Quantification de la cicatrice d'infarctus du myocarde par l'IRM avec rehaussement tardif (implications dans la prédiction de la survenue des troubles du rythme ventriculaires)

CAEN-BU Médecine pharmacie (141182102) / SudocSudocFranceF

APPORT DE L'ANALYSE DYNAMIQUE DE LA REPOLARISATION VENTRICULAIRE DANS L'IDENTIFICATION DU RISQUE RYTHMIQUE APRES UN INFARCTUS DU MYOCARDE (DES PATHOLOGIE CARDIOVASCULAIRE)

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Suivi des patients implantés par un défibrillateur automatique implantable sans fonction de resynchronisation en prévention primaire de cardiomyopathies ischémiques et dilatées non ischémiques de 2005 à 2007 au CHU de Caen

CAEN-BU Médecine pharmacie (141182102) / SudocSudocFranceF

Insuffisance cardiaque, aldostérone et troubles du rythme (effets protecteurs du blocage de l'aldostérone sur les arythmies auriculaires et ventriculaires)

PARIS7-Bibliothèque centrale (751132105) / SudocSudocFranceF

Influence du retard électrique gauche endocavitaire sur la prédiction de la réponse à la resynchronisation cardiaque

CAEN-BU Médecine pharmacie (141182102) / SudocSudocFranceF

Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease

International audienc

Prognostic value of ventricular arrhythmia in early post-infarction left ventricular dysfunction: the French nationwide WICD-MI study

International audienceBackground and Aims Prophylactic implantable cardioverter–defibrillators (ICDs) are not recommended until left ventricular ejection fraction (LVEF) has been reassessed 40 to 90 days after an acute myocardial infarction. In the current therapeutic era, the prognosis of sustained ventricular arrhythmias (VAs) occurring during this early post-infarction phase (i.e. within 3 months of hospital discharge) has not yet been specifically evaluated in post-myocardial infarction patients with impaired LVEF. Such was the aim of this retrospective study. Methods Data analysis was based on a nationwide registry of 1032 consecutive patients with LVEF ≤ 35% after acute myocardial infarction who were implanted with an ICD after being prescribed a wearable cardioverter–defibrillator (WCD) for a period of 3 months upon discharge from hospital after the index infarction. Results ICDs were implanted either because a sustained VA occurred while on WCD (VA+/WCD, n = 72) or because LVEF remained ≤35% at the end of the early post-infarction phase (VA−/WCD, n = 960). The median follow-up was 30.9 months. Sustained VAs occurred within 1 year after ICD implantation in 22.2% and 3.5% of VA+/WCD and VA−/WCD patients, respectively (P < .0001). The adjusted multivariable analysis showed that sustained VAs while on WCD independently predicted recurrence of sustained VAs at 1 year (adjusted hazard ratio [HR] 6.91; 95% confidence interval [CI] 3.73–12.81; P < .0001) and at the end of follow-up (adjusted HR 3.86; 95% CI 2.37–6.30; P < .0001) as well as 1-year mortality (adjusted HR 2.86; 95% CI 1.28–6.39; P = .012). Conclusions In patients with LVEF ≤ 35%, sustained VA during the early post-infarction phase is predictive of recurrent sustained VAs and 1-year mortality

Distinct Substrates of Idiopathic Ventricular Fibrillation Revealed by Arrhythmia Characteristics on Implantable Cardioverter-Defibrillator.

BACKGROUND Idiopathic ventricular fibrillation (IVF) can be associated with undetected distinct conditions such as microstructural cardiomyopathic alterations (MiCM) or Purkinje (Purk) activities with structurally normal hearts. OBJECTIVE This study sought to evaluate the characteristics of recurrent VF recorded on implantable defibrillator electrograms, associated with these substrates. METHODS This was a multicenter collaboration study. At 32 centers, we selected patients with an initial diagnosis of IVF and recurrent arrhythmia at follow-up without antiarrhythmic drugs, in whom mapping demonstrated Purk or MiCM substrate. We analyzed variables related to previous ectopy, sinus rate preceding VF, trigger, and initial VF cycle lengths. Logistic regression with cross validation was used to evaluate the performance of criteria to discriminate Purk or MiCM substrates. RESULTS Among 95 patients (35 women, age 35 ± 11 years) meeting the inclusion criteria, IVF was associated with MiCM in 41 and Purk in 54 patients. A total of 117 arrhythmia recurrences including 91% VF were recorded on defibrillator. Three variables were mostly discriminant. Sinus tachycardia (≤570 ms) was more frequent in MiCM (35.9% vs 13.4%, P = 0.014) whereas short-coupled (80%). Ectopy were inconsistently present before VF. CONCLUSIONS Characteristics of arrhythmia recurrences on implantable cardioverter- defibrillator provide phenotypic markers of the distinct and hidden substrates underlying IVF. These findings have significant clinical and genetic implications