78 research outputs found
A new leadless pacemaker with atrioventricular synchronous pacing replacing a still working VVI leadless pacemaker : a case report
No full textBackground A new intracardiac leadless pacemaker (ILP) has been developed to ensure atrioventricular (AV) synchrony (AVS) during ventricular pacing (VP). Recent studies have shown the feasibility and safety of accelerometer-based atrial sensing and an improvement in AVS among patients with atrioventricular block implanted with the Micra AV ILP (Medtronic Inc., Minneapolis, MN, USA). However, no data exists about the benefits of a VDD ILP in patients wearing a still working VVI Nanostim ILP (St Jude Medical, St Paul, MN, USA). We describe the feasibility of the procedure and the absence of device-related adverse events in the short-term follow-up.
Case summary We present the case of a 72-year-old man implanted with a VVI ILP (Nanostim, St Jude Medical, St Paul, MN, USA) on May 2014, who has developed symptomatic high percentage of VVI asynchronous pacing and was treated with an upgrade to synchronous AV pacemaker (PM) ILP-Micra AV (Medtronic Inc., Minneapolis, MN, USA), which has improved symptoms and functional class.
Discussion Intracardiac leadless pacemakers represent the best current option for patients requiring PM implantation who are at high risk of infection and bleeding. Our case shows that the new AVS ILP is a good alternative to VVI ILP in patients with sinus rhythm and a strong need for VP
A Left Atrial Appendage Closure Combined Procedure Review: past, present and future perspectives
No full textAtrial fibrillation (AF) represents the most common cardiac arrhythmia worldwide; it poses a great burden in terms of quality of life reduction and yearly stroke risk. Left atrial appendage closure (LAAC) is a stroke prevention strategy that has been proven a viable alternative to anti-thrombotic regimens in non-valvular AF patients. LAAC can be performed as a stand-alone procedure or alongside a concomitant AF trans catheter ablation, in a procedure known as "Combined Procedure". Aim of this study is to summarize the scientific evidence backing this combined strategy
Early Clinical Outcomes and Advantages of a Novel-Size Adjustable Second-Generation Cryoballoon: A Proof-of-Concept Study
No full text(1) Background/Objective Balloon-guided catheter ablation (CA) has emerged as an alternative option for atrial fibrillation (AF) management. The recent introduction of a novel-size adjustable second-generation cryoballoon (CB) system offers innovations, but clinical outcomes remain unexplored. This study aims to assess the acute performance of the POLARx FIT (TM) CB system in AFCA. (2) Methods: Consecutive patients undergoing AF ablation with the POLARx FIT (TM) CB system in our center were included. The primary outcome was the rate of 31 mm balloon-size utilization, with secondary outcomes including acute pulmonary vein isolation (PVI) rate, periprocedural complications, and in-hospital AF recurrences. (3) Results: Twenty-four patients with a mean age of 59.5 years, predominantly male (87.5%), and exhibiting paroxysmal AF (91.7%) were enrolled. Procedural characteristics demonstrated a high acute success rate (100% PV isolation) with a favorable safety profile. Notably, the 31 mm CB configuration was utilized in 51% of applications, showcasing its adaptability in challenging anatomies. No major complications occurred, with two patients experiencing in-hospital self-limiting AF recurrences. (4) Conclusions: This study represents the first comprehensive assessment of the POLARx FIT (TM) CB system in AF ablation. While acknowledging the study's limitations, this novel CB emerges as a promising tool, warranting further exploration in larger studies with extended follow-up periods
Culture Takeaway
No full textThis keynote is mainly based on Wallace's research for Volume X of La Cultura Italiana published by UTET in 2010. The volume is in Italian and, by translating it, it can now be shared with colleagues, students and friends. The relationship that each citizen has with his/her own country and culture is mediated by personal experiences and matured during a lifetime. It is a delicate task to identify what motivates the consciousness of “insiders” of a culture whilst, at the same time, stimulating the interest of outsiders. To be able to observe the prodigious artistic production of one’s own country from the point of view of another culture and another genetic material offers fresh cues. Curiosity, prodded by geographical and physical distance, helps to identify in a schematic way those characteristics that define a country’s visual culture in a decisively distinctive way
Combined LASER and femoral approach to remove a previous failure of Riata lead extraction
No full textTransvenous extraction of Riata lead could be a challenging procedure due to insulation failure and conductor cables' externalization through the eroded outer insulation. In this case, a complete lead extraction was achieved through a combined LASER and femoral approach because of the massive conductors' externalization
Rescue leadless pacemaker implantation in a pacemaker-dependent patient with congenital heart disease and no alternative routes for pacing
No full textCongenital heart disease patients are considered a unique group of patients regarding their high risk of conduction abnormalities, whether de novo or surgically induced, and the challenges in both implantation and management of device related complications. We present a case of a pacemaker-dependent patient with congenital heart disease who experienced complications of both previous epicardial and transvenous pacing which rendered her a non-suitable candidate of both routes
New Imaging Technologies To Characterize Arrhythmic Substrate
No full textThe cornerstone of the new imaging technologies to treat complex arrhythmias is the electroanatomic (EAM) mapping. It is based on tissue characterization and in particular on determination of low potential region and dense scar definition. Recently, the identification of fractionated isolated late potentials increased the specificity of the information derived from EAM. In addition, non-invasive tools and their integration with EAM, such as cardiac magnetic resonance imaging and computed tomography scanning, have been shown to be helpful to characterize the arrhythmic substrate and to guide the mapping and the ablation. Finally, intracardiac echocardiography, known to be useful for several practical uses in the setting of electrophysiological procedures, it has been also demonstrated to provide important informations about the anatomical substrate and may have potential to identify areas of scarred myocardium
The role of tax assessment in the fight against criminal phenomena
No full textLo scritto si occupa del possibile ruolo che l’attività di accertamento effettuata dall’Amministrazione finanziaria può assumere nella lotta ai fenomeni criminali. Ricostruendo i principali strumenti di accertamento sia in ambito nazionale che internazionale, l’Autore si interroga sui possibili punti di contatto e sulle sinergie interistituzionali che possono instaurarsi fra l’Amministrazione finanziaria e l’Autorità penale.The paper addresses the potential role that the assessment activity carried out by the Tax Administration can play in the fight against criminal phenomena. By reconstructing the main assessment tools at both national and international levels, the Author examines the possible contacts and the inter-institutional synergies that may be established between the Tax Administration and the Criminal Justice Authority
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