Federico Turreni
University of Florence
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Pacing and Clinical Electrophysiology | 2007
Alessio Lilli; Giuseppe Ricciardi; Maria Cristina Porciani; Alessandro Paoletti Perini; Paolo Pieragnoli; Nicola Musilli; Andrea Colella; Stefano Del Pace; Antonio Michelucci; Federico Turreni; Massimo Sassara; Augusto Achilli; S. Serge Barold; Luigi Padeletti
Cardiac resynchronization refers to pacing techniques that change the degree of atrial and ventricular electromechanical asynchrony in patients with major atrial and ventricular conduction disorders. Atrial and ventricular resynchronization is usually accomplished by pacing from more than one site in an electrical chamber--atrium or ventricle--and occasionally by stimulation at a single unconventional site. Resynchronization produces beneficial hemodynamic and antiarrhythmic effects by providing a more physiologic pattern of depolarization. Atrial resynchronization may prevent atrial fibrillation in selected patients with underlying bradycardia or interatrial block. Its antiarrhythmic effect in the absence of bradycardia is unclear. Ventricular resynchronization is of far greater clinical value than atrial resynchronization. Biventricular (or single-chamber left ventricular) pacing is beneficial for patients with congestive heart failure, severe left ventricular systolic dysfunction, dilated cardiomyopathy (either ischemic or idiopathic), and a major left-sided intraventricular conduction disorder, such as left bundle branch block. The change in electrical activation from resynchronization, which has no positive inotropic effect as such, is translated into mechanical improvement with a more coordinated left ventricular contraction. Several recent randomized trials and a number of observational studies have demonstrated the long-term effectiveness of ventricular resynchronization in the above group of patients. The high incidence of sudden death among these patients has encouraged ongoing clinical trials to evaluate the benefit of a system that combines biventricular pacing and cardioversion-defibrillation into a single implantable device.Aim: Gender related differences in epidemiology, treatment, and prognosis of heart failure (HF) have been reported. We examined the sex influence in patients treated with cardiac resynchronization therapy (CRT).
Circulation-arrhythmia and Electrophysiology | 2013
Massimo Santini; Antonio Castro; Franco Giada; Renato Ricci; Giuseppe Inama; Germano Gaggioli; Leonardo Calò; Serafino Orazi; Miguel Viscusi; Leandro Chiodi; Angelo Bartoletti; Giovanni Foglia-Manzillo; Fabrizio Ammirati; Maria Luisa Loricchio; Claudio Pedrinazzi; Federico Turreni; Gianni Gasparini; Francesco Accardi; Giovanni Raciti; Antonio Raviele
Background—Syncope in patients with bifascicular block (BFB) is a common event whose causes might be difficult to assess. Methods and Results—Prevention of syncope through permanent cardiac pacing in patients with bifascicular block (PRESS) is a multicenter, prospective, randomized, single-blinded study designed to demonstrate a reduction in symptomatic events in patients with bifascicular block and syncope of undetermined origin implanted with permanent pacemaker. Device programming mode (NASPE/BPEG code) at DDD with a lower rate of 60 ppm is compared with backup pacing at DDI with a lower rate of 30 ppm. The end point consisted of (1) syncope, (2) symptomatic presyncopal episodes associated with a device intervention (ventricular pacing), and (3) symptomatic episodes associated with intermittent or permanent atrioventricular block (any degree). One hundred one patients were enrolled and randomized. Primary end point events at 2 years were observed in 23 patients, with a significant lower incidence in the study group (hazard ratio, 0.32; 95% confidence interval [CI], 0.10–0.96; P=0.042). Reduction of any symptoms, associated or not with device intervention, was superior in DDD60 compared with DDI30 (hazard ratio, 0.4; 95% confidence interval, 0.25–0.78; P=0.0053). Fourteen patients developed other rhythm diseases and met class I indication for pacing. The annual incidence of rhythm disease development was 7.4%. Conclusions—In patients with bifascicular block and syncope of undetermined origin, the use of a dual chamber pacemaker programmed to DDD60 led to a significant reduction of syncope or symptomatic events associated with a cardioinhibitory origin, compared with DDI30 programming. Symptoms associated with a new onset of rhythm disease were found in 15% of the population at 2 years.
Journal of Cardiovascular Medicine | 2009
Antonio Castro; Maria Luisa Loricchio; Federico Turreni; Silvia Perna; Giuliano Altamura
Atrial standstill is characterized by failure of atrial excitation, either spontaneous or induced by atrial electric stimulation. We report the case of a 38-year-old man with severe bradycardia and junctional escape rhythm associated with dilative cardiomyopathy. Electroanatomic mapping showed the absence of atrial viability in almost the entire right atrial endocardial surface and excluded the feasibility of atrial pacing.
Journal of Cardiovascular Medicine | 2008
Augusto Achilli; Massimo Sassara; Daniele Pontillo; Federico Turreni; Pietro Rossi; Rosanna De Luca; Catherine Klersy; Nicolino Patruno; Paola Achilli; Luciano Sallusti; Paolo Spadaccia; Luigi Cricco; Francesco Serra
Objective Cardiac resynchronisation therapy has proven to be effective in refractory heart failure (HF) patients with QRS >120–130 ms. Therefore, the aim of our study was to verify the long-term effectiveness of cardiac resynchronisation therapy in HF patients with echocardiographic evidence of mechanical asynchrony regardless of QRS duration. Methods One hundred and six patients with New York Heart Association class II–IV HF and echocardiographic documentation of interventricular and intraventricular asynchrony underwent biventricular stimulation. A clinical and functional evaluation was performed at baseline, 1, 3, 6 months, and every 6 months thereafter. Results After a median follow-up of 16 months, a significant improvement was noted in ejection fraction, left ventricular diameters, mitral regurgitation jet area, interventricular and intraventricular echocardiographic indexes of asynchrony, and the 6-min walking distance (P < 0.001 for all). Death rates for all causes and for cardiac causes were 18.2 (95% confidence interval 12.8–25.9) and 13.5 (95% confidence interval 9.0–20.3) per 100 person-years, respectively. Patients in New York Heart Association class IV had an almost three-fold increase in risk of dying as compared to class II–III (hazard ratio 2.97, 95% confidence interval 1.30–6.79). Conclusions Interventricular and intraventricular asynchrony at echocardiography may be useful in identifying HF patients suitable for cardiac resynchronisation therapy, with results comparable to those obtained with QRS duration selection criteria.
Europace | 2007
Augusto Achilli; Federico Turreni; Maurizio Gasparini; Maurizio Lunati; Massimo Sassara; Massimo Santini; Maurizio Landolina; Luigi Padeletti; Andrea Puglisi; Mario Bocchiardo; Serafino Orazi; Giovanni B. Perego; Sergio Valsecchi; Alessandra Denaro
European Heart Journal Supplements | 2004
Luigi Padeletti; Marzia Giaccardi; Federico Turreni; Nicola Musilli; Andrea Colella; Paolo Pieragnoli; Antonio Michelucci; Giuseppe Ricciardi; Maria Cristina Porciani
Circulation-arrhythmia and Electrophysiology | 2013
Massimo Santini; Antonio Castro; Franco Giada; Renato Ricci; Giuseppe Inama; Germano Gaggioli; Leonardo Calò; Serafino Orazi; Miguel Viscusi; Leandro Chiodi; Angelo Bartoletti; Giovanni Foglia-Manzillo; Fabrizio Ammirati; Maria Luisa Loricchio; Claudio Pedrinazzi; Federico Turreni; Gianni Gasparini; Francesco Accardi; Giovanni Raciti; Antonio Raviele
Heart Rhythm | 2005
Giuseppe Ricciardi; Rita Nistri; Marzia Giaccardi; Alessia Pappone; Massimo Sassara; Federico Turreni; Augusto Achilli; Luigi Padeletti
Heart Rhythm | 2006
Giuseppe Ricciardi; Alessio Lilli; Andrea Colella; Alessia Pappone; Paolo Pieragnoli; Antonio Michelucci; Maria Cristina Porciani; Massimo Sassara; Federico Turreni; Augusto Achilli; Luigi Padeletti
Heart Rhythm | 2005
Luigi Padeletti; Rita Nistri; Giuseppe Ricciardi; Marzia Giaccardi; Alessia Pappone; Massimo Sassara; Federico Turreni; Augusto Achilli