Sonia Ferretto

Pacemaker Remote Monitoring in the Pediatric Population: Is It A Real Solution?

Clinical utility of remote monitoring of implantable cardiac devices has been previously demonstrated in several trials in the adult population. The aim of this study was to assess the clinical utility of remote monitoring in a pediatric population undergoing pacemakers implantation.

Twelve-year follow-up of catheter ablation for atrial fibrillation: A prospective, multicenter, randomized study

BACKGROUND Randomized and controlled studies have reported the effect of catheter ablation (CA) for atrial fibrillation (AF) over a follow-up of 12-24 months. OBJECTIVE We report on the effect of CA plus antiarrhythmic drugs in comparison with antiarrhythmic drugs alone on the maintenance of sinus rhythm over 12-year follow-up. METHODS We extended the follow-up duration of the 137 patients who were enrolled in the Catheter Ablation for the Cure of Atrial Fibrillation Study between February 1, 2002, and June 30, 2003, and randomized to antiarrhythmic drugs (control group) or antiarrhythmic drugs plus CA (ablation group). The primary end point was time to first symptomatic or asymptomatic recurrence of atrial arrhythmia lasting >30 seconds during follow-up. RESULTS During follow-up, 19 of 68 (27.9%; 95% confidence interval [CI] 18.7%-39.6%) ablation group patients and 3 of 69 (4.3%; 95% CI 1.49%-12.0%) control group patients did not experience any relapse of atrial tachyarrhythmia (P < .001). The Kaplan-Meier analysis performed to determine the probability of survival free from atrial arrhythmias showed a statistical difference in favor of the ablation group (log-rank, P < .001). The effect of CA was consistent in both patients with paroxysmal AF and those with persistent AF. In the multivariate Cox regression analysis, belonging to the control group (hazard ratio 2.95; 95% CI 1.896-4.726; P < .001) and longer time since first AF episode (hazard ratio 1.004; 95% CI 1.002-1.084; P = .041) were predictors of atrial tachyarrhythmia recurrence. CONCLUSION In patients with paroxysmal and persistent AF, CA significantly increased time to first recurrence of atrial arrhythmias during 12-year follow-up.

Interventricular conduction disorders after orthotopic heart transplantation: risk factors and clinical relevance.

Causes and significance of interventricular conduction disorders (IVCDs) after orthotopic heart transplantation (OHT) are still unknown.

Subcutaneous Implantable Cardioverter-Defibrillator and Left Ventricular Assist Device: A Safe and Effective Approach for Refractory Heart Failure

A 57-year-old man with dilated cardiomyopathy underwent single-chamber implantable cardioverter-defibrillator (ICD) implantation for primary prevention in March 2008. Because of device infection, mechanical lead extraction was performed without complications in April 2011. Subsequently, we decided

Effective and safe lead extraction using the bidirectional rotational Evolution® sheath in a child with congenital heart disease

We reported a challenging transvenous lead extraction procedure for lead failure in a child with congenital heart disease. Our report demonstrates that the new hand‐powered bidirectional rotational Evolution RL (Cook Medical, USA) mechanical extraction sheath is an effective and safe tool for the extraction of chronically implanted leads in children.

Implantable cardioverter-defibrillator in the elderly: Predictors of appropriate interventions and mortality at 12-month follow-up

The effectiveness of implantable cardioverter‐defibrillator (ICD) in the elderly is uncertain, given their competing risk of nonarrhythmic death. Guidelines state that an ICD should be implanted if the expectation of survival is at least 1 year. However, survival is not easy to predict in elderly patients with severe cardiac disease.

Successful transvenous mechanical lead extraction and stent implantation in a patient after Mustard palliation for D-transposition of great arteries and superior vena cava syndrome.

: We report a successful combined approach of transvenous mechanical pacing lead extraction and stent angioplasty for superior baffle occlusion in a young woman with D-transposition of great artery after Mustard procedure. After having extracted the pacing leads, the baffle was easily stented, thanks to the channel left by the extracted leads. Eventually, a new pacing lead was implanted into the pulmonic ventricle through the stented baffle. Our report demonstrates the safeness and feasibility of a combined interventional approach in avoiding the need for surgery.

Images in ElectrophysiologySubcutaneous Implantable Cardioverter-Defibrillator and Left Ventricular Assist Device: A Safe and Effective Approach for Refractory Heart Failure

A 57-year-old man with dilated cardiomyopathy underwent single-chamber implantable cardioverter-defibrillator (ICD) implantation for primary prevention in March 2008. Because of device infection, mechanical lead extraction was performed without complications in April 2011. Subsequently, we decided