F. Nacci, M. Anaclerio, G. Luzzi, S. Favale, N. Edvardsson, G. Rieger, C. Garutti, N. Linker, F. J. Lacunza Ruiz, A. Moya, J. D. Martinez-Alday, G. Baron-Esquivias, R. Ruiz-Granell, S. Gonzalez, M. Martin, A. Garcia-Alberola, E. Mejia Martinez, R. Salguero Bodes, B. Lopez Melgar, A. Fontenla Cerezuela, M. De Riva Silva, M. Lopez Gil, A. Jurado Roman, F. Arribas Ynsaurriaga, A. F. Folino, F. Migliore, A. Porta, S. Cerutti, S. Iliceto, and G. Buja
Subjects: medicine.medical_specialty, biology, business.industry, Physiology (medical), Syncope (genus), Medicine, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, biology.organism_classification, Work-up, Pathophysiology
Published: 2011
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25. Poster Session 4: Syncope

Author: M. Wnuk, H. Abe, E. K. Kramarz, J. Kowalczyk, S. Favale, S. Sideris, C. Stefanadis, P. Mitro, G. Karystinos, G. Nur-Mammadova, Y. Otsuji, V. Peppes, M. Maciel, W. Mazurek, A. Santos, P. Cooper, E. Konduracka, C. Forleo, R. M. Santos, A. Stanczyk, L. Gianfranchi, M. L. Sturmer, S. Rose, T. Gialernios, R. Maggi, T. L. L. Leiria, P. Guida, F. Ayala-Paredes, S. Sorrentino, R. Chirife, T. Tahir, R. Candeias, B. Godin, D. Zysko, C. Garratt, S. Cebula, D. Kontomerkos, G. Corbucci, T. Kus, A. Musialik-Lydka, A. Sedkowska, A. Antoniou, H. Sotiropoulos, J. Silva, A. Fitzpatrick, M. Nogues, M. Dimopoulos, P. Kirsch, M. Iacoviello, E. Wojewodka-Zak, F. Boomsma, J. P. Freitas, A. Z. Pietrucha, D. Mroczek-Czernecka, K. Gatzoulis, I. Mustafaev, H. Grancelli, M. Dinelli, I. Bzukala, M. Panunzio, J. Gajek, W. Piwowarska, V. Gomes, B. Clarke, S. Petkar, Z. Kalarus, R. Kohno, C. Tentori, I. Jesus, N. Marques, L. U. K. Olendrzynski, P. Alboni, T. Parisi, P. Arsenos, B. Sredniawa, G. A. Ruiz, L. K. Kubik, P. Dilaveris, A. Wozniak, V. D'andria, A. Sliwinska, G. Fuca, A. Lemieux, and M. M. Ciccone
Subjects: medicine.medical_specialty, biology, business.industry, Physiology (medical), Syncope (genus), Physical therapy, Medicine, Session (computer science), Cardiology and Cardiovascular Medicine, business, biology.organism_classification
Published: 2009
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26. Poster Session 4: Miscellaneous

Author: P. A. Brady, P. Erne, J. Val-Mejias, J. Schwab, R. Schimpf, M. Orlov, T. Mattioni, J. Amlie, H. Itou, M. Igarashi, A. Iga, T. Tubota, J. Yamazaki, K. Yoshihara, C. I. Santos De Sousa, L. Carpinteiro, P. Marques, M. R. Almeida, G. Miltemberger, M. J. Correia, J. Sousa, M. Lopes, R. Teixeira, M. J. Ferreira, P. Donato, M. Ventura, J. Cristovao, L. Elvas, L. A. Providencia, D. Chang, S. Zhang, L. Gao, D. Yang, Y. Lin, Z. Chu, Y. Yang, R. Pecini, S. Pehrson, X. Chen, A. M. Thoegersen, A. Kjaer, J. Hastrup-Svendsen, J. J. Sanchez-Munoz, A. Garcia-Alberola, J. Martinez-Sanchez, P. Penafiel-Verdu, J. A. Giner-Caro, F. J. Pastor-Perez, M. Valdes-Chavarri, S. Sorrentino, C. Forleo, M. Iacoviello, P. Guida, V. D'andria, S. Favale, E. Pasceri, A. Curcio, F. Achille, D. De Serio, S. Zinzi, D. Torella, P. Mastroroberto, C. Indolfi, O. Ozcan Celebi, A. Canbay, S. Aydogdu, E. Diker, A. De Sisti, J. Tonet, A. Benkaci, R. Frank, P. Penafiel Verdu, J. A. Giner Caro, N. Maroz-Vadalazhskaya, T. Denissevich, I. Ostrovskiy, N. Sharashidze, Z. Pagava, G. Saatashvili, R. Agladze, M. Noda, S. Yoshikawa, T. Fujinami, Y. Yamamoto, H. Tashiro, M. Usui, K. Ichikawa, M. Isobe, C. Meyer, E. Saygili, O. Rana, J. Floege, M. Hennersdorf, T. Rassaf, M. Kelm, P. Schauerte, B. Sredniawa, S. Cebula, J. Kowalczyk, A. Musialik-Lydka, A. Wozniak, M. Zakliczynski, M. Zembala, Z. Kalarus, O. I. Gumenyuk, Y. V. Chernenkov, I. V. Kosenkova, N. V. Bolotova, and A. P. Averyanov
Subjects: medicine.medical_specialty, business.industry, Physiology (medical), medicine, Medical physics, Session (computer science), Cardiology and Cardiovascular Medicine, business
Published: 2009
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27. [Transesophageal study in the diagnostic evaluation of pre-excitation]

Author: S, Favale, M V, Pitzalis, P, Totaro, M, Di Biase, and P, Rizzon
Subjects: Electrocardiography, Heart Conduction System, Cardiac Pacing, Artificial, Humans, Wolff-Parkinson-White Syndrome
Abstract: Electrophysiologic non-invasive transesophageal testing is compared to intracardiac study in the management of patients with Wolff-Parkinson-White (WPW) syndrome. Transesophageal study can be reliably used to identify the participation of the accessory pathway in reciprocating supraventricular tachycardia and to determine the anterograde conduction properties of the accessory pathway. Using the shortest pre-excited interval during induced atrial fibrillation, or programmed and continuous atrial transesophageal stimulation can markedly reduce the need of intracardiac evaluation. The greater safety and economy of transesophageal compared to the intracardiac technique justify its wider use in preliminary screening of all WPW patients, unless ablative treatment has been clinically indicated, and in evaluating long-term drug protection against a potential deleterious ventricular response during atrial tachyarrhythmias.
Published: 1991

28. [Localization of the accessory pathways using surface ECG in Wolff-Parkinson-White syndrome]

Author: M, Di Biase, M, Tritto, M V, Pitzalis, S, Favale, and P, Rizzon
Subjects: Electrocardiography, Heart Conduction System, Atrial Fibrillation, Humans, Wolff-Parkinson-White Syndrome
Abstract: During recent years criteria for localization of bypass tracts in the Wolff-Parkinson-White syndrome from the conventional ECG have been acquired utilizing epicardial and endocardial mapping data. The polarity of delta wave and QRS in the frontal and horizontal plane and the morphology of retrograde P waves during orthodromic reciprocating tachycardia, are the most indicative elements. An accurate analysis of QRS complexes during atrial fibrillation confirms the site of pre-excitation and could suggest the presence of 2 or more accessory pathways with sufficient spatial separation. Some criteria for identifying multiple accessory pathways are discussed.
Published: 1991

29. P-176 Clinical evaluation of the world s thinnest transvenous dual coil defibrillation lead

Author: A. Schaumann, S. Favale, K.H. Kuck, P. Vock, and A. Amiel
Subjects: medicine.medical_specialty, Defibrillation, business.industry, medicine.medical_treatment, Electric countershock, Dual coil, Physiology (medical), medicine, Medical physics, Cardiology and Cardiovascular Medicine, Intensive care medicine, Lead (electronics), business, Clinical evaluation
Published: 2003
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30. Electrophysiologic properties of intravenous Tenormine in man

Author: M, Di Biase, S, Favale, and P, Rizzon
Subjects: Electrophysiology, Male, Propanolamines, Atenolol, Heart Conduction System, Acetamides, Adrenergic beta-Antagonists, Injections, Intravenous, Humans, Female, Middle Aged, Sinoatrial Node
Abstract: The acute electrophysiologic effects of intravenous Tenormine (0.1 mg/kg body weight), a new cardioselective beta-adrenoreceptor blocking drug, were studied in 18 subjects with estimated normal impulse formation and conduction. The most significant (P less than 0.01) effects were sinus cycle lengthening, depression of intranodal conduction and prolongation of AV node refractory periods. Sinus node recovery time, sinoatrial conduction time and atrial refractory periods were only slightly prolonged (P less than 0.05). Intraatrial conduction and infra-His conduction were unchanged. These properties are compared with those of the most commonly employed beta-blocking agents. The clinical implications are discussed.
Published: 1979

31. [Supra-bundle of His conduction]

Author: M, Di Biase, S, Favale, and P, Rizzon
Subjects: Bundle of His, Heart Block, Heart Conduction System, Atrioventricular Node, Cardiac Pacing, Artificial, Exercise Test, Humans
Published: 1983

32. [Surface and intracavitary electrocardiography in mitral valve prolapse]

Author: M, Di Biase, S, Favale, L, Sorgente, P, Calabrese, and P, Rizzon
Subjects: Electrocardiography, Mitral Valve Prolapse, Humans
Published: 1979

33. Electrophysiologic evaluation of intravenous bunaphtine in man

Author: M, Di Biase, A, Scarcia, A, Chiddo, E, Nacci, S, Favale, and P, Rizzon
Subjects: Adult, Electrocardiography, Injections, Intravenous, Drug Evaluation, Humans, Arrhythmias, Cardiac, Middle Aged, Naphthalenes, Butylamines, Anti-Arrhythmia Agents, Aged
Abstract: The acute electrophysiologic effects of intravenous Bunaphtine 1,5 mg/kg body weight, a new antiarrhythmic drug, were studied in 19 subjects with estimated normal impulse formation and conduction. Significant effects were sinus bradycardia, prolongation of atrial refractory periods, depression of intranodal and infranodal conduction and prolongation of His-Purkinje system refractory periods. These properties are compared with those of amiodarone and quinidine and form the basis for a correct use of Bunaphtine in the management of arrhythmias.
Published: 1977

34. [Pre-excitation syndromes]

Author: S, Favale, F, Minafra, V, Massari, and G, Modugno
Subjects: Electrophysiology, Electrocardiography, Pre-Excitation Syndromes, Cardiac Pacing, Artificial, Humans, Heart, Wolff-Parkinson-White Syndrome, Prognosis
Published: 1987

35. Linee Guida AIAC 2006 all’impianto di pacemaker, dispositivi per la resincronizzazione cardiaca (CRT) e defibrillatori automatici impiantabili (ICD)

Author: Lunati, M., Bongiorni, Mg, Boriani, Giuseppe, Cappato, R., Corrado, D., Di Biase, A. Curnis M., Favale, S., Padeletti, L., FE Pedretti, R., Proclemer, A., Ricci, R., Santini, M., Spirito, P., Vergara, G., M Lunati, MG Bongiorni, G Boriani, R Cappato, D Corrado, A Curnis M Di Biase, S Favale, L Padeletti, R FE Pedretti, A Proclemer, R Ricci, M Santini, P Spirito, and G Vergara
Subjects: LINEE GUIDA, defibrillatori, PACEMAKER, CARDIAC RESYNCHRONIZATION THERAPY
Abstract: Fin dalla loro prima introduzione, le Linee Guida hanno sempre avuto lo scopo di informare il medico sulle evidenze scientifiche riportate in letteratura ed indirizzarlo verso il trattamento più appropriato di specifiche patologie. Debbono cioè identificare dei gruppi di pazienti con determinate caratteristiche e suggerire per essi il trattamento che, in trial clinici randomizzati, abbia dimostrato di garantire il miglior risultato per il paziente. Purtroppo, molto spesso non sono disponibili per tutte le categorie di pazienti, dati scientifici che evidenzino con chiarezza i potenziali benefici o non benefici di specifici trattamenti e ciò determina l’esistenza di grandi “zone grigie” nelle quali, in assenza di supporti scientifici chiari, la decisione terapeutica rimane totalmente nelle mani del medico curante il quale è chiamato a valutare la situazione clinica di ogni paziente su base individuale
Published: 2005

36. Atlas of Regional Left Ventricular Scar in Nonischemic Cardiomyopathies: Substrates and Etiologies.

Author: Del Franco A, Ruggieri R, Pieroni M, Ciabatti M, Zocchi C, Biagioni G, Tavanti V, Del Pace S, Leone O, Favale S, Guaricci AI, Udelson J, and Olivotto I
Abstract: Most acquired and inherited cardiomyopathies are characterized by regional left ventricular involvement and nonischemic myocardial scars, often with a disease-specific pattern. Irrespective of the etiology and pathophysiological mechanisms, myocardial disorders are invariably associated with cardiac fibrosis, which contributes to dysfunction and electrical instability. Accordingly, cardiac magnetic resonance plays a central role in the diagnostic work-up and prognostic risk stratification of cardiomyopathies, particularly with the increasing correlation between genetic background and specific disease phenotype. Starting from pattern and distribution of myocardial fibrosis at cardiac magnetic resonance, we provide a practical regional atlas of nonischemic myocardial scar to guide the diagnostic approach to nonischemic cardiomyopathies., Competing Interests: Dr Olivotto was supported by the European Union's 10.13039/100010661Horizon 2020 Research and Innovation Programme under Grant Agreement number: 777204: “SILICOFCM - In Silico trials for drug tracing the effects of sarcomeric protein mutations leading to familial cardiomyopathy”; by the Italian Ministry of Health (Left ventricular hypertrophy in aortic valve disease and hypertrophic cardiomyopathy: genetic basis, biophysical correlates and viral therapy models” (RF-2013-02356787); and by the EnteCassa di Risparmio di Firenze (bando 2016) “juvenile sudden cardiac death: just know and treat.” The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)
Published: 2024
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37. Percutaneous extraction of a Micra AV transcatheter pacing system due to a rare sudden battery failure after 19 months from implantation: A first experience worldwide.

Author: Santobuono VE, Basile P, Carella MC, Pomarico F, Favale S, Ciccone MM, and Guaricci AI
Subjects: Humans, Treatment Outcome, Equipment Design, Cardiac Pacing, Artificial, Arrhythmias, Cardiac, Pacemaker, Artificial adverse effects
Abstract: Introduction: Micra AV Transcatheter Pacing System (TPS) represents an innovative second-generation leadless pacemaker which represents an effective alternative to conventional devices in selected cases. Intrinsic malfunctions of these devices are rare, requiring sometimes their retrieval. When performed in experienced centers, this procedure is safe., Case Presentation: We describe a case of sudden battery malfunction of a Micra AV TPS, which required the extraction and the placement of a new pacing system in the right ventricle., Discussion: This case, which has never been reported, highlights the need to a careful fluoroscopic evaluation and the usefulness of remote monitoring., (© 2023 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.)
Published: 2024
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38. Disposizioni anticipate di trattamento: e se fosse un bene parlarne? Uno studio con metodo misto.

Author: Berardinelli D, Favale S, Re Viglietti S, Conti A, Campagna S, and Dimonte V
Published: 2023
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39. Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co-morbidities.

Author: Santobuono VE, Favale S, D'Onofrio A, Manzo M, Calò L, Bertini M, Savarese G, Santini L, Dello Russo A, Lavalle C, Viscusi M, Amellone C, Calvanese R, Arena G, Pangallo A, Rapacciuolo A, Porcelli D, Campari M, Valsecchi S, and Guaricci AI
Subjects: Humans, Algorithms, Morbidity, Defibrillators, Implantable, Cardiac Resynchronization Therapy methods, Heart Failure epidemiology, Heart Failure therapy, Atrial Fibrillation etiology
Abstract: Aims: The HeartLogic algorithm combines multiple implantable defibrillator (ICD) sensor data and has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation in cardiac resynchronization therapy (CRT-D) patients. We evaluated the performance of this algorithm in non-CRT ICD patients and in the presence of co-morbidities., Methods and Results: The HeartLogic feature was activated in 568 ICD patients (410 with CRT-D) from 26 centres. The median follow-up was 26 months [25th-75th percentile: 16-37]. During follow-up, 97 hospitalizations were reported (53 cardiovascular) and 55 patients died. We recorded 1200 HeartLogic alerts in 370 patients. Overall, the time IN the alert state was 13% of the total observation period. The rate of cardiovascular hospitalizations or death was 0.48/patient-year (95% CI: 0.37-0.60) with the HeartLogic IN the alert state and 0.04/patient-year (95% CI: 0.03-0.05) OUT of the alert state, with an incidence rate ratio of 13.35 (95% CI: 8.83-20.51, P < 0.001). Among patient characteristics, atrial fibrillation (AF) on implantation (HR: 1.62, 95% CI: 1.27-2.07, P < 0.001) and chronic kidney disease (CKD) (HR: 1.53, 95% CI: 1.21-1.93, P < 0.001) independently predicted alerts. HeartLogic alerts were not associated with CRT-D versus ICD implantation (HR: 1.03, 95% CI: 0.82-1.30, P = 0.775). Comparisons of the clinical event rates in the IN alert state with those in the OUT of alert state yielded incidence rate ratios ranging from 9.72 to 14.54 (all P < 0.001) in all groups of patients stratified by: CRT-D/ICD, AF/non-AF, and CKD/non-CKD. After multivariate correction, the occurrence of alerts was associated with cardiovascular hospitalization or death (HR: 1.92, 95% CI: 1.05-3.51, P = 0.036)., Conclusions: The burden of HeartLogic alerts was similar between CRT-D and ICD patients, while patients with AF and CKD seemed more exposed to alerts. Nonetheless, the ability of the HeartLogic algorithm to identify periods of significantly increased risk of clinical events was confirmed, regardless of the type of device and the presence of AF or CKD., (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Published: 2023
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40. The impact of UEFA Euro 2020 football championship on Takotsubo Syndrome: Results of a multicenter national registry.

Author: Polimeni A, Spaccarotella C, Ielapi J, Esposito G, Ravera A, Martuscelli E, Ciconte V, Menichelli M, Varbella F, Imazio M, Navazio A, Sinagra G, Oberhollenzer R, Sibilio G, Cacciavillani L, Meloni L, Dominici M, Tomai F, Amico F, Corda M, Musumeci G, Lupi A, Zezza L, De Caterina R, Cernetti C, Metra M, Rossi L, Calabrò P, Murrone A, Volpe M, Caldarola P, Carugo S, Cortese B, Valenti R, Boriani G, Fedele F, Ventura G, Manes MT, Colavita AR, Feola M, Versaci F, Assennato P, Arena G, Ceravolo R, Amodeo V, Tortorici G, Nassiacos D, Antonicelli R, Esposito N, Favale S, Licciardello G, Tedesco L, and Indolfi C
Abstract: Objectives: The UEFA 2020 European Football Championship held in multiple cities across Europe from June 11 to July 11, 2021, was won by Italy, providing an opportunity to examine the relationship between emotional stress and the incidence of acute cardiovascular events (ACE)., Methods and Results: Cardiovascular hospitalizations in the Cardiac Care Units of 49 hospital networks in Italy were assessed by emergency physicians during the UEFA Euro 2020 Football Championship. We compared the events that occurred during matches involving Italy with events that occurred during the remaining days of the championship as the control period. ACE was assessed in 1,235 patients. ACE during the UEFA Euro 2020 Football Championship semifinal and final, the most stressful matches ended with penalties and victory of the Italian team, were assessed. A significant increase in the incidence of Takotsubo Syndrome (TTS) by a factor of 11.41 (1.6-495.1, P < 0.003), as compared with the control period, was demonstrated during the semifinal and final, whereas no differences were found in the incidence of ACS [IRR 0.93(0.74-1.18), P = 0.57]. No differences in the incidence of ACS [IRR 0.98 (0.87-1.11; P = 0.80)] or TTS [IRR 1.66(0.80-3.4), P = 0.14] were found in the entire period including all matches of the UEFA Euro 2020 compared to the control period., Conclusions: The data of this national registry demonstrated an association between the semifinal and final of UEFA Euro 2020 and TTS suggesting that it can be triggered by also positive emotions such as the victory in the European Football Championship finals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Polimeni, Spaccarotella, Ielapi, Esposito, Ravera, Martuscelli, Ciconte, Menichelli, Varbella, Imazio, Navazio, Sinagra, Oberhollenzer, Sibilio, Cacciavillani, Meloni, Dominici, Tomai, Amico, Corda, Musumeci, Lupi, Zezza, De Caterina, Cernetti, Metra, Rossi, Calabrò, Murrone, Volpe, Caldarola, Carugo, Cortese, Valenti, Boriani, Fedele, Ventura, Manes, Colavita, Feola, Versaci, Assennato, Arena, Ceravolo, Amodeo, Tortorici, Nassiacos, Antonicelli, Esposito, Favale, Licciardello, Tedesco and Indolfi.)
Published: 2022
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41. Prognostic value of 12-leads admission electrocardiogram in low-risk patients hospitalized for COVID-19.

Author: Pepe M, Napoli G, Brindicci G, Carulli E, Nestola PL, Santoro CR, Biondi-Zoccai G, Giordano A, D'Ascenzo F, Cirillo P, Saracino A, and Favale S
Subjects: Bundle-Branch Block epidemiology, Electrocardiography, Hospital Mortality, Humans, Prognosis, Tachycardia, COVID-19 diagnosis
Abstract: Background: Cardiac involvement significantly contributes to coronavirus disease 2019 (COVID-19) mortality.12-lead electrocardiogram (ECG) represents a fast, cheap, and easy to perform exam with the adjunctive advantage of the remote reporting possibility. In this study, we sought to investigate if electrocardiographic parameters can identify patients, deemed at low-risk at admission, who will face in-hospital unfavorable course., Methods: From March 1, 2020, through March 30, 2021, 384 consecutive patients with confirmed low-risk COVID-19 were hospitalized at the University Hospital of Bari (Italy). Criteria for low risk were: admission to the division of Pneumology or Infectious Diseases, no need for immediate (within 24 hours from admission) transfer to Intensive Care Unit or for respiratory support with invasive mechanical ventilation (IMV) or for circulation support (either mechanical or pharmacological). Admission ECGs were reviewed and interpreted by two expert cardiologists. The primary outcomes were in-hospital death and the composite outcome of in-hospital death and IMV., Results: In low-risk COVID-19 patients, atrial fibrillation (AF), poor R wave progression (PRWP), tachycardia, and right bundle branch block (RBBB) resulted as statistically significant and independent predictors of in-hospital all-cause mortality; AF, PRWP, Tachycardia, RBBB, and corrected QT interval showed to be statistically significant and independent risk factors for the occurrence of the composite endpoint of death and IMV., Conclusions: Our study demonstrated for the first time that RBBB and PRWP, assessed upon admission with ECG, are associated with unfavorable clinical course in a baseline low-risk population hospitalized for COVID-19.
Published: 2022
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42. Unmasking the prevalence of amyloid cardiomyopathy in the real world: results from Phase 2 of the AC-TIVE study, an Italian nationwide survey.

Author: Merlo M, Pagura L, Porcari A, Cameli M, Vergaro G, Musumeci B, Biagini E, Canepa M, Crotti L, Imazio M, Forleo C, Cappelli F, Perfetto F, Favale S, Di Bella G, Dore F, Girardi F, Tomasoni D, Pavasini R, Rella V, Palmiero G, Caiazza M, Carella MC, Igoren Guaricci A, Branzi G, Caponetti AG, Saturi G, La Malfa G, Merlo AC, Andreis A, Bruno F, Longo F, Rossi M, Varrà GG, Saro R, Di Ienno L, De Carli G, Giacomin E, Arzilli C, Limongelli G, Autore C, Olivotto I, Badano L, Parati G, Perlini S, Metra M, Emdin M, Rapezzi C, and Sinagra G
Subjects: Humans, Middle Aged, Prevalence, Prospective Studies, Stroke Volume, Ventricular Function, Left, Amyloidosis diagnosis, Cardiomyopathies diagnostic imaging, Cardiomyopathies epidemiology, Heart Failure
Abstract: Aim: To investigate the prevalence of amyloid cardiomyopathy (AC) and the diagnostic accuracy of echocardiographic red flags of AC among consecutive adult patients undergoing transthoracic echocardiogram for reason other than AC in 13 Italian institutions., Methods and Results: This is an Italian prospective multicentre study, involving a clinical and instrumental work-up to assess AC prevalence among patients ≥55 years old with an echocardiogram suggestive of AC (i.e. at least one echocardiographic red flag of AC in hypertrophic, non-dilated left ventricles with preserved ejection fraction). The study was registered at ClinicalTrials.gov (NCT04738266). Overall, 381 patients with an echocardiogram suggestive of AC were identified among a cohort of 5315 screened subjects, and 217 patients completed the investigations. A final diagnosis of AC was made in 62 patients with an estimated prevalence of 29% (95% confidence interval 23%-35%). Transthyretin-related AC (ATTR-AC) was diagnosed in 51 and light chain-related AC (AL-AC) in 11 patients. Either apical sparing or a combination of ≥2 other echocardiographic red flags, excluding interatrial septum thickness, provided a diagnostic accuracy >70%., Conclusion: In a cohort of consecutive adults with echocardiographic findings suggestive of AC and preserved left ventricular ejection fraction, the prevalence of AC (either ATTR or AL) was 29%. Easily available echocardiographic red flags, when combined together, demonstrated good diagnostic accuracy., (© 2022 European Society of Cardiology.)
Published: 2022
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43. Role of Nuclear Lamin A/C in the Regulation of Nav1.5 Channel and Microtubules: Lesson From the Pathogenic Lamin A/C Variant Q517X.

Author: De Zio R, Pietrafesa G, Milano S, Procino G, Bramerio M, Pepe M, Forleo C, Favale S, Svelto M, Gerbino A, and Carmosino M
Abstract: In this work, we studied an lmna nonsense mutation encoding for the C-terminally truncated Lamin A/C (LMNA) variant Q517X, which was described in patients affected by a severe arrhythmogenic cardiomyopathy with history of sudden death. We found that LMNA Q517X stably expressed in HL-1 cardiomyocytes abnormally aggregates at the nuclear envelope and within the nucleoplasm. Whole-cell patch clamp experiments showed that LMNA Q517X-expressing cardiomyocytes generated action potentials with reduced amplitude, overshoot, upstroke velocity and diastolic potential compared with LMNA WT-expressing cardiomyocytes. Moreover, the unique features of these cardiomyocytes were 1) hyper-polymerized tubulin network, 2) upregulated acetylated α-tubulin, and 3) cell surface Nav1.5 downregulation. These findings pointed the light on the role of tubulin and Nav1.5 channel in the abnormal electrical properties of LMNA Q517X-expressing cardiomyocytes. When expressed in HEK293 with Nav1.5 and its β1 subunit, LMNA Q517X reduced the peak Na + current (I Na ) up to 63% with a shift toward positive potentials in the activation curve of the channel. Of note, both AP properties in cardiomyocytes and Nav1.5 kinetics in HEK293 cells were rescued in LMNA Q517X-expressing cells upon treatment with colchicine, an FDA-approved inhibitor of tubulin assembly. In conclusion, LMNA Q517X expression is associated with hyper-polymerization and hyper-acetylation of tubulin network with concomitant downregulation of Nav1.5 cell expression and activity, thus revealing 1) new mechanisms by which LMNA may regulate channels at the cell surface in cardiomyocytes and 2) new pathomechanisms and therapeutic targets in cardiac laminopathies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 De Zio, Pietrafesa, Milano, Procino, Bramerio, Pepe, Forleo, Favale, Svelto, Gerbino and Carmosino.)
Published: 2022
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44. A national survey on prevalence of possible echocardiographic red flags of amyloid cardiomyopathy in consecutive patients undergoing routine echocardiography: study design and patients characterization - the first insight from the AC-TIVE Study.

Author: Merlo M, Porcari A, Pagura L, Cameli M, Vergaro G, Musumeci B, Biagini E, Canepa M, Crotti L, Imazio M, Forleo C, Cappelli F, Favale S, Di Bella G, Dore F, Lombardi CM, Pavasini R, Rella V, Palmiero G, Caiazza M, Albanese M, Guaricci AI, Branzi G, Caponetti AG, Saturi G, La Malfa G, Merlo AC, Andreis A, Bruno F, Longo F, Sfriso E, Di Ienno L, De Carli G, Giacomin E, Spini V, Milidoni A, Limongelli G, Autore C, Olivotto I, Badano L, Parati G, Perlini S, Metra M, Emdin M, Rapezzi C, and Sinagra G
Subjects: Humans, Echocardiography, Prevalence, Amyloidosis diagnostic imaging, Amyloidosis epidemiology, Cardiomyopathies diagnostic imaging, Cardiomyopathies epidemiology
Published: 2022
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45. Wellens' Syndrome from COVID-19 Infection Assessed by Enhanced Transthoracic Coronary Echo Doppler: A Case Report.

Author: Caiati C, Desario P, Tricarico G, Iacovelli F, Pollice P, Favale S, and Lepera ME
Abstract: Wellens' syndrome (WS) is a preinfarction state caused by a sub-occlusion of the proximal left anterior descending coronary artery (LAD). In this case report, for the first time, we describe how this syndrome can be caused by COVID-19 infection and, most importantly, that it can be assessed bedside by enhanced transthoracic coronary echo Doppler (E-Doppler TTE). This seasoned technique allows blood flow Doppler to be recorded in the coronaries and at the stenosis site but has never been tested in an acute setting. Two weeks after clinical recovery from bronchitis allegedly caused by COVID-19 infection on the basis of epidemiologic criteria (no swab performed during the acute phase but only during recovery, at which time it was negative), our patient developed typical angina for the first time, mainly during effort but also at rest. He was admitted to our tertiary center, where pharyngeal swabs tested positive for COVID-19. A typical EKG finding supporting WS prompted an assessment of the left main coronary artery (LMCA) and the whole LAD blood flow velocity by E-Doppler TTE. Localized high velocity (transtenotic velocity) (100 cm/s) was recorded in the proximal LAD, with the reference velocity being 20 cm/s. This indicated severe stenosis with 90% area narrowing according to the continuity equation, as confirmed by coronary angiography. During follow-up after successful stenting, E-Doppler TTE showed a decrease in the transtenotic acceleration, confirming stent patency and a normal coronary flow reserve (3.2) and illustrating a normal microcirculatory function. Conclusion: COVID infection can trigger a coronary syndrome like WS. E-Doppler TTE, an ionizing radiation-free method, allows safe and rapid bedside management of the syndrome. This new strategy can be pivotal in distinguishing true WS from pseudo-WS. In cases of pseudo-WS, coronary angiography can be avoided. If E-Doppler TTE confirms the stenosis and PCI (percutaneous coronary intervention) is performed, the same method can allow assessment over time of the precise residual stenosis after stenting and verify the microvasculature status by evaluating coronary flow reserve.
Published: 2022
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46. Clinical use of cangrelor: a real-world multicenter experience from South Italy.

Author: Pepe M, Larosa C, Cirillo P, Carulli E, Forleo C, Nestola PL, Ercolano V, D'Alessandro P, Giordano A, Biondi-Zoccai G, Moscarelli M, Palmiotto AI, Esposito G, and Favale S
Subjects: Adenosine Monophosphate analogs & derivatives, Humans, Platelet Aggregation Inhibitors adverse effects, Purinergic P2Y Receptor Antagonists therapeutic use, Treatment Outcome, Acute Coronary Syndrome drug therapy, Myocardial Infarction, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods
Abstract: Background: Dual antiplatelet therapy (DAPT) with acetylsalicylic acid and oral P2Y12 inhibitor (P2Y12-I) represents the standard of care for patients with acute coronary syndromes (ACS) or with chronic coronary syndromes (CCS) treated with percutaneous coronary intervention (PCI). Cangrelor, the first intravenous P2Y12-I, is deemed to overcome the drawbacks of the oral administration; nevertheless, real world data on this new drug are scanty. We sought to investigate routine clinical use of cangrelor in four interventional centers of Italy., Methods: We enrolled 241 consecutive patients (196 ACS, 45 CCS) treated with cangrelor during PCI. Drug administration modalities and in-hospital clinical outcomes were evaluated. A subanalysis in patients selected based on the CHAMPION Phoenix trial inclusion/exclusion criteria (CHAMPION-like subpopulation) was also performed., Results: Cangrelor was mainly utilized in ACS patients, who presented poorer clinical conditions and higher bleeding risk. Cangrelor was given only in P2Y12-I naïve patients; switch to clopidogrel was always done at the end of the infusion, while ticagrelor or prasugrel were prevalently given 30 minutes before. In-hospital mortality was 10.0% and GUSTO moderate/severe bleeding was 2.5%. Bleeding data showed nevertheless to be in line with the CHAMPION Phoenix results in the "CHAMPION-like" subpopulation., Conclusions: Cangrelor was predominantly used in ACS with modalities substantially in accord with the label indications. Poor clinical outcomes are due to the prevalent utilization in highly challenging clinical settings, nevertheless the rate of bleeding and stent thrombosis are in line with the randomized trials if analyzed in a subpopulation of comparable risk profile.
Published: 2022
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47. Coronary-specific quantification of myocardial deformation by strain echocardiography may disclose the culprit vessel in patients with non-ST-segment elevation acute coronary syndrome.

Author: Guaricci AI, Chiarello G, Gherbesi E, Fusini L, Soldato N, Siena P, Ursi R, Ruggieri R, Guglielmo M, Muscogiuri G, Baggiano A, Rabbat MG, Memeo R, Lepera M, Favale S, and Pontone G
Abstract: Aims: To compare the diagnostic accuracy of speckle tracking echocardiography technique using territorial longitudinal strain (TLS) for the detection of culprit vessel vs. vessel-specific wall motion score index (WMSI) in non-ST-segment elevation-acute coronary syndrome (NSTE-ACS) patients scheduled for invasive coronary angiography (ICA)., Methods and Results: One hundred and eighty-three patients (mean age: 66 ± 12 years, male: 71%) diagnosed with NSTE-ACS underwent echocardiography evaluation at hospital admission and ICA within 24 h. Culprit vessels were left anterior descending (LAD), left circumflex (CX), and right coronary arteries (RCAs) in 38.5%, 39.6%, and 21.4%, respectively. An increase of affected vessels [1-, 2-, and 3-vessel coronary artery disease (CAD)] was associated with increased WMSI and TLS values. There was a statistically significant difference of both WMSI-LAD, WMSI-CX, WMSI-RCA and TLS-LAD, TLS-CX, TLS-RCA of myocardial segments with underlying severe CAD compared to no CAD ( P = 0.001 and P < 0.001, respectively). Moreover, a significant difference of TLS-LAD, TLS-CX, TLS-RCA, and WMSI-CX of myocardial segments with an underlying culprit vessel compared to non-culprit vessels ( P < 0.001, P < 0.001, P = 0.022, and P < 0.001, respectively) was identified. WMSI-LAD and WMSI-RCA did not show statistical significant differences. A regression model revealed that the combination of WMSI + TLS was more accurate compared to WMSI alone in detecting the culprit vessel (LAD, P = 0.001; CX, P < 0.001; and RCA, P = 0.019)., Conclusion: Territorial longitudinal strain allows an accurate identification of the culprit vessel in NSTE-ACS patients. In addition to WMSI, TLS may be considered as part of routine echocardiography for better clinical assessment in this subset of patients., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Published: 2022
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48. Conduction delays after transcatheter aortic valve implantation with balloon-expandable prosthesis and high implantation technique.

Author: Iacovelli F, Giugliano G, Gerardi D, Salemme L, Cioppa A, Pucciarelli A, Popusoi G, Loizzi F, Schettino G, Favale S, Solimene F, Esposito G, Tesorio T, and Stabile E
Subjects: Aortic Valve diagnostic imaging, Aortic Valve pathology, Aortic Valve surgery, Humans, Prosthesis Design, Risk Factors, Treatment Outcome, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Pacemaker, Artificial, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement methods
Abstract: Performing transcatheter aortic valve implantation with high implantation technique, i.e. with an aorto-ventricular ratio > 60/40, reduces the need of permanent pacemaker implantation. Valve calcification and prosthesis oversizing are predictors of permanent pacemaker implantation, but there are no available data on their role when transcatheter aortic valve implantation is performed with an aorto-ventricular ratio > 60/40. The aim of this study was to evaluate the effect of leaflets/annulus calcification and prosthesis oversizing on the incidence of permanent pacemaker implantation after transcatheter aortic valve implantation with a high implantation technique. Transcatheter aortic valve implantation was performed in 48 patients implanting a balloon-expandable transcatheter heart valve with an aorto-ventricular ratio > 60/40. Calcium burden was assessed by preprocedural multidetector computed tomography. An invasive electrophysiological study was performed before and after transcatheter aortic valve implantation. Five patients (10.4%) needed permanent pacemaker implantation. At univariate analysis, baseline right bundle branch block and postprocedural PR, QRS and His-ventricular interval elongation significantly predicted permanent pacemaker implantation (p < 0.05). Receiver-operating characteristic curve analysis showed a correlation between transcatheter heart valve oversizing and permanent pacemaker implantation need, with the best cut-off being 17% (AUC = 0.72, p = 0.033). Linear regression analysis demonstrated that QRS complex elongation was related to total, left and non-coronary leaflet calcification (p < 0.05). This study demonstrates that, when transcatheter aortic valve implantation is performed using a balloon-expandable transcatheter heart valve deployed with an aorto-ventricular ratio > 60/40, the presence of leaflets/annulus calcification or the need to oversize the prosthesis correlate with the occurrence of pathological cardiac conduction delays., (© 2021. Springer Japan KK, part of Springer Nature.)
Published: 2022
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49. Cardiorenal Syndrome Triggered by Slowly Progressive Drugs Toxicity-Induced Renal Failure along with Minimal Mitral Disease: A Case Report.

Author: Caiati C, Argentiero A, Favale S, and Lepera ME
Subjects: Aged, 80 and over, Female, Furosemide, Humans, Mitral Valve diagnostic imaging, Cardio-Renal Syndrome chemically induced, Cardio-Renal Syndrome complications, Cardio-Renal Syndrome diagnosis, Heart Failure chemically induced, Heart Failure diagnosis, Mitral Valve Insufficiency etiology
Abstract: Background: We report the case of a 93-year-old patient with normal left ventricular function and severe mitral annulus calcification, with mild mitral steno-insufficiency., Case Presentation: She had developed creeping drugs-induced renal toxicity that is generally totally overlooked, due mainly to statins, a proton pump inhibitor, and aspirin. The Na and fluid retention, along with hypertension that ensued, although not severe, caused acute heart failure (sub-pulmonary edema) by worsening the mitral insufficiency. This occurred due to a less efficient calcific mitral annulus contraction during systole and an increasing mitral transvalvular gradient, as the transvalvular mitral gradient has an exponential relation to flow. After the suspension of the nephrotoxic drugs and starting intravenous furosemide, she rapidly improved. At 6 months follow-up, she is stable, in an NYHA 1-2 functional class, despite the only partial recovery of the renal function., Conclusion: Progressive renal failure can functionally worsen even minimal mitral valvulopathy. Drug-induced nephrotoxicity can always be suspected in case of renal failure of unknown etiology. The suspension of the culprit drugs can improve renal function and dramatically improve the clinical symptoms even in a nonagenarian., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
Published: 2022
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50. Predictors of Exercise Capacity in Dilated Cardiomyopathy with Focus on Pulmonary Venous Flow Recorded with Transesophageal Eco-Doppler.

Author: Caiati C, Argentiero A, Forleo C, Favale S, and Lepera ME
Abstract: The aim of this study was to clarify the relative contribution of elevated left ventricle (LV) filling pressure (FP) estimated by pulmonary venous (PV) and mitral flow, transesophageal Doppler recording (TEE), and other extracardiac factors like obesity and renal insufficiency (KI) to exercise capacity (ExC) evaluated by cardiopulmonary exercise testing (CPX) in patients with dilated cardiomyopathy (DCM). During the CPX test, 119 patients (pts) with DCM underwent both peak VO 2 consumption and then TEE with color-guided pulsed-wave Doppler recording of PVF and transmitral flow. In 78 patients (65%), peak VO 2 was normal or mildly reduced (>14 mL/kg/min) (group 1) while it was markedly reduced (≤14 mL/kg/min) in 41 (group 2). In univariate analysis, systolic fraction (S Fract), a predictor of elevated pre-a LV diastolic FP, appeared to be the best diastolic parameter predicting a significantly reduced peak VO 2 . Logistic regression analysis identified five parameters yielding a unique, statistically significant contribution in predicting reduced ExC: creatinine clearance < 52 mL/min (odds ratio (OR) = 7.4, p = 0.007); female gender (OR = 7.1, p = 0.004); BMI > 28 (OR = 5.8, p = 0.029), age > 62 years (OR = 5.5, p = 0.03), S Fract < 59% (OR = 4.9, p = 0.02). Conclusion: KI was the strongest predictor of reduced ExC. The other modifiable factors were obesity and severe LV diastolic dysfunction expressed by blunted systolic venous flow. Contrarily, LV ejection fraction was not predictive, confirming other previous studies. This has important clinical implications.
Published: 2021
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