Browsing by Author "Russo, Vincenzo (55534141202)"

The aim of this European Heart Rhythm Association (EHRA) prospective snapshot survey is to assess procedural settings, safety measures, and short-term outcomes associated with implantation of leadless pacemakers (LLPM), across a broad range of tertiary European electrophysiology centres. An internet-based electronic questionnaire (30 questions) concerning implantation settings, peri-procedural routines, complications, and in-hospital patient outcomes was circulated to centres routinely implanting both LLPMs and transvenous pacemakers (TV-PM). The centres were requested to prospectively include consecutive patients implanted with either LLPMs or TV-PMs during the 10-week enrolment period. Overall, 21 centres from four countries enrolled 825 consecutive patients between November 2018 and January 2019, including 69 (9%) implanted with LLPMs. Leadless pacemakers were implanted mainly under local anaesthesia (69%), by an electrophysiologist (60%), in the electrophysiology laboratory (71%); 95% of patients received prophylactic antibiotics prior to implantation. Most patients on chronic oral anticoagulation were operated on-drug (35%), or during short-term (to 48 h) drug withdrawal (54%). Implantation was successful in 98% of patients and the only in-hospital procedure-related complication was groyne haematoma in one patient. This EHRA snapshot survey provides important insights into LLPM implantation routines and patient outcomes. These findings suggest that despite the unfavourable clinical profile of pacemaker recipients, LLPM implantation is associated with relatively low risk of complications and good short-term outcomes. © The Author(s) 2020.

Introduction: The aim of the present study was to evaluate the role of high-sensitivity cardiac troponin I, N terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase-MB mass concentration (CK-MB mass) and copeptin (CP) in predicting incident atrial fibrillation (AF) in myotonic dystrophy type 1 (DM1) patients. Materials and methods: The study enrolled 60 consecutive DM1 patients (age 50.3 ± 7.3 years, 34 male) who underwent pacemaker (PM) implantation for cardiac rhythm abnormalities and 60 PM recipients whose age and sex matched served as control group. All DM1 patients underwent a 12-lead electrocardiogram, 2D color Doppler echocardiogram, biomarkers measurements and device interrogation at implantation, 1 month after and every 6 months thereafter for a minimum of 2-year follow-up. Results: The study population was divided into two groups according to the presence of AF (AF group vs non-AF group). The AF group was older (47.3 ± 8 vs 38.6 ± 7 years, P =.03) and showed higher serum levels of NT-proBNP (151 ± 38.4 vs 107.3 ± 24.2 pg/mL, P <.001) and CP (18.9 ± 4.5 vs 7 ± 2.3 P <.001) than non-AF Group. NT-proBNP (P <.001) and CP (P <.001) were found to be an independent predictor of AF. Based on the receiver-operating characteristics curve analysis, the cut-off value for NT-proBNP that best predicted AF event in DM1 patients was 123 pg/ml (sensitivity of 83.3% and specificity of 86.5%); the cut-off value for CP that best predicted AF event in DM1 patients was 9 pmol/L (sensitivity of 89% and specificity of 87%). Conclusion: NT-proBNP and CP represent two independent predictors of AF onset in DM1 population with conduction disturbances underwent PM implantation. © 2019 Wiley Periodicals, Inc.

BackgroundThe association between atrial fibrillation and dementia has been described. Whether a specific association exists between atrial fibrillation and Alzheimer's disease remains uncertain. This study aims to assess the association between atrial fibrillation and Alzheimer's disease through a systematic review and meta-analysis of the literature.MethodsAn exhaustive search of electronic databases up to October 2018 was conducted. Studies that identified patients with and without atrial fibrillation as well as patients with and without Alzheimer's disease and reported results of at least one relevant outcome, including hazard ratio of the association between atrial fibrillation and Alzheimer's disease were included in this analysis. The hazard ratios and their confidence interval were then pooled using a DerSimonian and Laird random effects model.ResultsSix studies enrolling a total of 56 370 patients were included. At baseline, the mean or median ages ranged from 50 to 78 years with a subsequent follow-up of 3 to 25 years. The random-effect pooled analysis showed a hazard ratio of 1.30 (95% confidence interval 1.01-1.59) and the heterogeneity was not significant, I2 48.1%. All of the included studies were rated as good quality.ConclusionPooled analysis suggest that patients with atrial fibrillation may be exposed to an increased risk of developing new onset of Alzheimer's disease. Given the relevant clinical implications, further studies are required to corroborate these findings. © 2019 Italian Federation of Cardiology-I.F.C. All rights reserved.