Grapevine leafroll-associated virus 3.

Grapevine leafroll disease (GLD) is one of the most important grapevine viral diseases affecting grapevines worldwide. The impact on vine health, crop yield, and quality is difficult to assess due to a high number of variables, but significant economic losses are consistently reported over the lifespan of a vineyard if intervention strategies are not implemented. Several viruses from the family Closteroviridae are associated with GLD. However, Grapevine leafroll-associated virus 3 (GLRaV-3), the type species for the genus Ampelovirus, is regarded as the most important causative agent. Here we provide a general overview on various aspects of GLRaV-3, with an emphasis on the latest advances in the characterization of the genome. The full genome of several isolates have recently been sequenced and annotated, revealing the existence of several genetic variants. The classification of these variants, based on their genome sequence, will be discussed and a guideline is presented to facilitate future comparative studies. The characterization of sgRNAs produced during the infection cycle of GLRaV-3 has given some insight into the replication strategy and the putative functionality of the ORFs. The latest nucleotide sequence based molecular diagnostic techniques were shown to be more sensitive than conventional serological assays and although ELISA is not as sensitive it remains valuable for high-throughput screening and complementary to molecular diagnostics. The application of next-generation sequencing is proving to be a valuable tool to study the complexity of viral infection as well as plant pathogen interaction. Next-generation sequencing data can provide information regarding disease complexes, variants of viral species, and abundance of particular viruses. This information can be used to develop more accurate diagnostic assays. Reliable virus screening in support of robust grapevine certification programs remains the cornerstone of GLD management

Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter-defibrillator: A meta-summary of case reports

Background Air entrapment has been recently described as a cause of inappropriate shock (IAS) among patients who underwent subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation. Data about this complication are lacking in the literature. Methods In this meta-summary 14 case reports describing IAS due to air entrapment were included. Patients' characteristics, S-ICD implant technique and air entrapment properties were collected. Results All patients experienced IAS within 4 days following S-ICD implant. The subcutaneous air was demonstrated by chest x-ray in 11 cases (73.3%). The sensing vector was reprogrammed in 11 cases (73.3%), and ICD was switched off in 2 cases (1.3%). Conclusions IAS due to air entrapment is an early complication of S-ICD implant. No association was observed between the implant technique and air retention. Diagnosis is confirmed by chest x-ray and device interrogation. Management includes switching off the device or, preferably, changing the sensing vector

Direct Oral Anticoagulants in Octogenarians With Atrial Fibrillation: It Is Never Too Late

Atrial fibrillation is the most common arrhythmia in clinical practice, and age is one of the strongest predictors/risk factors for ischemic stroke in patients with atrial fibrillation. Elderly patients, in particular patients aged 80 years and older, are at higher risk of both ischemic and bleeding events compared with younger patients. Vitamin K antagonists (VKAs) reduce the risk of ischemic stroke, especially in the elderly, but increase the bleeding risk. In addition, frequent international normalized ratio monitoring is needed to ensure the optimal level of anticoagulation. Furthermore, VKAs have multiple drug and food interactions. Direct oral anticoagulants (DOACs) have recently emerged as alternatives to VKAs and are gradually increasing their popularity mainly because of their fewer drug and food interactions and ease of use. Their effectiveness and safety have been well-established in the general population, but the benefit in the very elderly (≥80 years old) is still unclear. Data about the safety and the effectiveness of DOACs in patients older than 75 years are available in literature, but the evidences of the use of DOACs in patients aged 80 years and older are lacking. This review aims to give light to the differences, in terms of benefits and safety, of the DOACs in this subset of patients

COVID-19 and Heart: From Clinical Features to Pharmacological Implications

A highly pathogenic human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been recently recognized in Wuhan, China, as the cause of the coronavirus disease 2019 (COVID-19) outbreak which has spread rapidly from China to other countries in the world, causing a pandemic with alarming morbidity and mortality. The emerging epidemiological data about COVID-19 patients suggest an association between cardiovascular diseases (CVD) and SARS-CoV-2 infection, in term of clinical features at hospital admission and prognosis for disease severity. The aim of our review is to describe the cardiological features of COVID-19 patients at admission, the acute cardiac presentation, the clinical outcome for patients with underlying CVD and the pharmacological implications for disease management

Arrhythmic CArdiac DEath in MYotonic dystrophy type 1 patients (ACADEMY 1) study: the predictive role of programmed ventricular stimulation

Aims Myotonic dystrophy type 1 (DM1) predisposes to the development of life-threatening arrhythmias and sudden cardiac death. Our study aimed to evaluate the prognostic value of programmed ventricular stimulation (PVS) in DM1 patients with conduction system disease. Methods and results Arrhythmic CArdiac DEath in MYotonic dystrophy type 1 patients (ACADEMY 1) is a double-arm non-randomized interventional prospective study. Myotonic dystrophy type 1 patients with permanent cardiac pacing indication were eligible for the inclusion. The study population underwent to pacemaker (PM) or implantable cardioverter-defibrillator (ICD) implantation according to the inducibility of ventricular tachyarrhythmias at PVS. Primary endpoint of the study was a composite of appropriate ICD therapy and cardiac arrhythmic death. The secondary study endpoint was all-cause mortality. Seventy-two adult-onset DM1 patients (51 +/- 12 years; 39 male) were enrolled in the study. A ventricular tachyarrhythmia was induced in 25 patients (34.7%) at PVS (PVS+) who underwent dual chambers ICD implantation. The remaining 47 patients (65.3%) without inducible ventricular tachyarrhythmia (PVS-) were treated with dual-chamber PM. During an average observation period of 44.7 +/- 10.2 months, nine patients (12.5%) met the primary endpoint, four in the ICD group (16%) and five (10.6%) in the PM group. Thirteen patients died (18.5%), 2 in the ICD group (8%) and 11 in PM group (23.4%). The Kaplan-Meier analysis did not show a significantly different risk of both primary and secondary endpoint event rates between the two groups. Conclusions The inducibility of ventricular tachyarrhythmias has shown a limited value in the arrhythmic risk stratification among DM1 patients

Retrieval of a leadless transcatheter pacemaker from the right pulmonary artery: A case report

This case report describes a procedure of retrieval of a leadless transcatheter pacemaker from the right pulmonary artery 3 days after device implantation. An 80-year-old man affected by ischemic cardiomyopathy and sinus node dysfunction was implanted with a leadless transcatheter pacemaker in the low septum of the right ventricle. Three days after the procedure, the leadless pacemaker migrated into a side branch of the right pulmonary artery. The device was successfully removed using two snares hooked to a tine via the proximal retrieval feature. This article is protected by copyright. All rights reserved

Retrieval of a leadless transcatheter pacemaker from the right pulmonary artery: A case report

This case report describes a procedure of retrieval of a leadless transcatheter pacemaker from the right pulmonary artery 3 days after device implantation. An 80-year-old man affected by ischemic cardiomyopathy and sinus node dysfunction was implanted with a leadless transcatheter pacemaker in the low septum of the right ventricle. Three days after the procedure, the leadless pacemaker migrated into a side branch of the right pulmonary artery. The device was successfully removed using two snares hooked to a tine via the proximal retrieval feature. This article is protected by copyright. All rights reserved

Czy większy odsetek stymulacji prawej komory wpływa na częstość występowania epizodów migotania przedsionków u chorych z dystrofią miotoniczną typu 1?

Background: Paroxysmal atrial tachyarrhythmias occur frequently in myotonic dystrophy type 1 (MD1) patients. Pacemakers, implanted for the treatment of bradyarrhythmias and including detailed diagnostic functions, may facilitate the diagnosis and management of frequent paroxysmal atrial fibrillation (AF) that may remain undetected during a conventional clinical follow-up. The effect of right ventricular pacing on AF incidence is still controversial.Aim: To evaluate the influence of a high percentage of right ventricular pacing on AF in MD1 patients during a 12-month follow-up period.Methods: We enrolled in the present study 70 MD1 patients (age 51.3 ± 5 years; 32 females) who underwent dual chamber pacemaker implantation. At 12 months of follow-up, the study population was divided into three groups according to the percentage of atrial and ventricular stimulation: Group 1, the atrial sensing ventricular sensing group (ASVS; n = 22; age 52 ± 7.7; eight female) with a percentage of atrial and ventricular stimulation lower than 50%; Group 2, the atrial sensingventricular pacing group (ASVP; n = 24; age 50.5 ± 7.6; 13 female) with a percentage of atrial stimulation lower than 50% and percentage of ventricular stimulation higher than 80%; and Group 3, the atrial pacing ventricular pacing group (APVP; n = 24; age 56 ± 4.3; 11 female) with a percentage of atrial and ventricular stimulation higher than 80%. We counted the number of episodes of atrial arrhythmia that occurred during the observation period and the duration of each episode.Results: We found a statistically significant difference in the number and duration of AF episodes between the three groups at the 12-month follow-up. In particular, there were more episodes (253 ± 30 vs. 80 ± 27 vs. 53 ± 32; p < 0.03) and longer durations of AF (8,700 ± 630 vs. 4,480 ± 975 vs. 3,853 ± 870 min; p < 0.03) in the ASVP group than in the ASVS group and the APVP group. Lead parameters remained stable over time and there were no displacements of the electrodes after implantation.Conclusions: In a 12-month follow-up comparison, we showed a statistically significant increase in paroxysmal AF episodesin MD1 patients with a high percentage of right ventricular pacing and a lower percentage of atrial stimulation.Wstęp: Napadowe tachyarytmie przedsionkowe występują często u chorych na dystrofię miotoniczną typu 1 (MD1). Stymulatory serca, wszczepiane w celu leczenia bradyarytmii, są wyposażone w funkcje umożliwiające szczegółową diagnostykę i mogą ułatwić rozpoznawanie i leczenie przypadków częstego napadowego migotania przedsionków (AF), które mogłyz ostać niewykryte w czasie rutynowej oceny klinicznej. Wpływ stymulacji prawej komory na występowanie AF nadal jest przedmiotem dyskusji.Cel: Celem badania była ocena wpływu wysokiego odsetka stymulacji prawej komory na AF u chorych z MD1 w okresierocznej obserwacji.Metody: Do badania włączono 70 chorych z MD1 (wiek 51,3 ± 5; 32 kobiety), którym wszczepiono dwujamowy stymulatorserca. Po 12 miesiącach obserwacji badaną populację podzielono na 3 grupy w zależności od odsetka stymulacji przedsionkówi komór: grupa ASVS (atrial sensing ventricular sensing, wyczuwanie przedsionkowe, wyczuwanie komorowe; n = 22; wiek 52 ± 7,7; 8 kobiet), w której odsetek stymulacji przedsionków i komór był mniejszy niż 50%; grupa ASVP (atrial sensing ventricular pacing, wyczuwanie przedsionkowe, stymulacja komór; n = 24; wiek 50,5 ± 7,6; 13 kobiet), w której odsetek stymulacji przedsionków był mniejszy niż 50%, a odsetek stymulacji komór większy niż 80%; grupa APVP (atrial pacing ventricul arpacing, stymulacja przedsionków, stymulacja komór; n = 24; wiek 56 ± 4,3; 11 kobiet), w której odsetek stymulacji przedsionków i komór był większy niż 80%. Określono liczbę epizodów arytmii przedsionkowej, które wystąpiły w okresie obserwacji i czas trwania każdego epizodu.Wyniki: Wykazano statystycznie istotną różnicę w liczbie i czasie trwania epizodów AF między trzema grupami w okresie 12-miesięcznej obserwacji. W grupie ASVP stwierdzono większą liczbę (253 ± 30 vs. 80 ± 27 vs. 53 ± 32; p < 0,03) i dłuższy czas trwania epizodów AF (8700 ± 630 vs. 4480 ± 975 vs. 3853 ± 870 min; p < 0,03) niż w grupach ASVS i APVP. Parametry odprowadzeń nie zmieniły się z upływem czasu; nie stwierdzono również przemieszczenia się elektrod po implantacji.Wnioski: Na podstawie porównania danych z rocznej obserwacji wykazano statystycznie istotne zwiększenie częstości epizodów napadowego AF u chorych z MD1, u których występował duży odsetek stymulacji prawej komory i mniejszy odsetek stymulacji przedsionków