Molecular-Based Ecosystem to Improve Personalized Medicine in Chronic Myelomonocytic Leukemia
Anno: 2026
Rivista: JOURNAL OF CLINICAL ONCOLOGY
Autori/autrici: Lanino, Luca; Hunter, Anthony M.; Gagelmann, Nico; Robin, Marie; Dall'Olio, Daniele; Flamigni, Alice; Sala, Claudia; Gurnari, Carmelo; Wang, Yu-Hung; Pleyer, Lisa; Xicoy, Blanca; Montalban-Bravo, Guillermo; Shih, Lee-Yung; Alsugair, Ali; Fathima, Saubia; Gregorio, Caterina; Rollo, Cesare; Palomo, Laura; Platzbecker, Anne Sophie; Asti, Gianluca; Itzykson, Raphael; Sallman, David A.; Fariselli, Piero; Kern, Wolfgang; Garcia-Manero, Guillermo; Platzbecker, Uwe; Solé, Francesc; Diez-Campelo, Maria; Maciejewski, Jaroslaw; Bejar, Rafael; Thol, Felicitas; Kroger, Nicolaus; Savona, Michael; Fenaux, Pierre; Sanz, Guillermo; Kordasti, Shahram; Santini, Valeria; Fontenay, Michaela; Zeidan, Amer M.; Komrokji, Rami S.; Haferlach, Torsten; Germing, Ulrich; Castellani, Gastone; D'Amico, Saverio; Patnaik, Mrinal; Ieva, Francesca; Solary, Eric; Tefferi, Ayalew; Padron, Eric; Della Porta, Matteo Giovanni; Icpss, Alliance; Haque, Tamanna; Abdel-Wahab, Omar; Geissler, Klaus; Bataller, Alex; Bazinet, Alexandre; Meggendorfer, Manja; Quintavalla, Mirco; Bruseghini, Alessandro; Sauta, Elisabetta; Carota, Luciana; Sanavia, Tiziana; Dall'Olio, Lorenzo; Travaglino, Erica; Zamora, Lurdes; Quintela, David; Jerez, Andres; Cornejo, Elena; Garcia Martin, Paloma; Diaz-Beya, Marina; Avendano Pita, Alejandro; Roldan, Veronica; Fiallo Suárez, Dolly Viviana; Cerezo Velasco, Estefania; Calabuig, Marisa; Such, Esperanza; Castilla-Llorente, Cristina; Bulabois, Claude E.; Souchet, Laetitia; Awada, Hussein; Bernardi, Massimo; Chiusolo, Patrizia; Curti, Antonio; Giaccone, Luisa; Finelli, Carlo; Casetti, Ilaria; Onida, Francesco; Borin, Lorenza Maria; Yung Follo, Matilde; Consagra, Angela; Passamonti, Francesco; Diral, Elisa; Vucinic, Vladan; Bergonzi, Gregorio M.; Voso, Maria Teresa; Hou, Hsin-An; Chou, Wen-Chien; Yao, Chi-Yuan; Lin, Chien-Chin; Tien, Hwei-Fang; Campagna, Alessia; Ubezio, Marta; Russo, Antonio; Todisco, Gabriele; Maggioni, Giulia; Tentori, Cristina A.; Buizza, Alessandro; Ferrari, Ivan; Di Matteo, Maria; Crespi, Alessandra; Figini, Giulia; Delponte, Camilla; Pesce, Francesco; Zampini, Matteo; Riva, Elena; Delleani, Mattia; Iascone, Eleonora; Crisafulli, Laura; Ficara, Francesca; Ventura, Denise; Pinocchio, Nicole; Brindisi, Matteo; Santoro, Armando; Kiwan, Ahmad; Vanoudenhove, Jennifer; Al Ali, Najla H.; Graubert, Timothy A.; Thota, Swapna; Griffiths, Elizabeth
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/357918
Citazioni:
Molecular-Based Ecosystem to Improve Personalized Medicine in Chronic Myelomonocytic Leukemia / Lanino, L., Hunter, A.M., Gagelmann, N., Robin, M., Dall'Olio, D., Flamigni, A., Sala, C., Gurnari, C., Wang, Y., Pleyer, L., Xicoy, B., Montalban-Bravo, G., Shih, L., Alsugair, A., Fathima, S., Gregorio, C., Rollo, C., Palomo, L., Platzbecker, A.S., Asti, G., et al.. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - 44:17(2026), pp. 1608-1623. [10.1200/jco-25-02116]
Abstract:
Purpose: Chronic myelomonocytic leukemia (CMML) is a rare myeloid neoplasm characterized by clinical heterogeneity and is associated with poor outcomes. To date, limited molecular information has been incorporated into disease classification and risk stratification. We aimed to integrate genomic fea...tures into the clinical decision-making process for CMML. Patients and methods: We analyzed a retrospective cohort of 3013 patients with CMML (training set) and a prospective population of 516 patients (validation set). Using an innovative framework for multimodal data analysis, we developed molecular-based disease taxonomy and prognostication. Results: Unsupervised clustering identified nine entities with distinct genomic features and outcomes (P < .001), including splicing machinery, transcription factors, signal transduction and tyrosine kinase pathways aberrations, and high-risk molecular signatures. Notably, 15% of patients showed molecular/clinical overlap with other myeloid neoplasms. We integrated molecular and clinical information to build the international CMML Prognostic Scoring System (iCPSS), incorporating mutations in nine genes together with hematologic parameters and cytogenetic abnormalities. The iCPSS identified five groups with distinct probability of overall and leukemia-free survival in both training and validation cohorts (P < .001), outperforming existing prognostic models. Importantly, 55% of patients were reassigned to higher or lower risk groups by the iCPSS. Decision analysis demonstrated that iCPSS could refine the optimal timing of allogeneic transplantation at the individual level; compared with conventional prognostic tools, iCPSS-based decision modeling changed transplantation strategy in 31% of cases, resulting in a significant gain-in-life expectancy for eligible patient population (P < .001). A federated learning platform was implemented to enable continuous, privacy-preserving model update across multiple centers. Conclusion: Molecular information improves CMML classification and prognostication, supports more effective clinical decision making, and potentially refines the design of clinical trials.
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Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation
Anno: 2026
Rivista: EUROPEAN JOURNAL OF INTERNAL MEDICINE
Autori/autrici: Liao, Yu; Trivedi, Chintan; Casella, Michela; Mohanty, Sanghamitra; Biase, Luigi Di; Cellucci, Selene; Ibrahim, Momen; Khurana, Tejas S; Su, Wilber; Weiss, J Peter; Zawaneh, Michael; Russo, Antonio Dello; Ma, Changsheng; Tondo, Claudio; Natale, Andrea; Bai, Rong
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/354457
Citazioni:
Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation / Liao, Y.u., Trivedi, C., Casella, M., Mohanty, S., Biase, L.D., Cellucci, S., Ibrahim, M., Khurana, T.S., Su, W., Weiss, J.P., Zawaneh, M., Russo, A.D., Ma, C., Tondo, C., Natale, A., Bai, R.. - In: EUROPEAN JOURNAL OF INTERNAL MEDICINE. - ISSN 1879-0828. - 144:(2026). [10.1016/j.ejim.2025.106558]
Abstract:
Background Being overweight has been associated with arrhythmia recurrence after atrial fibrillation (AF) ablation, but the optimal threshold to identify high risk patients has not been well established. Studies investigating the relationship between underweight and ablation outcome are also limited.... This study aimed to investigate the impact of body mass index (BMI) on the recurrence after AF ablation and to determine the optimal cut-off of BMI to identify patients at risk of recurrence. Methods Paroxysmal AF (PAF) patients undergoing primary ablation with pulmonary vein isolation were enrolled. Patients were grouped based on 3 BMI discretization methods: pre-defined BMI category, BMI quartile and optimal equal hazard cut-off. Atrial tachyarrhythmia recurrence at 12-month after ablation was the study endpoint which was compared between groups by using the Kaplan-Meier method. Results Out of 561 patients (mean BMI 25.5 ± 5.1 kg/m2) enrolled, arrhythmia recurrence at 12-month after ablation was found in 29 (43.9 %) of 66 underweight, 39 (21.7 %) of 180 normal weight, 30 (17.4 %) of 172 overweight, and 50 (35.0 %) of 143 obese patients (Log Rank P < 0.001). BMI presented a “U” shape relationship with arrhythmia-free survival. Hazard-based optimal BMI was 20.00 kg/m2 for left cutoff and 29.14 kg/m2 for right cutoff. In multivariable analysis, BMI ≤ 20.00 kg/m2 (HR=2.258, P < 0.001) or > 29.14 kg/m2 (HR=1.702, P = 0.006) was independently associated with arrhythmia recurrence after adjustment of other confounders. Conclusions The relationship between atrial tachyarrhythmia recurrence after PAF ablation and pre-ablation BMI appeared to be U-shaped. Individuals whose BMI was ≤20.00 kg/m2 or >29.14 kg/m2 were at high risk of arrhythmia recurrence.
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Determinants of Left Atrial Thrombus in Patients Undergoing Catheter Ablation for Atrial Fibrillation and Atrial Flutter
Anno: 2026
Rivista: PACING AND CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Barbarossa, Alessandro; Coraducci, Francesca; Torselletti, Lorenzo; Gatti, Chiara; Gaudenzi, Tommaso; Stronati, Giulia; Siragusa, Nicoletta; Principi, Samuele; Compagnucci, Paolo; Casella, Michela; Russo, Antonio Dello; Guerra, Federico
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/354460
Citazioni:
Determinants of Left Atrial Thrombus in Patients Undergoing Catheter Ablation for Atrial Fibrillation and Atrial Flutter / Barbarossa, A., Coraducci, F., Torselletti, L., Gatti, C., Gaudenzi, T., Stronati, G., Siragusa, N., Principi, S., Compagnucci, P., Casella, M., Russo, A.D., Guerra, F.. - In: PACING AND CLINICAL ELECTROPHYSIOLOGY. - ISSN 0147-8389. - 49:3(2026), pp. 339-346. [10.1111/pace.70117]
Abstract:
Background: Catheter ablation (CA) is a first-line therapy for rhythm control in patients with atrial fibrillation (AF) and atrial flutter (AFL). Left atrial thrombus (LAT) is an absolute contraindication to CA due to the increased risk of periprocedural ischemic complications. A recent consensus st...atement from the European Heart Rhythm Association (EHRA) recommended the exclusion of LAT before CA in patients receiving oral anticoagulant therapy (OAT) for less than three weeks or in patients at high risk, despite the substantial reduction in the rate of periprocedural stroke achieved by anticoagulation in recent years. Consequently, many patients are frequently screened by transesophageal echocardiography (TOE) despite the lack of evidence that such a procedure is actually useful. Methods: All consecutive patients undergoing TOE before AF or AFL CA were enrolled between January 2019 and April 2024. Inclusion criteria were AF/AFL with less than 3 weeks of optimal OAT, persistent AF/AFL, or paroxysmal AF/AFL with CHA2DS2-VASc ≥ 2. Three experienced operators performed all TOEs and were blinded to the clinical data. Risk factors associated with LAT were tested by regression analysis. Results: Five hundred eighty-six patients were enrolled (age 66 ± 6 years; 72% male). A total of 14 thrombi were identified (2.4% of all patients), all located in the left atrial appendage. Patients with LAT had a higher prevalence of coronary artery disease (CAD), heart failure (HF), and persistent AF (11 vs. 3 patients, p = 0.048) as well as lower left ventricular ejection fraction (56 vs. 49%, p = 0.01) and higher systolic pulmonary artery pressure (sPAP). No LAT was found in patients with atrial flutter. According to univariate analysis, higher sPAP, CAD, HF, and persistent AF were identified as predictors of LAT formation, while LVEF > 50% was associated with lower LAT prevalence. Conclusions: LAT is a rare occurrence in candidates for CA. Patients with persistent AF, a history of CAD or HF (particularly with low ejection fraction), and higher sPAP present an elevated risk and should be considered for TOE prior to CA. Patients with AFL and no structural disease have an extremely low risk of LAT.
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Fascicular tachycardia ablation using optrell mapping catheter: a case report
Anno: 2026
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Sabatelli, Ludovico; Silvetti, Giacomo; Giacomini, Giorgio; Compagnucci, Paolo; Casella, Michela; Russo, Antonio Dello
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/354458
Citazioni:
Fascicular tachycardia ablation using optrell mapping catheter: a case report / Sabatelli, L., Silvetti, G., Giacomini, G., Compagnucci, P., Casella, M., Russo, A.D.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - 69:(2026), pp. 5-9. [10.1007/s10840-025-02161-1]
Abstract:
Background: Fascicular ventricular tachycardia (VT) is an uncommon idiopathic VT affecting primarily young patients without structural heart disease. It typically involves a reentry mechanism within the Purkinje system, particularly the posterior fascicle, and appears on ECG with a right bundle bran...ch block and left anterior fascicular block pattern. Although generally benign, symptoms such as palpitations or syncope can affect the quality of life. Catheter ablation is the treatment of choice for patients who are refractory to or prefer not to use medical therapy. To our knowledge, a novel 48-electrode paddle-shaped catheter (Optrell) has never been used for mapping fascicular VT. Case summary: A 34-year-old competitive athlete with recurrent posterior fascicular VT underwent a second ablation after failed initial procedure and partial response to beta-blockers and verapamil. High-density electroanatomic mapping using the 48-electrode paddle-shaped catheter during tachycardia allowed identification of the abnormal Purkinje potentials (P1 and P2) and the critical fusion point of the reentry circuit at the mid-septum. Radiofrequency energy was delivered at this site, resulting in prompt termination of the arrhythmia. No recurrences were observed during the post-procedural observation period or at follow-up (6 months). Conclusions: This case demonstrates the safety and efficacy of high-resolution mapping using a novel 48-electrode catheter to facilitate ablation of fascicular VT.
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First clinical experience using a pentaspline pulse field ablation catheter with integrated electroanatomic 3-dimensional mapping for pulmonary vein isolation
Anno: 2026
Rivista: HEART RHYTHM
Autori/autrici: Mitacchione, Gianfranco; Tondo, Claudio; Dello Russo, Antonio; Malacrida, Maurizio; Bianchi, Stefano; Iacopino, Saverio; Rossi, Luca; Arabia, Gianmarco; Schiavone, Marco; Solimene, Francesco; Casella, Michela; Zingarini, Gianluca; Russo, Maurizio; Volpicelli, Mario; Maggio, Ruggero; Velcich, Vittoria; Calvanese, Raimondo; Rordorf, Roberto; Di Cori, Andrea; Tundo, Fabrizio; Curnis, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/354453
Citazioni:
First clinical experience using a pentaspline pulse field ablation catheter with integrated electroanatomic 3-dimensional mapping for pulmonary vein isolation / Mitacchione, G., Tondo, C., Dello Russo, A., Malacrida, M., Bianchi, S., Iacopino, S., Rossi, L., Arabia, G., Schiavone, M., Solimene, F., Casella, M., Zingarini, G., Russo, M., Volpicelli, M., Maggio, R., Velcich, V., Calvanese, R., Rordorf, R., Di Cori, A., Tundo, F., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - 23:3(2026), pp. 489-491. [10.1016/j.hrthm.2025.11.023]

De Novo Pulmonary Vein Isolation by Means of Pulsed Field Versus Conventional Thermal Ablation of Paroxysmal Atrial Fibrillation in Women: Safety, Efficiency, and Efficacy
Anno: 2026
Rivista: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE
Autori/autrici: Ribatti, Valentina; Dello Russo, Antonio; Riva, Stefania; Malacrida, Maurizio; Bianchi, Stefano; Solimene, Francesco; Iacopino, Saverio; De Simone, Antonio; Rossillo, Antonio; Pelargonio, Gemma; Zucchelli, Giulio; Maggio, Ruggero; Russo, Maurizio; Pecora, Domenico; Bertini, Matteo; Bandino, Stefano; Volpicelli, Mario; Compagnucci, Paolo; De Sanctis, Valerio; Anselmino, Matteo; Rordorf, Roberto; Zingarini, Gianluca; Rovaris, Giovanni; Agus, Elena; Themistoclakis, Sakis; Mitacchione, Gianfranco; Mea, Roberta; Valeri, Yari; Tondo, Claudio; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/354461
Citazioni:
De Novo Pulmonary Vein Isolation by Means of Pulsed Field Versus Conventional Thermal Ablation of Paroxysmal Atrial Fibrillation in Women: Safety, Efficiency, and Efficacy / Ribatti, V., Dello Russo, A., Riva, S., Malacrida, M., Bianchi, S., Solimene, F., Iacopino, S., De Simone, A., Rossillo, A., Pelargonio, G., Zucchelli, G., Maggio, R., Russo, M., Pecora, D., Bertini, M., Bandino, S., Volpicelli, M., Compagnucci, P., De Sanctis, V., Anselmino, M., et al.. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 15:5(2026). [10.1161/jaha.125.041873]
Abstract:
BACKGROUND: Women are frequently underrepresented in studies investigating atrial fibrillation (AF) ablation. We evaluated the acute efficacy, safety, and mid-term outcomes of de novo paroxysmal AF ablation in female patients using a pentaspline pulsed-field ablation (PFA) versus thermal-based techn...ologies. METHODS: In a cohort of consecutive female patients with paroxysmal AF undergoing de novo pulmonary vein isolation, enrolled in the ATHENA-CHARISMA (Advanced Technologies For Successful Ablation of AF in Clinical Practice - Catheter Ablation of Arrhythmias With High-DensityMapping System in the Real WorldPractice) registries, thermal ablation systems (radiofrequency or cryoablation) were compared to the PFA by means of a propensity score matching (ratio 1:1:1). RESULTS: One-thousand one female patients (mean age 63±10 years, mean left ventricular ejection fraction 60.8±6%) were included: 376 (37.6%) underwent cryoablation ablation, 342 (34.2%) radiofrequency ablation, and 283 (28.3%) PFA. Propensity score matching yielded 684 patients (228 per group). The PFA group had significantly shorter skin-to-skin time (60 [50-75] minutes) compared with both radiofrequency (120 [90-145] minutes, P<0.001) and cryoablation (75 [60-100] minutes, P<0.001), while fluoroscopy time was similar among groups (15 [11-21] minutes for PFA, 14 [10-20] minutes for cryoablation, P=0.599 versus PFA and 14 [9-20] minutes for radiofrequency, P=0.454 versus PFA). Overall complication rate was 3.4% and it was significantly higher after thermal ablation than PFA (4.6% versus 0.9%, OR, 5.5, 95% CI, 1.3-23.5, P=0.0227). During a median follow-up of 413 [277-589] days, 139 (20.3%) patients experienced AF recurrence. The Kaplan-Meier estimated freedom from AF at 1-year follow-up was 86.8% with PFA, 84.6% with cryoablation, and 83.3% with radiofrequency (log-rank P value: 0.839). CONCLUSIONS: Among this cohort of female patients, de novo paroxysmal AF using a pentaspline PFA system demonstrated significantly shorter procedural times, and a lower complication rate compared with thermal ablation systems. One-year follow-up revealed comparable rates of AF freedom across all ablation modalities. REGISTRATION: ATHENA (Advanced Technologies For Successful Ablation of AF in Clinical Practice). URL: http://clinicaltrials.gov/; Unique identifier: NCT05617456. CHARISMA (Catheter Ablation of Arrhythmias With High-Density Mapping System in the Real World Practice). URL: http://clinicaltrials.gov/; Unique Identifier: NCT03793998.
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Conventional pulsed-field ablation versus pulsed-field ablation with non-integrated three-dimensional mapping for paroxysmal and persistent atrial fibrillation ablation
Anno: 2026
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Rordorf, Roberto; Bianchi, Stefano; Dello Russo, Antonio; Solimene, Francesco; Tondo, Claudio; Malacrida, Maurizio; Petretta, Andrea; Rossillo, Antonio; Themistoclakis, Sakis; Russo, Maurizio; Bandino, Stefano; Bertini, Matteo; Volpicelli, Mario; Zingarini, Gianluca; Tola, Gianfranco; Meynet, Ilaria; Mitacchione, Gianfranco; De Simone, Antonio; Stegagno, Beatrice; Magnocavallo, Michele; Casella, Michela; Schillaci, Vincenzo; Tundo, Fabrizio; Sanzo, Antonio; Zucchelli, Giulio; Iacopino, Saverio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/354452
Citazioni:
Conventional pulsed-field ablation versus pulsed-field ablation with non-integrated three-dimensional mapping for paroxysmal and persistent atrial fibrillation ablation / Rordorf, R., Bianchi, S., Dello Russo, A., Solimene, F., Tondo, C., Malacrida, M., Petretta, A., Rossillo, A., Themistoclakis, S., Russo, M., Bandino, S., Bertini, M., Volpicelli, M., Zingarini, G., Tola, G., Meynet, I., Mitacchione, G., De Simone, A., Stegagno, B., Magnocavallo, M., et al.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - 69:(2026), pp. 89-98. [10.1007/s10840-025-02129-1]
Abstract:
Background: There is limited evidence on efficiency, effectiveness, and safety outcomes in the context of pulsed-field ablation (PFA) of atrial fibrillation (AF) when a 3D mapping system is used. Purpose: To assess the impact of non-integrated 3D mapping systems in PFA for the treatment of AF. Metho...ds: Consecutive patients undergoing PFA (FARAPULSE system) at 17 centers were included. Procedures were stratified according to the use of 3D mapping system (MAP vs standard; STD). Results: A total of 1804 patients were included, 484 (26.8%) with a 3D mapping system. MAP procedures had longer skin-to-skin (90 [75–120] min vs. 60 [50–70] min, p < 0.0001), cath lab utilization (120 [100–165] min vs. 70 [60–94] min, p < 0.0001), and fluoroscopy time (22 [17–28] min vs. 15 [11–21] min, p < 0.0001). The use of 3D mapping was not associated with a better long-term clinical outcome in the overall population (freedom from AF/atrial tachycardia (AT) of 82.5% in MAP procedures vs. 77.4% in STD procedures, HR = 0.737, 95% CI 0.53–1.03, p = 0.0746) as well as in PVI-only paroxysmal AF (86.5% vs. 80.3%, 0.67, 0.38–1.19, p = 0.172), in PVI plus additional lesion sets paroxysmal AF (72.7% vs. 77.8%, 1.08, 0.44–2.65, p = 0.869), or in PVI only persistent AF (76.0% vs. 68.0%, 0.86, 0.36–2.04, p = 0.727). A significantly higher arrhythmia recurrence-free rate was noticed in patients with persistent AF undergoing additional lesion set ablation (83.7% vs 70.3%, 0.45, 0.24 to 0.86, p = 0.016). Three major complications (0.2%) occurred, all in the STD group. Conclusion: The use of a non-integrated 3D mapping system for PFA of AF did not significantly affect long-term success rates in paroxysmal AF or in patients undergoing PVI-only procedures.
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Results of ICE-Guided Isolation of the Superior Vena Cava With Pulsed Field Ablation
Anno: 2025
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Pierucci, Nicola; La Fazia, Vincenzo Mirco; Mohanty, Sanghamitra; Schiavone, Marco; Doty, Brandon; Gabrah, Kirollos; Della Rocca, Domenico G.; Burkhardt, J. David; Al-Ahmad, Amin; Di Biase, Luigi; Casella, Michela; Russo, Antonio Dello; Nair, Devi; Mansour, Moussa; Tondo, Claudio; Natale, Andrea
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356358
Citazioni:
Results of ICE-Guided Isolation of the Superior Vena Cava With Pulsed Field Ablation / Pierucci, N., La Fazia, V.M., Mohanty, S., Schiavone, M., Doty, B., Gabrah, K., Della Rocca, D.G., Burkhardt, J.D., Al-Ahmad, A., Di Biase, L., Casella, M., Russo, A.D., Nair, D., Mansour, M., Tondo, C., Natale, A.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 11:4(2025), pp. 752-760. [10.1016/j.jacep.2024.11.009]
Abstract:
Background: Earlier studies have documented the risk for sinoatrial node injury and phrenic nerve paralysis as complications following radiofrequency catheter ablation for electrical isolation of the superior vena cava (SVCI). Objectives: The aim of this study was to assess the safety and feasibilit...y of SVCI in patients with atrial fibrillation undergoing pulsed field ablation (PFA) Methods: A total of 1,600 consecutive patients undergoing PFA for pulmonary vein isolation plus SVCI were included in this multicenter analysis. Superior vena cava (SVC) ablation was performed under the continuous guidance of intracardiac echocardiography. The PFA catheter was placed at the junction between the SVC and the right atrium at the level of the lower border of the pulmonary artery. A total of 4 applications were given to achieve complete electrical isolation of the SVC. Sinus node injury and phrenic nerve stunning were checked during the procedure, before discharge, and at 2-month follow-up. Results: A total of 616 patients receiving SVCI were included in the analysis. Acute SVCI was achieved in all 616 patients (100%). In the flower configuration used in the first 10 patients, 2 transient sinus node injuries and 2 episodes of phrenic nerve stunning were observed, which resolved spontaneously during the procedure. In the remaining patients, the basket configuration was used; only 1 episode of phrenic nerve stunning was registered, which regressed before the end of the procedure. No permanent damages were registered at discharge and at 2-month follow-up. Conclusions: Intracardiac echocardiography–guided PFA can effectively isolate the SVC with a good safety profile.
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Long-term prognosis of pure and impure tachycardiomyopathy
Anno: 2025
Rivista: ESC HEART FAILURE
Autori/autrici: Stronati, Giulia; Alfieri, Michele; Tombolesi, Niki; Barbarossa, Alessandro; Principi, Samuele; Gullì, Federico; Massari, Arianna; Bastianoni, Gianmarco; Roccetti, Francesca; Casella, Michela; Dello Russo, Antonio; Guerra, Federico
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356364
Citazioni:
Long-term prognosis of pure and impure tachycardiomyopathy / Stronati, G., Alfieri, M., Tombolesi, N., Barbarossa, A., Principi, S., Gullì, F., Massari, A., Bastianoni, G., Roccetti, F., Casella, M., Dello Russo, A., Guerra, F.. - In: ESC HEART FAILURE. - ISSN 2055-5822. - 12:6(2025), pp. 4288-4298. [10.1002/ehf2.15444]
Abstract:
Background and aims: Tachycardia-induced cardiomyopathy (TCM) is a reversible form of heart failure (HF) driven by arrhythmias, often atrial fibrillation (AF). While reversible, TCM's long-term prognosis remains unclear, especially in comparison to HF with reduced ejection fraction (HFrEF). Thi...s study examines the prognosis of pure and impure TCM against other causes of HFrEF. Methods: Prospective, monocentric, observational study of 456 patients hospitalized with de novo, acute decompensated HFrEF, classified into pure TCM, impure TCM, ischaemic HF and non-ischaemic HF. The primary endpoint was all-cause mortality, and the secondary endpoint was the incidence of unplanned cardiovascular hospitalisations. Sensitivity analyses were performed using propensity score matching between the four groups. Results: During a median follow-up of 3 years (interquartile range 1.5–5.1 years), pure TCM had the highest survival rate, and ischaemic HF had the lowest (pure TCM 78.2%; impure TCM 64.8%; non-ischaemic HF 73.4%; ischaemic HF 58.5%; log-rank P < 0.0001). Pure and impure TCM presented the lowest free-from-readmission estimates over follow-up (pure TCM 43.2%; impure TCM 60.0%; non-ischaemic HF 83.2%; ischaemic HF 69.9%; log-rank P < 0.0001). An initial rhythm control strategy was associated with better overall survival in TCM (79% vs. 63%; log-rank P < 0.0001) but similar rates of unplanned hospitalization. Conclusions: Pure TCM shows a favourable survival prognosis but high readmission rates, emphasizing the need for early rhythm control and sustained monitoring for arrhythmia recurrence. An initial rhythm control strategy seems associated with an increased survival, highlighting the importance of early recognition of arrhythmias as a culprit of HF worsening.
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How can we improve on selecting the appropriate therapy in Brugada syndrome?
Anno: 2025
Rivista: EXPERT REVIEW OF CARDIOVASCULAR THERAPY
Autori/autrici: Compagnucci, Paolo; Dello Russo, Antonio; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356355
Citazioni:
How can we improve on selecting the appropriate therapy in Brugada syndrome? / Compagnucci, P., Dello Russo, A., Casella, M.. - In: EXPERT REVIEW OF CARDIOVASCULAR THERAPY. - ISSN 1477-9072. - 23:10(2025), pp. 593-596. [10.1080/14779072.2025.2549432]

Redefining the blanking period after pulsed field ablation in patients with atrial fibrillation
Anno: 2025
Rivista: HEART RHYTHM
Autori/autrici: Mohanty, Sanghamitra; Torlapati, Prem Geeta; Casella, Michela; Della Rocca, Domenico G.; Schiavone, Marco; Doty, Brandon; La Fazia, Vincenzo Mirco; Pahi, Shubham; Pierucci, Nicola; Valeri, Yari; Gianni, Carola; Al-Ahmad, Amin; Burkhardt, John D.; Gallinghouse, J. G.; Di Biase, Luigi; Chierchia, Gian-Battista; Nair, Devi G.; Dello Russo, Antonio; Tondo, Claudio; Natale, Andrea
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345753
Citazioni:
Redefining the blanking period after pulsed field ablation in patients with atrial fibrillation / Mohanty, S., Torlapati, P.G., Casella, M., Della Rocca, D.G., Schiavone, M., Doty, B., La Fazia, V.M., Pahi, S., Pierucci, N., Valeri, Y., Gianni, C., Al-Ahmad, A., Burkhardt, J.D., Gallinghouse, J.G., Di Biase, L., Chierchia, G., Nair, D.G., Dello Russo, A., Tondo, C., Natale, A.. - In: HEART RHYTHM. - ISSN 1547-5271. - 22:4(2025), pp. 891-897. [10.1016/j.hrthm.2024.08.011]
Abstract:
Background: Recurrence during the 3-month blanking period after radiofrequency ablation of atrial fibrillation (AF) is typically not considered as a predictor for late recurrence. Objective: We investigated the significance of early recurrence as a risk factor for late recurrence in patients with AF... receiving pulsed-field ablation (PFA). Methods: Consecutive patients undergoing PFA were prospectively followed up for 1 year. All patients received isolation of pulmonary veins. Additional ablation procedures were performed per operator's discretion. After the procedure, all remained on their previously ineffective antiarrhythmic drugs (AADs) during the 2-month blanking period after which the AADs were discontinued. Early recurrence was defined as atrial arrhythmia of >30-second duration during the 3-month blanking period, and any recurrence beyond 3 months was considered as late recurrence. Results: A total of 337 patients undergoing PFA for AF were included. Early recurrence was recorded in 53 patients (15.7%): 10 in the first month, 12 in the second month, and 31 in the third month. Of the 10 patients having recurrence during the first month, 7 (70%) remained in sinus rhythm after cardioversion whereas 3 (30%) underwent a redo procedure because of late recurrence. At 1 year, all patients with recurrence in the second and third months experienced late recurrence; among these patients, 10 (83.3%) of 12 and 27 (87%) of 31 underwent a redo procedure and the remaining 6 patients were in sinus rhythm on AADs. Conclusion: In this consecutive series of patients with AF, early recurrence in the second or third month after the PFA procedure was associated with a high risk of late recurrence. Thus, blanking period could be redefined as 1 month after PFA.
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Does Age Impact Safety and Efficacy During Pulse-Field Ablation for Atrial Fibrillation?
Anno: 2025
Rivista: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE
Autori/autrici: Dello Russo, A; Tondo, C; Bianchi, S; Schillaci, V; Iacopino, S; Casella, M; Rossillo, A; Maggio, R; Themistoclakis, S; Bertini, M; Russo, M; Volpicelli, M; Viola, G; Rordorf, R; Schiavone, M; Valeri, Y; Colella, J; Rossi, P; Tundo, F; Zingarini, G; De Simone, A; Bianchini, L; Di Vilio, A; Compagnucci, P; Malacrida, M; Zucchelli, G; Solimene, F
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348957
Citazioni:
Does Age Impact Safety and Efficacy During Pulse-Field Ablation for Atrial Fibrillation? / Dello Russo, A., Tondo, C., Bianchi, S., Schillaci, V., Iacopino, S., Casella, M., Rossillo, A., Maggio, R., Themistoclakis, S., Bertini, M., Russo, M., Volpicelli, M., Viola, G., Rordorf, R., Schiavone, M., Valeri, Y., Colella, J., Rossi, P., Tundo, F., Zingarini, G., et al.. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 14:9(2025). [10.1161/JAHA.124.037959]
Abstract:
Background There is no evidence evaluating efficiency, effectiveness, and safety outcomes in older patients in the context of pulsed-field ablation technology for the ablation of atrial fibrillation. We aimed to compare safety, efficacy, and acute and long-term outcomes of pulsed-field ablation in o...lder patients (>= 75 years) with younger ones. Methods We enrolled consecutive patients who had undergone atrial fibrillation ablation with the pulsed-field ablation FARAPULSE system (Boston Scientific) at 15 centers. Patients were stratified by age (<65, 65-74, and >= 75 years) and efficacy and safety profiles of these groups were compared. Results A total of 1082 patients were included: 108 (10%) were >= 75 years old, 374 (34.6%) were 65-74 years old and 600 (55.4%) were <65 years old. Older patients displayed a more pronounced risk profile compared with their younger counterparts, characterized by a significant higher burden of comorbidities. No differences in terms of procedural metrics were found. Pulmonary vein isolation was achieved in all patients. An overall low rate of procedural-related complications was reported (3.0%) without difference between young and older patients (P=0.241). During a mean follow-up of 342 +/- 111 days, a primary efficacy end point occurred in 605 of 748 (80.9%) patients with available outcome information. The arrhythmia recurrence rate ranged from 14.4% in patients <65 years old to 26.9% of older patients (P=0.011). Conclusions Drawing from these findings, using the FARAPULSE system for atrial fibrillation ablation in older patients demonstrated swift, safe, and effective acute outcomes, mirroring a comparable pattern observed in younger patients and recurrence rates in line with the literature in older patients
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AI-Assisted 3D Intracardiac Echocardiography for Pulsed Field Ablation of Atrial Fibrillation Using a Novel Variable Loop Circular Catheter: A Multicenter Evaluation
Anno: 2025
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Dello Russo, Antonio; Valeri, Yari; Ciconte, Giuseppe; Schiavone, Marco; Compagnucci, Paolo; Di Monaco, Antonio; Riva, Stefania; Salerno, Raffaele; Volpato, Giovanni; Cipolletta, Laura; Parisi, Quintino; Casella, Michela; Grimaldi, Massimo; Tondo, Claudio; Pappone, Carlo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356361
Citazioni:
AI-Assisted 3D Intracardiac Echocardiography for Pulsed Field Ablation of Atrial Fibrillation Using a Novel Variable Loop Circular Catheter: A Multicenter Evaluation / Dello Russo, A., Valeri, Y., Ciconte, G., Schiavone, M., Compagnucci, P., Di Monaco, A., Riva, S., Salerno, R., Volpato, G., Cipolletta, L., Parisi, Q., Casella, M., Grimaldi, M., Tondo, C., Pappone, C.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 14:20(2025). [10.3390/jcm14207249]
Abstract:
Background: The VARIPULSE platform is an advanced Pulsed Field Ablation (PFA) system fully integrated with electro-anatomical mapping system, employing a variable loop circular catheter (VLCC) for atrial fibrillation (AF) ablation. The objective of the study is to assess for the first time the feasi...bility, safety, and procedural impact of AI (artificial intelligence)-assisted ICE (intracardiac echocardiography) mapping with the CARTOSOUND FAM Module compared with conventional electroanatomical mapping during PFA. Methods: In this retrospective, multicenter study, 157 consecutive patients undergoing PFA for paroxysmal or persistent AF were included. Patients were divided into two groups: ICE-guided cohort (n = 64) and non-ICE-guided cohort (n = 93). Propensity score matching (PSM) was used to adjust for baseline differences. Results: AI-assisted ICE mapping was feasible in all cases. Compared with conventional mapping, it significantly reduced LA (left atrium) mapping time (median 5 vs. 8 min; p < 0.001), LA dwell time (33.5 vs. 38.5 min; p = 0.001), and fluoroscopy time (7.5 vs. 14 min; p < 0.001). The total number of PFA applications was similar across groups (p = 0.136). No major adverse events occurred in either cohort during the procedure or within the first month of follow-up. Conclusions: AI-assisted ICE mapping using the CARTOSOUND FAM Module enables accurate anatomical reconstruction and significantly optimizes procedural efficiency in PFA. This approach supports further development toward radiation-sparing and potentially fluoroscopy-free PFA workflows. For the first time, it addresses a gap in the current evidence regarding the use of ICE in PFA, building on evidence already established for radiofrequency ablation procedures.
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Long-Term Risk Assessment in Athletes With Complex Ventricular Arrhythmias
Anno: 2025
Rivista: CIRCULATION. ARRHYTHMIA AND ELECTROPHYSIOLOGY
Autori/autrici: Compagnucci, Paolo; Casella, Michela; Narducci, Maria Lucia; Conte, Edoardo; Cammarano, Michela; Pelargonio, Gemma; Andreini, Daniele; Palmieri, Vincenzo; Stronati, Giulia; Lo Russo, Gerardo V.; Brusamolino, Matteo; Pontone, Gianluca; Guerra, Federico; Natale, Andrea; Tondo, Claudio; Crea, Filippo; Zeppilli, Paolo; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356353
Citazioni:
Long-Term Risk Assessment in Athletes With Complex Ventricular Arrhythmias / Compagnucci, P., Casella, M., Narducci, M.L., Conte, E., Cammarano, M., Pelargonio, G., Andreini, D., Palmieri, V., Stronati, G., Lo Russo, G.V., Brusamolino, M., Pontone, G., Guerra, F., Natale, A., Tondo, C., Crea, F., Zeppilli, P., Dello Russo, A.. - In: CIRCULATION. ARRHYTHMIA AND ELECTROPHYSIOLOGY. - ISSN 1941-3149. - 18:6(2025), pp. 447-457. [10.1161/circep.124.013480]
Abstract:
BACKGROUND: Ventricular arrhythmias (VAs) are a major concern in athletes. We sought to determine the prognostic role of noninvasive and invasive assessments in athletes with complex VAs. METHODS: One-hundred-ninety athletes (82% men; 28 [19-43] years; 148 [78%] competitive athletes) with frequent o...r exercise-induced premature ventricular complexes or nonsustained ventricular tachycardia were included in a multicenter cohort study and categorized based on VA ECG morphology into common (n=99) and uncommon (n=91) VA groups. Each athlete underwent a comprehensive diagnostic workup, including cardiac magnetic resonance in 94% (n=178) and electrophysiology study/electroanatomical mapping in 87% (n=166). The primary end point was the occurrence of sudden death or sustained VAs during long-term follow-up. RESULTS: Athletes with uncommon VA morphology had higher rates of abnormal findings at multimodality assessment and more final diagnoses of structural heart disease. Over a median follow-up of 6.2 (4.3-8.1) years, 7 (4%) athletes experienced a primary outcome event, including 1 sudden death. Interestingly, no events occurred in athletes with common morphology VAs. In univariable Cox models, factors associated with the primary end point included uncommon VA morphology (P=0.003), lack of VA suppression (P=0.049), and nonsustained ventricular tachycardia/ventricular tachycardia induction (P=0.010) during stress testing, late gadolinium enhancement (P=0.045), electroanatomical scar regions (P=0.022), and sustained VA inducibility by electrophysiology study (P<0.001). Incorporating findings of invasive tests improved prediction of primary outcome events over clinical/noninvasive findings in isolation (log-likelihood ratio for nested models, P=0.004). A survival tree model based on VA morphology, late gadolinium enhancement, VA response to exercise testing, and electroanatomical mapping allowed risk stratification, identifying subgroups of athletes without primary outcome events during follow-up. Among 148 competitive athletes, 101 (68%) regained eligibility after 3 months of detraining, but only 42 (28%) continued long-term. CONCLUSIONS: A comprehensive diagnostic assessment integrating ECG, stress testing, and imaging findings, along with the selective use of invasive electrophysiology assessments, may help refine the prognostic evaluation of athletes with complex VAs.
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How to Approach Left Ventricular Hypertrabeculation: A Practical Guide and Literature Review
Anno: 2025
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Alfieri, Michele; Principi, Samuele; Barbarossa, Alessandro; Stronati, Giulia; Antonicelli, Roberto; Casella, Michela; Dello Russo, Antonio; Guerra, Federico
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356363
Citazioni:
How to Approach Left Ventricular Hypertrabeculation: A Practical Guide and Literature Review / Alfieri, M., Principi, S., Barbarossa, A., Stronati, G., Antonicelli, R., Casella, M., Dello Russo, A., Guerra, F.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 14:3(2025). [10.3390/jcm14030695]
Abstract:
Left ventricular hypertrabeculation is one of the most debated conditions in modern cardiology. Many studies have tried to characterise this disease by addressing the various clinical risks and diagnostic tools, but its very nosological existence is currently being challenged. The latest ESC guideli...nes on cardiomyopathies state that it should be addressed as a morphologic trait rather than an intrinsic disease of the cardiac muscle. Despite the huge number of diagnostic criteria and possible phenocopies, no specific consensus identifies a specific flowchart regarding the management of patients with suspected hypertrabeculation. This review aims to provide a clinical approach for patients with a phenotypical appearance of excessive trabeculation.
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Catheter Ablation of Atrial Fibrillation in Patients With Psoriasis: A Multicenter Study
Anno: 2025
Rivista: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE
Autori/autrici: Compagnucci, Paolo; Dello Russo, Antonio; Mohanty, Sanghamitra; Bergonti, Marco; Torlapati, Pem Geeta; Valeri, Yari; Gigante, Carlo; Conte, Edoardo; Manfredi, Roberto; Giannoni, Melania; Cipolletta, Laura; Volpato, Giovanni; Parisi, Quintino; D'Angelo, Leonardo; Campanelli, Francesca; Saenen, Johan; Simonetti, Oriana; Andreini, Daniele; Offidani, Annamaria; Natale, Andrea; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356357
Citazioni:
Catheter Ablation of Atrial Fibrillation in Patients With Psoriasis: A Multicenter Study / Compagnucci, P., Dello Russo, A., Mohanty, S., Bergonti, M., Torlapati, P.G., Valeri, Y., Gigante, C., Conte, E., Manfredi, R., Giannoni, M., Cipolletta, L., Volpato, G., Parisi, Q., D'Angelo, L., Campanelli, F., Saenen, J., Simonetti, O., Andreini, D., Offidani, A., Natale, A., et al.. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 14:6(2025). [10.1161/jaha.124.038882]
Abstract:
BACKGROUND: Psoriasis is linked to an increased risk of atrial fibrillation (AF). However, data on the electrophysiological substrate and outcomes of AF ablation in patients with psoriasis are lacking. METHODS: We conducted a retrospective, multicenter study involving 48 patients with psoriasis (med...ian age, 66 years [56–72]; 79% male) and paroxysmal (n=25.52%) or persistent AF (n=23.48%) who underwent ablation at 4 high-volume institutions between 2018 and 2023. Propensity score-matching identified 96 controls without psoriasis undergoing AF ablation at the same institutions. The primary end point was survival free from atrial tachyarrhythmia recurrence after an 8-week blanking period. RESULTS: Baseline clinical characteristics were well balanced between groups. However, patients with psoriasis had higher CRP (C-reactive protein) than controls (0.85 mg/dL [0.45–1.2] versus 0.3 mg/dL [0.3–0.4], P<0.001) and a greater burden of left atrial low-voltage regions at electroanatomical mapping (20% [11%–20%] versus 5% [5%–10%]; P=0.013). Over a median follow-up of 20 (13–32) months, atrial tachyarrhythmia recurrence occurred in a higher proportion of patients with psoriasis (40% versus 24%, log-rank P=0.023). Patients with psoriasis also had a slightly higher risk of acute coronary syndrome (log-rank P=0.045), with similar risks of death (log-rank P=0.517) and procedural complications (2% versus 2%, P=1.000), whereas no stroke occurred. Multivariable analysis identified early recurrence within blanking period (adjusted hazard ratio [aHR], 5.9, P<0.001), preablation CRP levels (aHR, 1.2, P=0.016), and psoriasis history (aHR, 2.2, P=0.046) as predictors of atrial tachyar-rhythmia recurrence. In the group with psoriasis, the optimal CRP cutoff associated with atrial tachyarrhythmia recurrence was found to be 1 mg/dL. CONCLUSIONS: Psoriasis is associated with low-grade systemic inflammation, more severe electroanatomical markers of atrial cardiomyopathy, and worse postablation outcomes. The association between CRP levels and rhythm outcomes suggests that inflammation may drive recurrences among patients with psoriasis undergoing AF ablation.
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Cardiac biomarker temporal dynamics after radiofrequency and pulsed field catheter ablation of atrial fibrillation
Anno: 2025
Rivista: HEART RHYTHM O2
Autori/autrici: Casella, Michela; Valeri, Yari; Compagnucci, Paolo; Finori, Luca; Volpato, Giovanni; Cipolletta, Laura; Parisi, Quintino; Grandin, Riccardo; Campanelli, Francesca; D'Angelo, Leonardo; Giacomini, Giorgio; Cardinali, Francesco; Castellucci, Giacomo; Rita, Enrico; Messano, Loredana; Ciliberti, Giuseppe; Malacrida, Maurizio; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356365
Citazioni:
Cardiac biomarker temporal dynamics after radiofrequency and pulsed field catheter ablation of atrial fibrillation / Casella, M., Valeri, Y., Compagnucci, P., Finori, L., Volpato, G., Cipolletta, L., Parisi, Q., Grandin, R., Campanelli, F., D'Angelo, L., Giacomini, G., Cardinali, F., Castellucci, G., Rita, E., Messano, L., Ciliberti, G., Malacrida, M., Dello Russo, A.. - In: HEART RHYTHM O2. - ISSN 2666-5018. - 6:11(2025), pp. 1688-1695. [10.1016/j.hroo.2025.07.022]
Abstract:
Background There is a lack of data on the temporal dynamics of cardiac biomarkers after radiofrequency and pulsed field ablation (PFA) catheter ablation of atrial fibrillation. Objective To evaluate the kinetics of release of several biomarkers following pulmonary vein isolation (PVI). Methods All p...atients underwent baseline and regular post-procedural blood sampling (at 3, 24, and 48 hours) to assess major markers of myocardial injury (troponin I, creatinine kinase-MB, and myoglobin) and inflammatory (C-reactive protein [CRP]). The population was stratified into 3 groups according to the ablation system: radiofrequency (RF) ablation catheter (RF group), pentaspline FarapulseTM PFA system (PFA-FAR group), and variable-loop VaripulseTM PFA system (PFA-VAR group). Results A total of 186 patients were included: 79 RF (42.5%), 69 PFA-FAR (37.1%), and 38 PFA-VAR (20.4%). A greater extent of myocardial injury was noticed in the PFA groups vs RF, and cellular electroporation via pentaspline PFA resulted in a greater biomarker increase compared with loop-variable PFA. Kinetics of biomarkers of inflammation increase following PVI with both PFA technologies and RF. However, both PFA systems resulted in a faster CRP biomarker recovery compared with RF, while CRP continued to increase beyond 24 hours post-ablation only in the RF group. PVI was achieved in all patients (100%) using only PFA or RF. Conclusion Cellular electroporation induced by pentaspline PFA was associated with a significantly greater elevation in these cardiac biomarkers compared with variable-loop PFA and RF. After an initial increase, both PFA systems were associated with a more rapid decline in CRP levels compared with RF.
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The Diagnostic and Prognostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy
Anno: 2025
Rivista: JACC. ADVANCES
Autori/autrici: Calò, Leonardo; Crescenzi, Cinzia; Di Marco, Andrea; Fanisio, Francesca; Romeo, Fabiana; Gargaro, Alessio; Martino, Annamaria; Cappelletto, Chiara; Merlo, Marco; Targetti, Mattia; Toso, Elisabetta; Toto, Federica; Musumeci, Maria Beatrice; Tini, Giacomo; Ciabatti, Michele; Stefanini, Matteo; Canestrelli, Stefano; Fedele, Elisa; Lanzillo, Chiara; Fusco, Armando; Sangiuolo, Federica Carla; Radesich, Cinzia; Perotto, Maria; Pieroni, Maurizio; Mango, Ruggiero; Gasperetti, Alessio; Autore, Camillo; Casella, Michela; Dello Russo, Antonio; Stolfo, Davide; Laredo, Mikael; Gandjbakhch, Estelle; Graziosi, Maddalena; Biagini, Elena; Catalano, Costantina; Barile, Ludovica; Drago, Fabrizio; Cicenia, Marianna; Baban, Anwar; Pelargonio, Gemma; Narducci, Maria Lucia; Re, Federica; Peretto, Giovanni; Paiotti, Elena; Díez-López, Carles; Olivotto, Iacopo; Gaita, Fiorenzo; Sinagra, Gianfranco; Novelli, Giuseppe
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356352
Citazioni:
The Diagnostic and Prognostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy / Calò, L., Crescenzi, C., Di Marco, A., Fanisio, F., Romeo, F., Gargaro, A., Martino, A., Cappelletto, C., Merlo, M., Targetti, M., Toso, E., Toto, F., Musumeci, M.B., Tini, G., Ciabatti, M., Stefanini, M., Canestrelli, S., Fedele, E., Lanzillo, C., Fusco, A., et al.. - In: JACC. ADVANCES. - ISSN 2772-963X. - 4:6 Part. 1(2025). [10.1016/j.jacadv.2025.101766]
Abstract:
Background: Electrocardiographic findings in arrhythmogenic left ventricular cardiomyopathy (ALVC) have been limited to small studies. Objectives: The authors aimed to analyze the electrocardiogram (ECG) characteristics of ALVC, to correlate ECG with cardiac magnetic resonance and genetic data, and ...to evaluate its prognostic value. Methods: We reviewed data of 125 consecutive patients with ALVC (81.5% desmoplakin pathogenic/likely pathogenic variants). The composite endpoint of major arrhythmic events (MAEs) included sudden cardiac death, aborted sudden cardiac death, and appropriate implantable cardioverter-defibrillator shock. Predictors of MAE were evaluated with logistic regression. Results: ALVC showed distinct ECG signs, including left posterior fascicular block (LPFB) (13.6%), pathological Q waves (26.4%), R/S ratio in V1 ≥0.5 (26.4%), and SV1 + RV6 ≤12 mm and RI + RII ≤8 mm (44%). Fifteen (12%) patients had a normal ECG. MAE occurred in 35 patients (28%). In multivariable analysis, LPFB (OR: 4.7; 95% CI: 1.2-18.3), syncope (OR: 84.95; 95% CI: 14-496), transmural late gadolinium enhancement (OR: 9.95; 95% CI: 2.3-36), and right ventricular ejection fraction (OR: 0.92; 95% CI: 0.87-0.97) were the independent predictors of MAE. The model including these 4 variables achieved a remarkable predictive capability (area under the curve: 0.9). In the primary prevention scenario, with Cox regression, LPFB (HR: 3.98; 95% CI: 1.3-12.0), syncope (HR: 19.13; 95% CI: 5.8-63.0), and transmural late gadolinium enhancement (HR: 10.57; 95% CI: 2.9-38.0) were independent predictors of MAE. Conclusions: In ALVC, ECG is a valuable diagnostic tool and may have a relevant prognostic role, since LFPB is a strong and independent predictor of MAE.
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Real-world experience with the pentaspline pulsed field ablation system: one-year outcomes of the FARADISE registry
Anno: 2025
Rivista: EUROPACE
Autori/autrici: Boersma, Lva; Széplaki, G; Dello Russo, A; García-Bolao, I; Efremidis, M; Szegedi, N; Willems, S; Haqqani, H; Gandjbakhch, E; Solimene, F; Andrikopoulos, G; Fiala, M; Defaye, P; Luik, A; Lugenbiel, P; Eckardt, L; Ouss, A; Herzet, Jm; Maqueda, Jr; Abbey, S; Osca, J; Hussin, A; Cielen, N; Johnson, M; Albrecht, Em; Sutton, Bs; Vijgen, J
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348958
Citazioni:
Real-world experience with the pentaspline pulsed field ablation system: one-year outcomes of the FARADISE registry / Boersma, L., Széplaki, G., Dello Russo, A., García-Bolao, I., Efremidis, M., Szegedi, N., Willems, S., Haqqani, H., Gandjbakhch, E., Solimene, F., Andrikopoulos, G., Fiala, M., Defaye, P., Luik, A., Lugenbiel, P., Eckardt, L., Ouss, A., Herzet, J.m., Maqueda, J.r., Abbey, S., et al.. - In: EUROPACE. - ISSN 1532-2092. - 27:9(2025). [10.1093/europace/euaf182]
Abstract:
Aims Clinical studies with protocol-mandated workflow and monitoring have analysed performance of pulsed field ablation (PFA) for treating atrial fibrillation (AF). The FARADISE registry captures global use of the pentaspline PFA catheter in real-world clinical practice with a follow-up of 3 years M...ethods FARADISE is a prospective, non-randomized, multi-national registry (NCT05501873) that enrolled subjects clinically indi- and results cated for ablation using the pentaspline PFA catheter per medical judgement and hospital standard-of-care. Procedural characteristics, safety, and clinical effectiveness up to 12-months were collected. In total, 1158 AF patients received PFA across 48 centres in 21 countries (64 ± 11 years, 33% female, 90% de novo, 65% paroxysmal AF). Pulmonary vein isolation (PVI)only procedures were performed in 80.8% of paroxysmal vs. 57.5% for non-paroxysmal patients (P < 0.01). Median procedure, left atrial dwell, and fluoroscopy times were 51[40–70], 31[24–41], and 12[8–17] min, respectively. The rate of early onset serious adverse events was 1.5% and did not differ by ablation strategy or AF indication. At 1-year, clinical effectiveness was 80.8% for paroxysmal AF and 67.7% for non-paroxysmal AF, with no difference within indication by lesion set (paroxysmal: 81.2% PVI-only vs. 79.0% PVI+, P = 0.65; non-paroxysmal: 67.5% PVI-only vs. 67.7% PVI+, P = 0.79). Acute results reinforce a short procedural learning curve with no difference in 1-year effectiveness by operator experience. Conclusion The FARADISE registry provides a snapshot of real-world clinical use of the pentaspline PFA catheter. Acute results demonstrate favourable procedural and safety outcomes regardless of AF indication. One-year outcomes are encouraging, with no differences seen within indication based on ablation strategy
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Genomically matched therapy in advanced solid tumors: the randomized phase 2 ROME trial
Anno: 2025
Rivista: NATURE MEDICINE
Autori/autrici: Marchetti, Paolo; Curigliano, Giuseppe; Biffoni, Mauro; Lonardi, Sara; Scagnoli, Simone; Fornaro, Lorenzo; Guarneri, Valentina; De Giorgi, Ugo; Ascierto, Paolo Antonio; Blandino, Giovanni; D'Amati, Giulia; Aglietta, Massimo; Cremolini, Chiara; Conte, Pierfranco; Crimini, Edoardo; Ceracchi, Maurizio; Pisegna, Simona; Verkhovskaia, Sofia; Bordonaro, Roberto; Bracarda, Sergio; Butturini, Giovanni; Del Mastro, Lucia; Decensi, Andrea; Fabbri, Agnese; Fenocchio, Elisabetta; Gori, Stefania; Metro, Giulio; Pessino, Annamaria; Pozzessere, Daniele; Puglisi, Fabio; Tamberi, Stefano; Zambelli, Alberto; Marino, Donatella; Capoluongo, Ettore; Cappuzzo, Federico; Cerbelli, Bruna; Giannini, Giuseppe; Malapelle, Umberto; Mazzuca, Federica; Nuti, Marianna; Pruneri, Giancarlo; Simmaco, Maurizio; Strigari, Lidia; Tonini, Giuseppe; Martini, Nello; Botticelli, Andrea; The Rome Trial Investigators, Consortia; Savarese, Antonella; Adamo, Vincenzo; Quaresmini, Davide; Tagliaferri, Pierosandro; Damiano, Paola; Urbini, Benedetta; Bengala, Carmelo; Zaffignani, Elena; Pinto, Carmine; Tosoni, Alicia; Buffoni, Lucio; Maiello, Evaristo; Mucciarini, Claudia; Russo, Antonio; Berardi, Rossana; Lombardi, Giuseppe; Piancastelli, Alessandra; Masi, Gianluca; Bonanno, Laura; Vanella, Vito; Mannozzi, Francesca
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/358000
Citazioni:
Genomically matched therapy in advanced solid tumors: the randomized phase 2 ROME trial / Marchetti, P., Curigliano, G., Biffoni, M., Lonardi, S., Scagnoli, S., Fornaro, L., Guarneri, V., De Giorgi, U., Ascierto, P.A., Blandino, G., D'Amati, G., Aglietta, M., Cremolini, C., Conte, P., Crimini, E., Ceracchi, M., Pisegna, S., Verkhovskaia, S., Bordonaro, R., Bracarda, S., et al.. - In: NATURE MEDICINE. - ISSN 1078-8956. - 31:(2025), pp. 3514-3523. [10.1038/s41591-025-03918-x]
Abstract:
Despite recent advancements demonstrating the potential of tumor-agnostic biomarkers to guide effective therapies, randomized evidence supporting the clinical superiority of precision oncology approaches compared to standard therapies remains limited. The ROME trial was a multicenter, randomized, op...en-label phase 2 study comparing tailored treatment (TT) to standard of care (SoC) in patients with advanced solid tumors progressing after one or two lines of therapy. Comprehensive genomic profiling on tissue and blood was performed to identify actionable alterations. Overall response rate (ORR) was the primary endpoint, and progression-free survival (PFS), overall survival (OS), time to treatment failure (TTF), time to next treatment (TTNT) and safety were the secondary endpoints. Between November 2020 and August 2023, 1,794 patients were screened, 897 were evaluated by the molecular tumor board (MTB) and 400 were randomized to TT or SoC. TT achieved a significantly higher ORR (17.5% versus 10%; P = 0.0294) and improved median PFS (3.5 months versus 2.8 months; hazard ratio = 0.66 (0.53–0.82), P = 0.0002). TT also showed superior 12-month PFS rates (22.0% versus 8.3%). Median OS was similar, with a 52% crossover rate. Grade 3/4 adverse events were also similar (40% TT versus 52% SoC). These results highlight the potential of TT to improve outcomes for patients with diverse actionable genomic alterations. These results also provide relevant evidence supporting a tumor-agnostic precision oncology strategy and highlight the potential of TTs, guided by genomic profiling and MTB recommendations, to significantly improve outcomes for patients with diverse actionable genomic alterations. ClinicalTrials.gov identifier: NCT04591431.
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Temporal trends of characteristics and management of patients with suspected MINOCA
Anno: 2025
Rivista: INTERNATIONAL JOURNAL OF CARDIOLOGY
Autori/autrici: Ciliberti, Giuseppe; Fortuni, Federico; Santucci, Andrea; Timi, Alessandro; Barnoffi, Emanuel; Coiro, Stefano; Guerra, Federico; Del Pinto, Maurizio; Compagnucci, Paolo; Sclafani, Rocco; Casella, Michela; Savino, Ketty; Dello Russo, Antonio; Ambrosio, Giuseppe; Carluccio, Erberto
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356372
Citazioni:
Temporal trends of characteristics and management of patients with suspected MINOCA / Ciliberti, G., Fortuni, F., Santucci, A., Timi, A., Barnoffi, E., Coiro, S., Guerra, F., Del Pinto, M., Compagnucci, P., Sclafani, R., Casella, M., Savino, K., Dello Russo, A., Ambrosio, G., Carluccio, E.. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 424:(2025). [10.1016/j.ijcard.2025.133039]
Abstract:
Background: Myocardial infarction without obstructive coronary artery disease (MINOCA) is a challenging condition which requires appropriate management and therapy. Although specific guidelines and recommendations for this condition have been introduced, there are few data about management implement...ation over time. The aim of this study is to compare two cohorts of patients affected by suspected MINOCA to assess the temporal trends change in the clinical characteristics and management. Methods: Two patient cohorts were retrospectively selected from a single centre (Cardiology Department of Perugia University Hospital) and compared to investigate the differences in characteristics and management before and after the release of 2018 MINOCA guidelines. The Group included patients enrolled from January 2006 to December 2014, and the Group 2 from July 1st, 2020, to July 31st, 2023. Results: Group 1 included 150 patients and Group 2 83 patients. Compared to group 1, group 2 showed higher prevalence of hypercholesterolemia (57 % vs 27 % p < 0,001), prior acute myocardial infarction (23 % vs 5 %, p <0,001), preserved left ventricular ejection fraction (90 % vs 67 %, p = 0,03), use of cardiovascular magnetic resonance (27 % vs 0 %,p < 0.001), prescription of beta-blockers (69 % vs 31 %,p < 0.001), calcium channel blockers (46 % vs 16 %, p < 0.001), statins (81 % vs 59 %, p = 0.03) and a less frequent occurrence of ST-elevation on admission ECG (9 % vs 24 %, p = 0.005), prescription of dual antiplatelet therapy (20 % vs 58 %, p < 0.001) and nitrates (12 % vs 54 %, p < 0.001). Conclusions: In the present study, characteristics and management of patients with suspected MINOCA has significantly changed over time. However, discrepancies with guidelines recommendation still exist and implementation strategies are needed to fill this gap and improve clinical practice.
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Brugada Syndrome in Sports Cardiology: An Expert Opinion Statement of the Italian Society of Sports Cardiology (SICSport)
Anno: 2025
Rivista: THE AMERICAN JOURNAL OF CARDIOLOGY
Autori/autrici: Scarà, Antonio; Sciarra, Luigi; Russo, Antonio Dello; Cavarretta, Elena; Palamà, Zefferino; Zorzi, Alessandro; Brancati, Francesco; Compagnucci, Paolo; Casella, Michela; Novelli, Valeria; Patrizi, Giampiero; Delise, Pietro
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/356360
Citazioni:
Brugada Syndrome in Sports Cardiology: An Expert Opinion Statement of the Italian Society of Sports Cardiology (SICSport) / Scarà, A., Sciarra, L., Russo, A.D., Cavarretta, E., Palamà, Z., Zorzi, A., Brancati, F., Compagnucci, P., Casella, M., Novelli, V., Patrizi, G., Delise, P.. - In: THE AMERICAN JOURNAL OF CARDIOLOGY. - ISSN 0002-9149. - 244:(2025), pp. 9-17. [10.1016/j.amjcard.2025.02.031]
Abstract:
Brugada syndrome (BrS) is a genetic disorder marked by a characteristic electrocardiogram (ECG) pattern of ST-segment elevation and T-wave inversion in right precordial leads, which is associated with an increased risk of ventricular fibrillation in the absence of structural heart disease. Despite a...dvancements in understanding its epidemiology, pathophysiology, and treatment, there is considerable variability in how sports cardiologists approach BrS. This expert opinion by the Italian Society of Sports Cardiology (SICSPORT) aim to review the current definition, diagnosis, epidemiology, genetics, risk stratification, and treatment of BrS and provide guidance for sport eligibility provides guidance for sports doctors and cardiologists in assessing competitive sports eligibility in athletes with BrS. A multiparametric approach to diagnosis and risk stratification is recommended, noting that the presence of a Brugada ECG pattern (BrP) does not confirm a BrS diagnosis. The risk of sudden cardiac death (SCD) is low in asymptomatic individuals with type 1 BrP, especially those with a drug-induced pattern. Pharmacological testing is not required for type 2 or 3 patterns without other risk factors. Low-risk individuals do not require therapy, while intermediate or high-risk patients may need pharmacological treatment, ICD implantation, or ablation. Asymptomatic individuals with type 2 or 3 BrP, no family history of SCD, and no other risk factors may be eligible for competitive sports, as well as asymptomatic type 1 BrP without risk factors and negative electrophysiological study. Conversely, sports eligibility should be denied in patients with BrS who have a history of syncope or cardiac arrest (high-risk subjects), regardless of ICD presence.
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Serial cardiac magnetic resonance imaging for guidance of therapy management in patients treated with anakinra due to recurrent pericarditis
Anno: 2024
Rivista: EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE
Autori/autrici: Bianco, Francesco; Bucciarelli, Valentina; Coretti, Francesca; Cataldi, Serena; Damadei, Francesca; Raffaelli, Elena; Schicchi, Nicolò; Omenetti, Alessia; Lattanzi, Bianca; Berton, Emanuela; Surace, Francesca Chiara; Baldinelli, Alessandra; Breda, Luciana; Cazzato, Salvatore; Catassi, Carlo; Dello Russo, Antonio; Gallina, Sabina
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/328374
Citazioni:
Serial cardiac magnetic resonance imaging for guidance of therapy management in patients treated with anakinra due to recurrent pericarditis / Bianco, F., Bucciarelli, V., Coretti, F., Cataldi, S., Damadei, F., Raffaelli, E., Schicchi, N., Omenetti, A., Lattanzi, B., Berton, E., Surace, F.C., Baldinelli, A., Breda, L., Cazzato, S., Catassi, C., Dello Russo, A., Gallina, S.. - In: EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE. - ISSN 2755-9637. - 2:1(2024). [10.1093/ehjimp/qyae019]
Abstract:
Aims: To determine the utility of serial cardiac magnetic resonance (CMR) imaging for guidance of therapy management in patients treated with anakinra due to recurrent pericarditis (RP), compared with C-reactive protein (CRP) assay alone. Methods and results: In 2018–21, we enrolled 18 (14.5... ± 1.8 years old, 72% males) consecutive RP patients treated with anakinra (100 mg/day in patients ≥ 18 years old; 2 mg/kg/day < 18 years old) due to RP corticosteroid-dependent or not responsive to colchicine or non-steroidal anti-inflammatory drugs. After hospitalization, they were 1:1 randomized to CMR [no pericardial oedema and/ or late gadolinium enchantment (LGE)] or CRP (<0.6 mg/dL). Tests were repeated every 3 months until negative to halve the anakinra dosage and cessation. The idiopathic aetiology was the most prevalent (n = 8, 44%), followed by post-pericardiotomy (n = 6, 33%). After a median treatment period of 8.7 ± 3.6 months, CRP-guided RP patients experienced more recurrences than CMR-guided ones (6 vs. 1, P = 0.016), with the worst prognosis in terms of recurrences (log-rank, P = 0.025) and significantly increased time of treatment (12.7 ± 2 vs. 16.1 ± 3.4 months, P = 0.019). In a multivariable exploratory Cox regression model, the number of previous recurrences and the idiopathic aetiology were independent predictors of RP during the anakinra treatment. New recurrences were subsequently directed to CMR imaging, and therapy was modified according to the LGE/oedema trend. After 1-year follow-up, no further recurrence was detected. Conclusion Among patients with RP and treated with anakinra, serial CMR imaging of the pericardium can be utilized as an imaging biomarker, more informative for therapy duration than the solely CRP assessment.
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Posterior wall ablation for persistent atrial fibrillation: Very-high-power short-duration versus standard-power radiofrequency ablation
Anno: 2024
Rivista: HEART RHYTHM O2
Autori/autrici: Compagnucci, Paolo; Volpato, Giovanni; Cipolletta, Laura; Parisi, Quintino; Valeri, Yari; Campanelli, Francesca; D'Angelo, Leonardo; Ciliberti, Giuseppe; Stronati, Giulia; Carboni, Laura; Giovagnoni, Andrea; Guerra, Federico; Natale, Andrea; Casella, Michela; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345754
Citazioni:
Posterior wall ablation for persistent atrial fibrillation: Very-high-power short-duration versus standard-power radiofrequency ablation / Compagnucci, P., Volpato, G., Cipolletta, L., Parisi, Q., Valeri, Y., Campanelli, F., D'Angelo, L., Ciliberti, G., Stronati, G., Carboni, L., Giovagnoni, A., Guerra, F., Natale, A., Casella, M., Dello Russo, A.. - In: HEART RHYTHM O2. - ISSN 2666-5018. - 5:6(2024), pp. 374-384. [10.1016/j.hroo.2024.04.011]
Abstract:
Background: Posterior wall ablation (PWA) is commonly added to pulmonary vein isolation (PVI) during catheter ablation (CA) of persistent atrial fibrillation (AF). Objective: The purpose of this study was to compare PVI plus PWA using very-high-power short-duration (vHPSD) vs standard-power (SP) abl...ation index-guided CA among consecutive patients with persistent AF and to determine the voltage correlation between microbipolar and bipolar mapping in AF. Methods: We compared 40 patients undergoing PVI plus PWA using vHPSD to 40 controls receiving PVI plus PWA using SP. The primary efficacy endpoint was recurrence of atrial tachyarrhythmias after a 3-month blanking period. The primary safety outcome was a composite of major complications within 30 days after CA. In the vHPSD group, high-density mapping of the posterior wall was performed using both a multipolar catheter and microelectrodes on the tip of the ablation catheter. Results: PVI was more commonly obtained with vHPSD compared to SP ablation (98%vs 75%; P = .007), despite shorter procedural and fluoroscopy times (P &lt;.001). Survival free from recurrent atrial tachyarrhythmias at 18 months was 68% and 47% in the vHPSD and SP groups, respectively (log-rank P = .071), without major adverse events. The vHPSD approach was significantly associated with reduced risk of recurrent AF at multivariable analysis (hazard ratio 0.39; P = .030). Microbipolar voltage cutoffs of 0.71 and 1.69 mV predicted minimum bipolar values of 0.16 and 0.31 mV in AF, respectively, with accuracies of 0.67 and 0.88. Conclusion: vHPSD PWA plus PVI may be faster and as safe as SP CA among patients with persistent AF, with a trend for superior efficacy. Adapted voltage cutoffs should be used for identifying atrial low-voltage areas with microbipolar mapping.
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Multimodality Imaging for Transcatheter Tricuspid Regurgitation Interventions: Novel Approaches to the Forgotten Valve
Anno: 2024
Rivista: ECHOCARDIOGRAPHY
Autori/autrici: Coraducci, Francesca; Barbarossa, Alessandro; Lofiego, Carla; Vagnarelli, Fabio; Schicchi, Nicolo; Fogante, Marco; Piva, Tommaso; Capestro, Filippo; Casella, Michela; Di Eusanio, Marco; Guerra, Federico; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345757
Citazioni:
Multimodality Imaging for Transcatheter Tricuspid Regurgitation Interventions: Novel Approaches to the Forgotten Valve / Coraducci, F., Barbarossa, A., Lofiego, C., Vagnarelli, F., Schicchi, N., Fogante, M., Piva, T., Capestro, F., Casella, M., Di Eusanio, M., Guerra, F., Dello Russo, A.. - In: ECHOCARDIOGRAPHY. - ISSN 0742-2822. - 41:12(2024). [10.1111/echo.70044]
Abstract:
Tricuspid regurgitation (TR) poses a significant healthcare burden and is a major concern for patients who experience debilitating symptoms and face a poorer prognosis. Cardiologists are showing renewed interest in TR, as the previous belief that it was merely a bystander of left-sided heart disease... has evolved. As a result, more transcatheter techniques addressing TR are emerging. Although a clear impact on mortality from these transcatheter tricuspid valve interventions (TTVI) has not yet been demonstrated, the improvement in symptoms and quality of life for patients is substantial, leading to increased use of these procedures in clinical practice. In this review, we focus on multimodality imaging as an essential tool for quantifying TR severity, assessing right ventricular (RV) function, understanding the underlying mechanisms, selecting the appropriate intervention, and ensuring thorough and accurate preprocedural planning to minimize complications.
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Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024
Anno: 2024
Rivista: MINERVA MEDICA
Autori/autrici: Zeppilli, Paolo; Biffi, Alessandro; Cammarano, Michela; Castelletti, Silvia; Cavarretta, Elena; Cecchi, Franco; Colivicchi, Furio; Contursi, Maurizio; Corrado, Domenico; D'Andrea, Antonello; Deferrari, Francesco; Delise, Pietro; Dello Russo, Antonio; Gabrielli, Domenico; Giada, Franco; Indolfi, Ciro; Maestrini, Viviana; Mascia, Giuseppe; Mos, Lucio; Oliva, Fabrizio; Palamà, Zefferino; Palermi, Stefano; Palmieri, Vincenzo; Patrizi, Giampiero; Pelliccia, Antonio; Perrone Filardi, Pasquale; Porto, Italo; Schwartz, Peter J; Scorcu, Marco; Sollazzo, Fabrizio; Spampinato, Andrea; Verzeletti, Andrea; Zorzi, Alessandro; D'Ascenzi, Flavio; Casasco, Maurizio; Sciarra, Luigi
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/344532
Citazioni:
Italian Cardiological Guidelines (COCIS) for Competitive Sport Eligibility in athletes with heart disease: update 2024 / Zeppilli, P., Biffi, A., Cammarano, M., Castelletti, S., Cavarretta, E., Cecchi, F., Colivicchi, F., Contursi, M., Corrado, D., D'Andrea, A., Deferrari, F., Delise, P., Dello Russo, A., Gabrielli, D., Giada, F., Indolfi, C., Maestrini, V., Mascia, G., Mos, L., Oliva, F., et al.. - In: MINERVA MEDICA. - ISSN 1827-1669. - 115:5(2024), pp. 533-564. [10.23736/S0026-4806.24.09519-3]
Abstract:
Nearly 35 years after its initial publication in 1989, the Italian Society of Sports Cardiology and the Italian Federation of Sports Medicine (FMSI), in collaboration with other leading Italian Cardiological Scientific Associations (ANCE - National Association of Outpatient Cardiology, ANMCO - Natio...nal Association of Inpatient Cardiology, SIC - Italian Society of Cardiology), proudly present the 2023 version of the Cardiological Guidelines for Competitive Sports Eligibility. This publication is an update of the previous guidelines, offering a comprehensive and detailed guide for the participation of athletes with heart disease in sports. This edition incorporates the latest advances in cardiology and sports medicine, providing current information and recommendations. It addresses various topics, including the details of the pre-participation screening in Italy and recommendations for sports eligibility and disqualification in competitive athletes with various heart conditions. This revised version of the Cardiological Guidelines for Competitive Sports Eligibility, recorded in the Italian Guidelines Registry of the Italian Minister of Health, stands as a crucial resource for sports medicine professionals, cardiologists, and healthcare providers, marked by its completeness, reliability, and scientific thoroughness. It is an indispensable tool for those involved in the care, management and eligibility process of competitive athletes with heart conditions.
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Impact of ventricular tachycardia ablation in subcutaneous implantable cardioverter defibrillator carriers: a multicentre, international analysis from the iSUSI project
Anno: 2024
Rivista: EUROPACE
Autori/autrici: Schiavone, Marco; Gasperetti, Alessio; Compagnucci, Paolo; Vogler, Julia; Laredo, Mikael; Montemerlo, Elisabetta; Gulletta, Simone; Breitenstein, Alexander; Ziacchi, Matteo; Martinek, Martin; Casella, Michela; Palmisano, Pietro; Kaiser, Lukas; Lavalle, Carlo; Calò, Leonardo; Seidl, Sebastian; Saguner, Ardan M; Rovaris, Giovanni; Kuschyk, Jürgen; Biffi, Mauro; Di Biase, Luigi; Dello Russo, Antonio; Tondo, Claudio; Della Bella, Paolo; Tilz, Roland; Forleo, Giovanni B; Null, Null; Schiavone, M; Gasperetti, A; Arosio, R; Viecca, M; Forleo, G B; Ziacchi, M; Diemberger, I; Angeletti, A; Biffi, M; Fierro, N; Gulletta, S; Della Bella, P; Tondo, C; Mitacchione, G; Curnis, A; Compagnucci, P; Casella, M; Dello Russo, A; Santini, L; Pignalberi, C; Magnocavallo, M; Piro, A; Lavalle, C; Picarelli, F; Ricciardi, D; Bressi, E; Calò, L; Montemerlo, E; Rovaris, G; De Bonis, S; Bisignani, A; Bisignani, G; Russo, G; Pisanò, E; Palmisano, P; Guarracini, F; Vitali, F; Bertini, M; Vogler, J; Fink, T; Tilz, R; Fastenrath, F; Kuschyk, J; Kaiser, L; Hakmi, S; Laredo, M; Waintraub, X; Gandjbakhch, E; Badenco, N; Breitenstein, A; Saguner, A M; Martine, M; Seidl, S; Di Biase, L
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345758
Citazioni:
Impact of ventricular tachycardia ablation in subcutaneous implantable cardioverter defibrillator carriers: a multicentre, international analysis from the iSUSI project / Schiavone, M., Gasperetti, A., Compagnucci, P., Vogler, J., Laredo, M., Montemerlo, E., Gulletta, S., Breitenstein, A., Ziacchi, M., Martinek, M., Casella, M., Palmisano, P., Kaiser, L., Lavalle, C., Calò, L., Seidl, S., Saguner, A.M., Rovaris, G., Kuschyk, J., Biffi, M., et al.. - In: EUROPACE. - ISSN 1099-5129. - 26:4(2024). [10.1093/europace/euae066]
Abstract:
Aims Catheter ablation (CA) of ventricular tachycardia (VT) has become an important tool to improve clinical outcomes in patients with appropriate transvenous implantable cardioverter defibrillator (ICD) shocks. The aim of our analysis was to test whether VT ablation (VTA) impacts long-term clinical... outcomes even in subcutaneous ICD (S-ICD) carriers Methods International Subcutaneous Implantable Cardioverter Defibrillator (iSUSI) registry patients who experienced either an ICD and results shock or a hospitalization for monomorphic VT were included in this analysis. Based on an eventual VTA after the index event, patients were divided into VTA+ vs. VTA− cohorts. Primary outcome of the study was the occurrence of a combination of device-related appropriate shocks, monomorphic VTs, and cardiovascular mortality. Secondary outcomes were addressed individually. Among n = 1661 iSUSI patients, n = 211 were included: n = 177 experiencing ICD shocks and n = 34 hospitalized for VT. No significant differences in baseline characteristics were observed. Both the crude and the yearly event rate of the primary outcome (5/59 and 3.8% yearly event rate VTA+ vs. 41/152 and 16.4% yearly event rate in the VTA−; log-rank: P value = 0.0013) and the cardiovascular mortality (1/59 and 0.7% yearly event rate VTA+ vs. 13/152 and 4.7% yearly event rate VTA−; log-rank P = 0.043) were significantly lower in the VTA + cohort. At multivariate analysis, VTA was the only variable remaining associated with a lower incidence of the primary outcome [adjusted hazard ratio 0.262 (0.100–0.681), P = 0.006]. Conclusion In a real-world registry of S-ICD carriers, the combined study endpoint of arrhythmic events and cardiovascular mortality was lower in the patient cohort undergoing VTA at long-term follow-up.
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Idiopathic Premature Ventricular Contraction Catheter Ablation, Sedentary Population vs. Athlete’s Populations: Outcomes and Resumption of Sports Activity
Anno: 2024
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Valeri, Yari; Compagnucci, Paolo; Volpato, Giovanni; Luciani, Lara; Crepaldi, Eleonora; Maiorino, Francesco; Parisi, Quintino; Cipolletta, Laura; Campanelli, Francesca; D'Angelo, Leonardo; Gaggiotti, Gemma; Gasperetti, Alessio; Giovagnoni, Andrea; Curcio, Antonio; Dello Russo, Antonio; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345760
Citazioni:
Idiopathic Premature Ventricular Contraction Catheter Ablation, Sedentary Population vs. Athlete’s Populations: Outcomes and Resumption of Sports Activity / Valeri, Y., Compagnucci, P., Volpato, G., Luciani, L., Crepaldi, E., Maiorino, F., Parisi, Q., Cipolletta, L., Campanelli, F., D'Angelo, L., Gaggiotti, G., Gasperetti, A., Giovagnoni, A., Curcio, A., Dello Russo, A., Casella, M.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:7(2024). [10.3390/jcm13071871]
Abstract:
There are no investigations about the outcomes of idiopathic PVC catheter ablation (CA) in athletes compared to the sedentary population. We conducted a prospective single-centre observational study. The primary and secondary procedural outcomes were the post-ablation reduction of premature ventricu...lar contractions (PVCs) in an athletes vs. non-athletes group and in agonist vs. leisure-time athletes. The third was the evaluation of the resumption of physical activity and the improvement of symptoms in agonist and leisure-time athletes. From January 2020 to October 2022 we enrolled 79 patients with RVOT/LVOT/fascicular PVC presumed origin. The median percentage of decrease between the pre-procedure and post-procedure Holter monitoring in the non-athletes group was 96 (IQR 68–98) and 98 in the athletes group (IQR 92–99) (p = 0.08). Considering the athletes, the median percentage of decrease in the number of PVCs was 98 (IQR 93–99) and 98 (IQR 87–99), respectively, in leisure-time and agonistic athletes (p = 0.42). Sixteen (70%) leisure time and seventeen (90%) agonist athletes (p = 0.24) have resumed physical activity 3 months after PVC CA; among agonistic athletes, 59% have resumed competitive physical activity. Many leisure-time (88%) and agonist (70%) athletes experienced an improvement in symptoms after ablation. PVC CA was effective and safe in both groups, reducing symptoms and allowing a quick and safe return to sports activities in athletes.
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Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still "Enemies"?
Anno: 2024
Rivista: MEDICINA
Autori/autrici: Fogante, Marco; Volpato, Giovanni; Esposto Pirani, Paolo; Cela, Fatjon; Compagnucci, Paolo; Valeri, Yari; Selimi, Adelina; Alfieri, Michele; Brugiatelli, Leonardo; Belleggia, Sara; Coraducci, Francesca; Argalia, Giulio; Casella, Michela; Dello Russo, Antonio; Schicchi, Nicolò
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/344672
Citazioni:
Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still "Enemies"? / Fogante, M., Volpato, G., Esposto Pirani, P., Cela, F., Compagnucci, P., Valeri, Y., Selimi, A., Alfieri, M., Brugiatelli, L., Belleggia, S., Coraducci, F., Argalia, G., Casella, M., Dello Russo, A., Schicchi, N.. - In: MEDICINA. - ISSN 1648-9144. - 60:4(2024). [10.3390/medicina60040522]
Abstract:
The application of cardiac magnetic resonance (CMR) imaging in clinical practice has grown due to technological advancements and expanded clinical indications, highlighting its superior capabilities when compared to echocardiography for the assessment of myocardial tissue. Similarly, the utilization... of implantable cardiac electronic devices (CIEDs) has significantly increased in cardiac arrhythmia management, and the requirements of CMR examinations in patients with CIEDs has become more common. However, this type of exam often presents challenges due to safety concerns and image artifacts. Until a few years ago, the presence of CIED was considered an absolute contraindication to CMR. To address these challenges, various technical improvements in CIED technology, like the reduction of the ferromagnetic components, and in CMR examinations, such as the introduction of new sequences, have been developed. Moreover, a rigorous protocol involving multidisciplinary collaboration is recommended for safe CMR examinations in patients with CIEDs, emphasizing risk assessment, careful monitoring during CMR, and post-scan device evaluation. Alternative methods to CMR, such as computed tomography coronary angiography with tissue characterization techniques like dual-energy and photon-counting, offer alternative potential solutions, although their diagnostic accuracy and availability do limit their use. Despite technological advancements, close collaboration and specialized staff training remain crucial for obtaining safe diagnostic CMR images in patients with CIEDs, thus justifying the presence of specialized centers that are equipped to handle these type of exams.
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Direct Epicardial Validation of Posterior Wall Electroporation in Persistent Atrial Fibrillation
Anno: 2024
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Solimene, Francesco; Compagnucci, Paolo; Tondo, Claudio; La Fazia, Vincenzo Mirco; Schillaci, Vincenzo; Mohanty, Sanghamitra; Cipolletta, Laura; Fassini, Gaetano Michele; Chiariello, Paola; Mottola, Gaetano; Schiavone, Marco; Casella, Michela; Dello Russo, Antonio; Natale, Andrea
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/344655
Citazioni:
Direct Epicardial Validation of Posterior Wall Electroporation in Persistent Atrial Fibrillation / Solimene, F., Compagnucci, P., Tondo, C., La Fazia, V.M., Schillaci, V., Mohanty, S., Cipolletta, L., Fassini, G.M., Chiariello, P., Mottola, G., Schiavone, M., Casella, M., Dello Russo, A., Natale, A.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 10:6(2024), pp. 1200-1202. [10.1016/j.jacep.2024.04.003]

Arrhythmic Mitral Valve Prolapse and Sports Activity: Pathophysiology, Risk Stratification, and Sports Eligibility Assessment
Anno: 2024
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Compagnucci, Paolo; Selimi, Adelina; Cipolletta, Laura; Volpato, Giovanni; Gasperetti, Alessio; Valeri, Yari; Parisi, Quintino; Curcio, Antonio; Natale, Andrea; Dello Russo, Antonio; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/344656
Citazioni:
Arrhythmic Mitral Valve Prolapse and Sports Activity: Pathophysiology, Risk Stratification, and Sports Eligibility Assessment / Compagnucci, P., Selimi, A., Cipolletta, L., Volpato, G., Gasperetti, A., Valeri, Y., Parisi, Q., Curcio, A., Natale, A., Dello Russo, A., Casella, M.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 13:5(2024). [10.3390/jcm13051350]
Abstract:
Although mitral valve prolapse (MVP) is the most prevalent valvular abnormality in Western countries and generally carries a good prognosis, a small subset of patients is exposed to a significant risk of malignant ventricular arrhythmias (VAs) and sudden cardiac death (SCD), the so-called arrhythmic... MVP (AMVP) syndrome. Recent work has emphasized phenotypical risk features of severe AMVP and clarified its pathophysiology. However, the appropriate assessment and risk stratification of patients with suspected AMVP remains a clinical conundrum, with the possibility of both overestimating and underestimating the risk of malignant VAs, with the inappropriate use of advanced imaging and invasive electrophysiology study on one hand, and the catastrophic occurrence of SCD on the other. Furthermore, the sports eligibility assessment of athletes with AMVP remains ill defined, especially in the grey zone of intermediate arrhythmic risk. The definition, epidemiology, pathophysiology, risk stratification, and treatment of AMVP are covered in the present review. Considering recent guidelines and expert consensus statements, we propose a comprehensive pathway to facilitate appropriate counseling concerning the practice of competitive/leisure-time sports, envisioning shared decision making and the multidisciplinary “sports heart team” evaluation of borderline cases. Our final aim is to encourage an active lifestyle without compromising patients’ safety.
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Characteristics and Clinical Value of Electroanatomic Voltage Mapping in Cardiac Amyloidosis
Anno: 2024
Rivista: CANADIAN JOURNAL OF CARDIOLOGY
Autori/autrici: Casella, Michela; Compagnucci, Paolo; Ciliberti, Giuseppe; Falanga, Umberto; Barbarossa, Alessandro; Valeri, Yari; Cipolletta, Laura; Volpato, Giovanni; Stronati, Giulia; Rizzo, Stefania; De Gaspari, Monica; Vagnarelli, Fabio; Lofiego, Carla; Perna, Gian Piero; Giovagnoni, Andrea; Natale, Andrea; Basso, Cristina; Guerra, Federico; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327544
Citazioni:
Characteristics and Clinical Value of Electroanatomic Voltage Mapping in Cardiac Amyloidosis / Casella, M., Compagnucci, P., Ciliberti, G., Falanga, U., Barbarossa, A., Valeri, Y., Cipolletta, L., Volpato, G., Stronati, G., Rizzo, S., De Gaspari, M., Vagnarelli, F., Lofiego, C., Perna, G.P., Giovagnoni, A., Natale, A., Basso, C., Guerra, F., Dello Russo, A.. - In: CANADIAN JOURNAL OF CARDIOLOGY. - ISSN 0828-282X. - 40:3(2024), pp. 372-384. [10.1016/j.cjca.2023.10.022]
Abstract:
Background: Cardiac amyloidoses (CAs) are an increasingly recognised group of infiltrative cardiomyopathies associated with high risk of adverse cardiac events. We sought to characterise the characteristics and clinical value of right ventricular (RV) electroanatomic voltage mapping (EVM) in CA. Met...hods: Fifteen consecutive patients undergoing endomyocardial biopsy (EMB) for suspected CA (median age 75 years, 1st-3rd quartiles 64-78 years], 67% male) were enrolled in an observational prospective study. Each patient underwent RV high-density EVM using a multipolar catheter and EMB. The primary outcome was death or heart failure hospitalisation at 1-year follow-up. We recorded electrographic features at EMB sampling sites and electroanatomic data in the overall RV, and explored their correlations with histopathologic findings and primary outcomes events. Results: A final EMB-proven diagnosis of immunoglobulin light chain or transthyretin CA was formulated in 6 and 9 patients, respectively. Electrogram amplitudes in the bipolar and unipolar configurations averaged 1.55 ± 0.44 mV and 5.14 ± 1.50 mV, respectively, in the overall RV, with lower values in AL CA patients. We found a significant inverse correlation between both bipolar and unipolar electrogram amplitude and amyloid burden according to EMB (P = 0.001 and P = 0.025, respectively). At 1-year follow-up, 7 patients (47%) experienced a primary outcome event; the extent of bipolar dense scar area at RV EVM was an independent predictor of primary outcome events at multivariable analysis (odds ratio 2.40; P = 0.037). Conclusions: In CA, electrogram amplitudes are around the lower limit of normal yet disproportionately low compared with the increased wall thickness. Out data suggest that RV electrogram amplitude may be a quantitative marker of amyloid burden, and that RV EVM may have prognostic value.
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Speckle-tracking global longitudinal strain predicts death and cardiovascular events in patients with systemic sclerosis
Anno: 2024
Rivista: EUROPEAN HEART JOURNAL OPEN
Autori/autrici: Stronati, Giulia; Guerra, Federico; Benfaremo, Devis; Dichiara, Cristina; Paolini, Federico; Bastianoni, Gianmarco; Brugiatelli, Leonardo; Alfieri, Michele; Compagnucci, Paolo; Dello Russo, Antonio; Moroncini, Gianluca
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/330170
Citazioni:
Speckle-tracking global longitudinal strain predicts death and cardiovascular events in patients with systemic sclerosis / Stronati, G., Guerra, F., Benfaremo, D., Dichiara, C., Paolini, F., Bastianoni, G., Brugiatelli, L., Alfieri, M., Compagnucci, P., Dello Russo, A., Moroncini, G.. - In: EUROPEAN HEART JOURNAL OPEN. - ISSN 2752-4191. - 4:2(2024). [10.1093/ehjopen/oeae023]
Abstract:
Aims: Albeit often asymptomatic, heart involvement in systemic sclerosis (SSc) represents a negative prognostic factor, accounting for nearly one-fourth of all deaths. Global longitudinal strain (GLS) is accurate in detecting heart involvement in patients with SSc and no overt cardiac disease and al...lows early detection and longitudinal monitoring, but its association with clinical endpoints has not been tested so far. The primary outcome was the association between left and right GLS and mortality for all causes. The secondary outcome was the association between left and right GLS and hospitalizations. Methods and results: A prospective longitudinal study enrolling all consecutive patients with SSc without structural heart disease or previous cardiovascular event.A total of 164 patients were enrolled, of whom 19 (11.5%) died during follow-up and 48 (29.3%) were hospitalized. Both left (LV) and right ventricle (RV) GLS at enrolment were independently associated with an increased risk of death for all causes and hospitalizations. Patients with biventricular GLS impairment, respectively, had a 4.2-, 4.9-, and 13.9-fold increased risk of death when compared with patients with only LV, only RV, or no impairment (P < 0.001). The incidence of hospitalization in patients with biventricular GLS impairment was nearly four times higher when compared with patients with only LV or only RV impairment, and nine times higher when compared with normal biventricular GLS (P < 0.001). Conclusion: Biventricular GLS is associated with an increased risk of death and hospitalization in patients with SSc during a median of 3-year follow-up, acting as a reliable and accurate prognostic tool in everyday practice.
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Acute Kidney Injury Resulting From Hemoglobinuria After Pulsed-Field Ablation in Atrial Fibrillation: Is it Preventable?
Anno: 2024
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Mohanty, Sanghamitra; Casella, Michela; Compagnucci, Paolo; Torlapati, Prem Geeta; Della Rocca, Domenico Giovanni; La Fazia, Vincenzo Mirco; Gianni, Carola; Chierchia, Gian-Battista; Macdonald, Bryan; Mayedo, Angel; Khan, Umer N.; Allison, John; Bassiouny, Mohamed; Gallinghouse, G. Joseph; Burkhardt, John D.; Horton, Rodney; Al-Ahmad, Amin; Di Biase, Luigi; de Asmundis, Carlo; Russo, Antonio Dello; Natale, Andrea
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327553
Citazioni:
Acute Kidney Injury Resulting From Hemoglobinuria After Pulsed-Field Ablation in Atrial Fibrillation: Is it Preventable? / Mohanty, S., Casella, M., Compagnucci, P., Torlapati, P.G., Della Rocca, D.G., La Fazia, V.M., Gianni, C., Chierchia, G., Macdonald, B., Mayedo, A., Khan, U.N., Allison, J., Bassiouny, M., Gallinghouse, G.J., Burkhardt, J.D., Horton, R., Al-Ahmad, A., Di Biase, L., de Asmundis, C., Russo, A.D., et al.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 10:4(2024), pp. 709-715. [10.1016/j.jacep.2023.12.008]
Abstract:
Background: High-voltage pulses can cause hemolysis. Objectives: The authors evaluated the occurrence of hemoglobinuria after pulsed-field ablation (PFA) and its impact on renal function in patients with atrial fibrillation (AF). Methods: A consecutive series of patients with AF undergoing PFA were ...included in this analysis. The initial patients who did not receive postablation hydration immediately after the procedure were classified as group 1 (n = 28), and the rest of the study patients who received planned fluid infusion (0.9% sodium chloride ≥2 L) after the procedure were categorized as group 2 (n = 75). Results: Of the 28 patients in group 1, 21 (75%) experienced hemoglobinuria during the 24 hours after catheter ablation. The mean postablation serum creatinine (S-Cr) was significantly higher than the baseline value in those 21 patients (1.46 ± 0.28 mg/dL vs 0.86 ± 0.24 mg/dL, P < 0.001). Of those 21 patients, 4 (19%) had S-Cr. >2.5 mg/dL (mean: 2.95 ± 0.21 mg/dL). The mean number of PF applications was significantly higher in those 4 patients than in the other 17 patients experiencing hemoglobinuria (94.63 ± 3.20 vs 46.75 ± 9.10, P < 0.001). In group 2 patients, no significant changes in S-Cr were noted. The group 2 patients received significantly higher amounts of fluid infusion after catheter ablation than did those in group 1 (2,082.50 ± 258.08 mL vs 494.01 ± 71.65 mL, P < 0.001). In multivariable analysis, both hydration (R2 = 0.63, P < 0.01) and number of PFA applications (R2 = 0.33, P < 0.01) were independent predictors of postprocedure acute kidney injury. Conclusions: On the basis of our findings, both the number of PFA applications and postablation hydration were independent predictors of renal insult that could be prevented using planned fluid infusion immediately after the procedure.
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Differentiating sensor changes in a composite heart failure ICD monitoring index: clinical correlates and implications
Anno: 2024
Rivista: HEART RHYTHM
Autori/autrici: Compagnucci, Paolo; Santobuono, Vincenzo Ezio; D'Onofrio, Antonio; Vitulano, Gennaro; Calò, Leonardo; Bertini, Matteo; Santini, Luca; Savarese, Gianluca; Lavalle, Carlo; Viscusi, Miguel; Giammaria, Massimo; Pecora, Domenico; Calvanese, Raimondo; Santoro, Amato; Ziacchi, Matteo; Casella, Michela; Averina, Viktoria; Campari, Monica; Valsecchi, Sergio; Capucci, Alessandro; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345759
Citazioni:
Differentiating sensor changes in a composite heart failure ICD monitoring index: clinical correlates and implications / Compagnucci, P., Santobuono, V.E., D'Onofrio, A., Vitulano, G., Calò, L., Bertini, M., Santini, L., Savarese, G., Lavalle, C., Viscusi, M., Giammaria, M., Pecora, D., Calvanese, R., Santoro, A., Ziacchi, M., Casella, M., Averina, V., Campari, M., Valsecchi, S., Capucci, A., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - (2024). [10.1016/j.hrthm.2024.10.021]
Abstract:
Background: The HeartLogic algorithm (Boston Scientific, St Paul, MN) integrates data from implantable cardioverter-defibrillator (ICD) sensors to predict heart failure (HF) decompensation: first (S1) and third (S3) heart sounds, intrathoracic impedance, respiration rate, ratio of respiration rate t...o tidal volume (RSBI), and night heart rate. Objective: This study assessed the relative changes in ICD sensors at the onset of HeartLogic alerts, their association with patient characteristics, and outcomes. Methods: The study included 568 patients with HF carrying ICDs (CRT-D, n = 410) across 26 centers, with a median follow-up of 26 months. HeartLogic alerts triggered patient contact and potential treatment. Results: A total of 1200 HeartLogic alerts were recorded in 370 patients. The sensor with the highest change at the alert's onset was S3 in 27% of alerts, followed by S3/S1 (25%). Patients with atrial fibrillation (AF) and chronic kidney disease (CKD) at implantation had higher prevalence of alerts (AF, 84% vs no AF, 58%; CKD, 72% vs no CKD, 59%; P &lt; .05) and rate (AF, 1.51 per patient-year vs no AF, 0.88 per patient-year; CKD, 1.30 per patient-year vs no CKD, 0.89 per patient-year; P &lt; .05). During follow-up, 247 patients experienced more than 1 alert; in 85%, the sensor with the highest change varied between successive alerts. Of the 88 (7%) alerts associated with HF hospitalization or death, respiration rate or RSBI (11%, P = .007 vs S3/S1) and night heart rate (11%, P = .031 vs S3/S1) were more commonly the sensors showing the highest change. Clinical events were more common with the first alert (12.6%) than subsequent alerts (5.2%, P &lt; .001). Conclusion: HeartLogic alerts are mostly triggered by changes in heart sounds, but clinical events are more linked to respiration rate, RSBI, and night heart rate. Recurrent alerts often involve different sensors, indicating diverse mechanisms of HF progression.
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An idiopathic floating ascending aorta thrombus in a triple rule-in CT
Anno: 2024
Rivista: EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING
Autori/autrici: Barbarossa, Alessandro; Finori, Luca; Berretta, Paolo; Dello Russo, Antonio; Di Eusanio, Marco
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/331679
Citazioni:
An idiopathic floating ascending aorta thrombus in a triple rule-in CT / Barbarossa, A., Finori, L., Berretta, P., Dello Russo, A., Di Eusanio, M.. - In: EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING. - ISSN 2047-2404. - 25:9(2024), pp. e204-e204. [10.1093/ehjci/jeae087]

Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe
Anno: 2024
Rivista: EUROPEAN HEART JOURNAL
Autori/autrici: Carrick, Richard T; De Marco, Corrado; Gasperetti, Alessio; Bosman, Laurens P; Gourraud, Jean-Baptiste; Trancuccio, Alessandro; Mazzanti, Andrea; Murray, Brittney; Pendleton, Catherine; Tichnell, Crystal; Tandri, Harikrishna; Zeppenfeld, Katja; Wilde, Arthur A M; Davies, Brianna; Seifer, Colette; Roberts, Jason D; Healey, Jeff S; Macintyre, Ciorsti; Alqarawi, Wael; Tadros, Rafik; Cutler, Michael J; Targetti, Mattia; Calò, Leonardo; Vitali, Francesco; Bertini, Matteo; Compagnucci, Paolo; Casella, Michela; Dello Russo, Antonio; Cappelletto, Chiara; De Luca, Antonio; Stolfo, Davide; Duru, Firat; Jensen, Henrik K; Svensson, Anneli; Dahlberg, Pia; Hasselberg, Nina E; Di Marco, Andrea; Jordà, Paloma; Arbelo, Elena; Moreno Weidmann, Zoraida; Borowiec, Karolina; Delinière, Antoine; Biernacka, Elżbieta K; van Tintelen, J Peter; Platonov, Pyotr G; Olivotto, Iacopo; Saguner, Ardan M; Haugaa, Kristina H; Cox, Moniek; Tondo, Claudio; Merlo, Marco; Krahn, Andrew D; te Riele, Anneline S J M; Wu, Katherine C; Calkins, Hugh; James, Cynthia A; Cadrin-Tourigny, Julia
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327549
Citazioni:
Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe / Carrick, R.T., De Marco, C., Gasperetti, A., Bosman, L.P., Gourraud, J., Trancuccio, A., Mazzanti, A., Murray, B., Pendleton, C., Tichnell, C., Tandri, H., Zeppenfeld, K., Wilde, A.A.M., Davies, B., Seifer, C., Roberts, J.D., Healey, J.S., Macintyre, C., Alqarawi, W., Tadros, R., et al.. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 45:7(2024), pp. 538-548. [10.1093/eurheartj/ehad799]
Abstract:
Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free f...rom sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs.
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National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety
Anno: 2024
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Bisignani, Antonio; Schiavone, Marco; Solimene, Francesco; Dello Russo, Antonio; Filannino, Pasquale; Magnocavallo, Michele; Tondo, Claudio; Schillaci, Vincenzo; Casella, Michela; Petretta, Andrea; Rossi, Pietro; Fassini, Gaetano; Rossillo, Antonio; Maggio, Ruggero; Themistoclakis, Sakis; Pandozi, Claudio; Polselli, Marco; Tundo, Fabrizio; Arestia, Alberto; Compagnucci, Paolo; Valente Perrone, Annelisa; Malacrida, Maurizio; Iacopino, Saverio; Bianchi, Stefano
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/344617
Citazioni:
National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety / Bisignani, A., Schiavone, M., Solimene, F., Dello Russo, A., Filannino, P., Magnocavallo, M., Tondo, C., Schillaci, V., Casella, M., Petretta, A., Rossi, P., Fassini, G., Rossillo, A., Maggio, R., Themistoclakis, S., Pandozi, C., Polselli, M., Tundo, F., Arestia, A., Compagnucci, P., et al.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - 67:9(2024), pp. 2127-2136. [10.1007/s10840-024-01835-6]
Abstract:
Background: Recent data on pulsed field ablation (PFA) for atrial fibrillation (AF) ablation suggest a progressive reduction in procedural times. Real-world data regarding the relationship between the learning curve of PFA and clinical outcomes are scarce. The objective was to evaluate the PFA learn...ing curve and its impact on acute outcomes. Methods: Consecutive patients undergoing AF ablation with the FARAPULSE™ PFA system were included in a prospective, non-randomized multicenter study. Procedural times were stratified on the operators’ learning curve. Comparative analysis of skin-to-skin time was conducted with radiofrequency (RF) and cryoablation (CB) pulmonary vein isolation (PVI) procedures performed by the same operators in the previous year. Results: Among 752 patients, 35.1% were females, and 66.9% had paroxysmal AF; mean age was 62.2 ± 10 years. A total of 62.5% of procedures were performed by operators with &gt; 20 PFA procedures. Both time to PVI (25.6 ± 10 min vs 16.5 ± 8, p &lt; 0.0001) and fluoroscopy time (19.8 ± 8 min vs 15.9 ± 8 min, p = 0.0045) significantly improved after 10 associated with consistent linear trend towards procedural time reduction (R2 0.92–0.68 across various procedural metrics). Current PFA skin-to-skin time was lower than the historical skin-to-skin one in 217 (62.4%) procedures; it was similar in 112 (32.2%) cases and higher than the historical skin-to-skin one in 19 (5.5%). No major complications were reported. Conclusions: In this nationwide multicentric experience, the novel PFA system proved to be fast, safe, and acutely effective in both paroxysmal and persistent AF patients. The learning curve appears to be rapid, as improvements in procedural parameters were observed after only a few procedures. Clinical Trial Registration: Advanced TecHnologies For SuccEssful AblatioN of AF in Clinical Practice (ATHENA). URL: http://clinicaltrials.gov/ Identifier: NCT05617456
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Forensic perspectives on postmortem CIED interrogation: A systematic review and meta-analysis
Anno: 2024
Rivista: FORENSIC SCIENCE INTERNATIONAL
Autori/autrici: Fede, M. S.; Compagnucci, P.; Montana, A.; Dello Russo, Antonio.; Giorgetti, Raffaele; Busardo, F. P.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348874
Citazioni:
Forensic perspectives on postmortem CIED interrogation: A systematic review and meta-analysis / Fede, M.S., Compagnucci, P., Montana, A., Dello Russo, Antonio., Giorgetti, R., Busardo, F.P.. - In: FORENSIC SCIENCE INTERNATIONAL. - ISSN 0379-0738. - 359:(2024). [10.1016/j.forsciint.2024.112001]
Abstract:
Background: Cardiac implantable electronic devices (CIED) are a heterogeneous group of medical devices with increasingly sophisticated diagnostic capabilities, which could be exploited in forensic investigations. However, current guidelines are lacking clear recommendations on the topic. The first a...im of this systematic review is to provide an updated assessment of the role of postmortem CIED interrogation, and to give practical recommendations, which can be used in daily practice. Secondly, the authors aim to determine the rates of postmortem CIED interrogation and autopsy investigations, the type of final rhythm detected close to death (with a focus on the significance of documented arrhythmias), as well as the role of postmortem CIED interrogation in the determination of final cause/time of death, and any potentially fatal device malfunctions. Methods: A systematic search in MEDLINE and Scopus aiming to identify reports concerning postmortem human CIED interrogation was performed, including a systematic screening of reference lists. Case reports, letters to the editors, commentaries, review articles or guidelines were excluded, along with studies related to cardiac devices other than CIED. All data were pooled and analyzed using fixed-effects meta-analysis models, and the I2 statistic was used to assess heterogeneity. Results: A total of 25 articles were included in the systematic review, enrolling 3194 decedent CIED carriers. Ten studies (40%) had a 100% autopsy rate, whereas in further 6 studies autopsy findings were variably reported; CIED interrogation was available from 22 studies (88%), and it was never performed prior to autopsy. The overall rate of successful postmortem CIED interrogation was 89%, with high heterogeneity among studies, mainly due to device deactivation/battery discharge. Twenty-four percent of CIED carriers experienced sudden cardiac death (SCD), whereas non-sudden cardiac and non-cardiac death (NSCD, NCD) were reported in 37% and 30% of decedents, respectively. Ventricular tachyarrhythmias were recorded in 34% of overall successfully interrogated CIED, and in 62% of decedents who experienced a SCD; of all ventricular tachyarrhythmias recorded, 40% was found in NSCD or NCD. A clear interpretation of the etiological role of recorded arrhythmias in the causation of death required integration with autopsy findings. Overall, potentially fatal device malfunctions were detected in 12% of cases. Conclusions: Postmortem CIED interrogation is a valuable tool for the determination of the cause of death, and may complement autopsy. Forensic pathologists need to know the potential utility, pitfalls, and limitations of this diagnostic examination to make this tool as much reliable as possible.
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Pulsed-field ablation of atrial fibrillation: kinetics of release of multiple cardiac biomarkers
Anno: 2024
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Casella, Michela; Compagnucci, Paolo; Malacrida, Maurizio; Cipolletta, Laura; Parisi, Quintino; Valeri, Yari; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327548
Citazioni:
Pulsed-field ablation of atrial fibrillation: kinetics of release of multiple cardiac biomarkers / Casella, M., Compagnucci, P., Malacrida, M., Cipolletta, L., Parisi, Q., Valeri, Y., Dello Russo, A.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - 67:6(2024), pp. 1315-1317. [10.1007/s10840-023-01733-3]

Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study
Anno: 2024
Rivista: NATURE MEDICINE
Autori/autrici: Ekanem, E; Neuzil, P; Reichlin, T; Kautzner, J; Van Der Voort, P; Jais, P; Chierchia, Gb; Bulava, A; Blaauw, Y; Skala, T; Fiala, M; Duytschaever, M; Szeplaki, G; Schmidt, B; Massoullie, G; Neven, K; Thomas, O; Vijgen, J; Gandjbakhch, E; Scherr, D; Johannessen, A; Keane, D; Boveda, S; Maury, P; García-Bolao, I; Anic, A; Hansen, Ps; Raczka, F; Lepillier, A; Guyomar, Y; Gupta, D; Van Opstal, J; Defaye, P; Sticherling, C; Sommer, P; Kucera, P; Osca, J; Tabrizi, F; Roux, A; Gramlich, M; Bianchi, S; Adragão, P; Solimene, F; Tondo, C; Dello Russo, A; Schreieck, J; Luik, A; Rana, O; Frommeyer, G; Anselme, F; Kreis, I; Rosso, R; Metzner, A; Geller, L; Baldinger, Sh; Ferrero, A; Willems, S; Goette, A; Mellor, G; Mathew, S; Szumowski, L; Tilz, R; Iacopino, S; Jacobsen, Pk; George, A; Osmancik, P; Spitzer, S; Balasubramaniam, R; Parwani, As; Deneke, T; Glowniak, A; Rossillo, A; Pürerfellner, H; Duncker, D; Reil, P; Arentz, T; Steven, D; Olalla, Jj; De Jong, Jssg; Wakili, R; Abbey, S; Timo, G; Asso, A; Wong, T; Pierre, B; Ewertsen, Nc; Bergau, L; Lozano-Granero, C; Rivero, M; Breitenstein, A; Inkovaara, J; Fareh, S; Latcu, Dg; Linz, D; Müller, P; Ramos-Maqueda, J; Beiert, T; Themistoclakis, S; Meininghaus, Dg; Stix, G; Tzeis, S; Baran, J; Almroth, H; Munoz, Dr; De Sousa, J; Efremidis, M; Balsam, P; Petru, J; Küffer, T; Peichl, P; Dekker, L; Della Rocca, Dg; Moravec, O; Funasako, M; Knecht, S; Jauvert, G; Chun, J; Eschalier, R; Füting, A; Zhao, A; Koopman, P; Laredo, M; Manninger, M; Hansen, J; O'Hare, D; Rollin, A; Jurisic, Z; Fink, T; Chaumont, C; Rillig, A; Gunawerdene, M; Martin, C; Kirstein, B; Nentwich, K; Lehrmann, H; Sultan, A; Bohnen, J; Turagam, Mk; Reddy, Vy
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/348956
Citazioni:
Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study / Ekanem, E., Neuzil, P., Reichlin, T., Kautzner, J., Van Der Voort, P., Jais, P., Chierchia, G.b., Bulava, A., Blaauw, Y., Skala, T., Fiala, M., Duytschaever, M., Szeplaki, G., Schmidt, B., Massoullie, G., Neven, K., Thomas, O., Vijgen, J., Gandjbakhch, E., Scherr, D., et al.. - In: NATURE MEDICINE. - ISSN 1078-8956. - 30:7(2024), pp. 2020-2029. [10.1038/s41591-024-03114-3]
Abstract:
Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K stu...dy we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.
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Oral Anticoagulation and Factor VIII Replacement Therapy in Patients With Hemophilia Undergoing Pulsed-Field or Radiofrequency Catheter Ablation for Atrial Fibrillation
Anno: 2024
Rivista: CIRCULATION. ARRHYTHMIA AND ELECTROPHYSIOLOGY
Autori/autrici: Mohanty, Sanghamitra; Casella, Michela; Compagnucci, Paolo; Torlapati, Prem Geeta; La Fazia, Vincenzo Mirco; Gianni, Carola; Macdonald, Bryan; Mayedo, Angel Quintero; Della Rocca, Domenico Giovanni; Allison, John; Bassiouny, Mohamed; Gallinghouse, G. Joseph; Burkhardt, John D.; Horton, Rodney; Al-Ahmad, Amin; Di Biase, Luigi; Dello Russo, Antonio; Natale, Andrea
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345755
Citazioni:
Oral Anticoagulation and Factor VIII Replacement Therapy in Patients With Hemophilia Undergoing Pulsed-Field or Radiofrequency Catheter Ablation for Atrial Fibrillation / Mohanty, S., Casella, M., Compagnucci, P., Torlapati, P.G., La Fazia, V.M., Gianni, C., Macdonald, B., Mayedo, A.Q., Della Rocca, D.G., Allison, J., Bassiouny, M., Gallinghouse, G.J., Burkhardt, J.D., Horton, R., Al-Ahmad, A., Di Biase, L., Dello Russo, A., Natale, A.. - In: CIRCULATION. ARRHYTHMIA AND ELECTROPHYSIOLOGY. - ISSN 1941-3149. - 17:10(2024), pp. e012921.745-e012921.747. [10.1161/circep.124.012921]

Pulsed field ablation technology for pulmonary vein and left atrial posterior wall isolation in patients with persistent atrial fibrillation
Anno: 2024
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Schiavone, Marco; Solimene, Francesco; Moltrasio, Massimo; Casella, Michela; Bianchi, Stefano; Iacopino, Saverio; Rossillo, Antonio; Schillaci, Vincenzo; Fassini, Gaetano; Compagnucci, Paolo; Salito, Armando; Rossi, Pietro; Filannino, Pasquale; Maggio, Ruggero; Themistoklakis, Sakis; Pandozi, Claudio; Caprioglio, Francesco; Malacrida, Maurizio; Russo, Antonio Dello; Tondo, Claudio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/344652
Citazioni:
Pulsed field ablation technology for pulmonary vein and left atrial posterior wall isolation in patients with persistent atrial fibrillation / Schiavone, M., Solimene, F., Moltrasio, M., Casella, M., Bianchi, S., Iacopino, S., Rossillo, A., Schillaci, V., Fassini, G., Compagnucci, P., Salito, A., Rossi, P., Filannino, P., Maggio, R., Themistoklakis, S., Pandozi, C., Caprioglio, F., Malacrida, M., Russo, A.D., Tondo, C.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1540-8167. - 35:6(2024), pp. 1101-1111. [10.1111/jce.16246]
Abstract:
Introduction: Limited data exist on pulsed-field ablation (PFA) in patients with persistent atrial fibrillation (PeAF) undergoing left atrial posterior wall isolation (LAPWI). Methods: The Advanced TecHnologies For SuccEssful AblatioN of AF in Clinical Practice (ATHENA) prospective registry included... consecutive patients referred for PeAF catheter ablation at 9 Italian centers, treated with the FARAPULSETM-PFA system. The primary efficacy and safety study endpoints were the acute LAPWI rate, freedom from arrhythmic recurrences and the incidence of major periprocedural complications. Patients undergoing pulmonary vein isolation (PVI) alone, PWI + LAPWI and redo procedures were compared. Results: Among 249 patients, 21.7% had long-standing PeAF, 79.5% were male; mean age was 63 ± 9 years. LAPWI was performed in 57.6% of cases, with 15.3% being redo procedures. Median skin-to-skin times (PVI-only 68 [60−90] vs. PVI + LAPWI 70 [59−88] mins) did not differ between groups. 45.8% LAPWI cases were approached with a 3D-mapping system, and 37.3% with intracardiac echocardiography. LAPWI was achieved in all patients by means of PFA alone, in 88.8% cases at first pass. LAPWI was validated either by an Ultrahigh-density mapping system or by recording electrical activity + pacing maneuvers. No major complications occurred, while 2.4% minor complications were detected. During a median follow-up of 273 [191–379] days, 41 patients (16.5%) experienced an arrhythmic recurrence after the 90-day blanking period, with a mean time to recurrence of 223 ± 100 days and no differences among ablation strategies. Conclusion: LAPWI with PFA demonstrates feasibility, rapidity, and safety in real-world practice, offering a viable alternative for PeAF patients. LAPWI is achievable even with a fluoroscopy-only method and does not significantly extend overall procedural times.
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Advancing diagnosis in a cardiac arrest case and suspected MINOCA: the complementary roles of imaging, biopsy, and genetic testing
Anno: 2024
Rivista: EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE
Autori/autrici: Ciliberti, Giuseppe; Compagnucci, Paolo; Casella, Michela; Schiavone, Francesco; De Gaspari, Monica; Rizzo, Stefania; Basso, Cristina; Giovagnoni, Andrea; Guerra, Federico; Tortora, Giada; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345762
Citazioni:
Advancing diagnosis in a cardiac arrest case and suspected MINOCA: the complementary roles of imaging, biopsy, and genetic testing / Ciliberti, G., Compagnucci, P., Casella, M., Schiavone, F., De Gaspari, M., Rizzo, S., Basso, C., Giovagnoni, A., Guerra, F., Tortora, G., Dello Russo, A.. - In: EUROPEAN HEART JOURNAL. IMAGING METHODS AND PRACTICE. - ISSN 2755-9637. - 2:3(2024). [10.1093/ehjimp/qyae135]

Pulsed field vs very high-power short-duration radiofrequency ablation for atrial fibrillation: Results of a multicenter, real-world experience
Anno: 2024
Rivista: HEART RHYTHM
Autori/autrici: Dello Russo, Antonio; Compagnucci, Paolo; Anselmino, Matteo; Schillaci, Vincenzo; Campanelli, Francesca; Ascione, Maria Rosaria; Volpato, Giovanni; Cipolletta, Laura; Parisi, Quintino; Valeri, Yari; D'Angelo, Leonardo; Chiariello, Paola; Casella, Michela; Solimene, Francesco
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345752
Citazioni:
Pulsed field vs very high-power short-duration radiofrequency ablation for atrial fibrillation: Results of a multicenter, real-world experience / Dello Russo, A., Compagnucci, P., Anselmino, M., Schillaci, V., Campanelli, F., Ascione, M.R., Volpato, G., Cipolletta, L., Parisi, Q., Valeri, Y., D'Angelo, L., Chiariello, P., Casella, M., Solimene, F.. - In: HEART RHYTHM. - ISSN 1547-5271. - 21:9(2024), pp. 1526-1536. [10.1016/j.hrthm.2024.05.042]
Abstract:
Background: Pulsed field ablation (PFA) and very high-power short-duration (vHPSD) radiofrequency ablation are the most recently introduced technologies for atrial fibrillation (AF) ablation. The procedural performance, safety, and effectiveness of PFA vs vHPSD are currently unknown. Objective: The ...study aimed to compare PFA with vHPSD for the treatment of paroxysmal or persistent AF. Methods: We conducted an observational, multicenter study enrolling 534 consecutive patients (63 ± 9 years; 36% female) with paroxysmal (n = 368 [69%]) or persistent (n = 166 [31%]) AF undergoing ablation by either PFA (Farapulse; n = 192) or vHPSD (90 W/4 seconds; QDOT Micro; n = 342) between 2020 and 2023. Atrial tachyarrhythmia recurrence after a 1-month blanking period was the primary efficacy end point and was assessed both overall and in propensity score–matched patients. The primary safety end point was a composite of procedure-related complications. Results: Successful pulmonary vein isolation was achieved in all patients, with shorter procedure duration (PFA,70 minutes; vHPSD, 100 minutes; P &lt; .001) but longer fluoroscopy time (PFA, 15 minutes; vHPSD, 7 minutes; P &lt; .001) in the PFA group. PFA was associated with more frequent use of general anesthesia (P &lt; .001). Primary safety outcome events occurred in 19 patients (3.5%), with similar prevalence in both groups (PFA, 4%; vHPSD, 3%; P = .745). After a median follow-up of 12 (9–12) months, survival free from recurrent atrial tachyarrhythmia was similar between the PFA and vHPSD groups, both overall (12-month estimate: PFA, 75%; vHPSD, 76%; log-rank P = .73) and in propensity score–matched patients (n = 342; 12-month estimate: PFA, 75%; vHPSD, 77%; log-rank P = .980). Conclusion: In a large, multicenter experience, PFA was associated with more common use of general anesthesia, shorter procedural times, and longer fluoroscopy exposure compared with vHPSD ablation, with both techniques displaying superimposable safety and efficacy.
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Prevalence and prognosis of structural heart disease among athletes with negative T waves and normal transthoracic echocardiography
Anno: 2024
Rivista: CLINICAL RESEARCH IN CARDIOLOGY
Autori/autrici: Conte, Edoardo; Pizzamiglio, Francesca; Dessanai, Maria Antonietta; Guarnieri, Gianluca; Ardizzone, Valentina; Schillaci, Matteo; Dello Russo, Antonio; Casella, Michela; Mushtaq, Saima; Melotti, Eleonora; Marchetti, Davide; Volpato, Valentina; Drago, Gabrile; Gigante, Carlo; Sforza, Chiarella; Bartorelli, Antonio L.; Pepi, Mauro; Pontone, Gianluca; Tondo, Claudio; Andreini, Daniele
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/345761
Citazioni:
Prevalence and prognosis of structural heart disease among athletes with negative T waves and normal transthoracic echocardiography / Conte, E., Pizzamiglio, F., Dessanai, M.A., Guarnieri, G., Ardizzone, V., Schillaci, M., Dello Russo, A., Casella, M., Mushtaq, S., Melotti, E., Marchetti, D., Volpato, V., Drago, G., Gigante, C., Sforza, C., Bartorelli, A.L., Pepi, M., Pontone, G., Tondo, C., Andreini, D.. - In: CLINICAL RESEARCH IN CARDIOLOGY. - ISSN 1861-0684. - 113:5(2024), pp. 706-715. [10.1007/s00392-023-02282-5]
Abstract:
Introduction: The aim of the present study was to evaluate the prevalence and prognosis of structural heart disease (SHD) among competitive athletes with negative T waves without pathological findings at transthoracic echocardiogram. Methods: From a prospective register of 450 athletes consecutively... evaluated during a second-level cardiological examination, we retrospectively identified all subjects with the following inclusion criteria: (1) not previously known cardiovascular disease; (2) negative T waves in leads other than V1–V2; (3) normal transthoracic echocardiogram. Patients underwent cardiac MRI and CT. The primary endpoint was the diagnosis of definite SHD after multimodality imaging evaluation. A follow-up was collected for a combined end-point of sudden death, resuscitated sudden cardiac death and hospitalization for any cardiovascular causes. Results: A total of 55 competitive athletes were finally enrolled (50 males, 90%) with a mean age of 27.5 ± 14.1 years. Among the population enrolled 16 (29.1%) athletes had a final diagnosis of SHD. At multivariate analysis, only deep negative T waves remained statistically significant [OR (95% CI) 7.81 (1.24–49.08), p = 0.0285]. Contemporary identification of deep negative T waves and complex arrhythmias in the same patients appeared to have an incremental diagnostic value. No events were collected at 49.3 ± 12.3 months of follow-up. Conclusions: In a cohort of athletes with negative T waves at ECG, cardiac MRI (and selected use of cardiac CT) enabled the identification of 16 (29.1%) subjects with SHD despite normal transthoracic echocardiography. Deep negative T waves and complex ventricular arrhythmias were the only clinical characteristic associated with SHD diagnosis. Graphical abstract: (Figure presented.)
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Interpretation and management of premature ventricular beats in athletes: An expert opinion document of the Italian Society of Sports Cardiology (SICSPORT)
Anno: 2023
Rivista: INTERNATIONAL JOURNAL OF CARDIOLOGY
Autori/autrici: Zorzi, Alessandro; D'Ascenzi, Flavio; Andreini, Daniele; Castelletti, Silvia; Casella, Michela; Cavarretta, Elena; Cipriani, Alberto; Compagnucci, Paolo; Delise, Pietro; Dello Russo, Antonio; Graziano, Francesca; Palamà, Zefferino; Pelliccia, Antonio; Sarto, Patrizio; Corrado, Domenico; Sciarra, Luigi
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327539
Citazioni:
Interpretation and management of premature ventricular beats in athletes: An expert opinion document of the Italian Society of Sports Cardiology (SICSPORT) / Zorzi, A., D'Ascenzi, F., Andreini, D., Castelletti, S., Casella, M., Cavarretta, E., Cipriani, A., Compagnucci, P., Delise, P., Dello Russo, A., Graziano, F., Palamà, Z., Pelliccia, A., Sarto, P., Corrado, D., Sciarra, L.. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 391:(2023). [10.1016/j.ijcard.2023.131220]
Abstract:
Premature ventricular beats (PVBs) are recorded in a sizeable proportion of athletes during pre-participation screening, especially if the evaluation includes both resting and exercise ECG. While in the majority of cases no underlying heart disease is present, in others PVBs may be the sign of a con...dition at risk of sudden cardiac death, including cardiomyopathies, congenital, coronary artery, heart valves and ion channels diseases. In this expert opinion document of the Italian Society of Sports Cardiology, we propose a multiparametric interpretation approach to PVBs in athletes and a stepwise diagnostic algorithm. The clinical work-up should include the assessment of the probable site of origin based on the ECG pattern of the ectopic QRS and of the arrhythmia behavior (including the number of different PVB morphologies, complexity, response to exercise and reproducibility), as well as first-line tests such as echocardiography. Based on this initial evaluation, most athletes can be reassured of the benign nature of PVBs and cleared for competition under periodical follow-up. However, when the clinical suspicion is high, further investigations with non-invasive (e.g. cardiac magnetic resonance, cardiac computed tomography, genetic testing) and, in very selected cases, invasive (e.g. endocardial voltage mapping and endomyocardial biopsy) tests should be carried out to rule out a high-risk condition. Importantly, such advanced tests should be performed in centers with a consolidated experience not only in the technique, but also in evaluation of athletes.
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Microelectrode voltage mapping for substrate assessment in catheter ablation of ventricular tachycardia: A dual-center experience
Anno: 2023
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Dello Russo, Antonio; Compagnucci, Paolo; Bergonti, Marco; Cipolletta, Laura; Parisi, Quintino; Volpato, Giovanni; Santarelli, Giulia; Colonnelli, Michela; Saenen, Johan; Valeri, Yari; Carboni, Laura; Marchese, Procolo; Marini, Marco; Sarkozy, Andrea; Natale, Andrea; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327534
Citazioni:
Microelectrode voltage mapping for substrate assessment in catheter ablation of ventricular tachycardia: A dual-center experience / Dello Russo, A., Compagnucci, P., Bergonti, M., Cipolletta, L., Parisi, Q., Volpato, G., Santarelli, G., Colonnelli, M., Saenen, J., Valeri, Y., Carboni, L., Marchese, P., Marini, M., Sarkozy, A., Natale, A., Casella, M.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 34:5(2023), pp. 1216-1227. [10.1111/jce.15908]
Abstract:
Introduction: The assessment of the ventricular myocardial substrate critically depends on the size of mapping electrodes, their orientation with respect to wavefront propagation, and interelectrode distance. We conducted a dual-center study to evaluate the impact of microelectrode mapping in patien...ts undergoing catheter ablation (CA) of ventricular tachycardia (VT). MethodsWe included 21 consecutive patients (median age, 68 [12], 95% male) with structural heart disease undergoing CA for electrical storm (n = 14) or recurrent VT (n = 7) using the QDOT Micro catheter and a multipolar catheter (PentaRay, n = 9). The associations of peak-to-peak maximum standard bipolar (BVc) and minibipolar (PentaRay, BVp) with microbipolar (BV mu Max) voltages were respectively tested in sinus rhythm with mixed effect models. Furthermore, we compared the features of standard bipolar (BE) and microbipolar (mu BE) electrograms in sinus rhythm at sites of termination with radiofrequency energy. ResultsBV(mu Max) was moderately associated with both BVc (beta = .85, p < .01) and BVp (beta = .56, p < .01). BV mu Max was 0.98 (95% CI: 0.93-1.04, p < .01) mV larger than corresponding BVc, and 0.27 (95% CI: 0.16-0.37, p < .01) mV larger than matching BVp in sinus rhythm, with higher percentage differences in low voltage regions, leading to smaller endocardial dense scar (2.3 [2.7] vs. 12.1 [17] cm(2), p < .01) and border zone (3.2 [7.4] vs. 4.8 [20.1] cm(2), p = .03) regions in microbipolar maps compared to standard bipolar maps. Late potentials areas were nonsignificantly greater in microelectrode maps, compared to standard electrode maps. At sites of VT termination (n = 14), mu BE were of higher amplitude (0.9 [0.8] vs. 0.4 [0.2] mV, p < .01), longer duration (117 [66] vs. 74 [38] ms, p < .01), and with greater number of peaks (4 [2] vs. 2 [1], p < .01) in sinus rhythm compared to BE. Conclusionmicroelectrode mapping is more sensitive than standard bipolar mapping in the identification of viable myocytes in SR, and may facilitate recognition of targets for CA.
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Catheter Ablation for Ventricular Tachycardia in Patients With Desmoplakin Cardiomyopathy
Anno: 2023
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Gasperetti, Alessio; Peretto, Giovanni; Muller, Steven A.; Hasegawa, Kanae; Compagnucci, Paolo; Casella, Michela; Murray, Brittney; Tichnell, Crystal; Carrick, Richard T.; Cadrin-Tourigny, Julia; Schiavone, Marco; James, Cynthia; Amin, Ahmad S.; Saguner, Ardan M.; Dello Russo, Antonio; Tondo, Claudio; Stevenson, William; Della Bella, Paolo; Calkins, Hugh; Tandri, Harikrishna
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327550
Citazioni:
Catheter Ablation for Ventricular Tachycardia in Patients With Desmoplakin Cardiomyopathy / Gasperetti, A., Peretto, G., Muller, S.A., Hasegawa, K., Compagnucci, P., Casella, M., Murray, B., Tichnell, C., Carrick, R.T., Cadrin-Tourigny, J., Schiavone, M., James, C., Amin, A.S., Saguner, A.M., Dello Russo, A., Tondo, C., Stevenson, W., Della Bella, P., Calkins, H., Tandri, H.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - (2023). [10.1016/j.jacep.2023.11.017]
Abstract:
Background: Desmoplakin (DSP) pathogenic/likely pathogenic (P/LP) variants are associated with malignant phenotypes of arrhythmogenic cardiomyopathy (DSP-ACM). Reports of outcomes after ventricular tachycardia (VT) ablation in DSP-ACM are scarce. Objectives: In this study, the authors sought to repo...rt on long-term outcomes of VT ablation in DSP-ACM. Methods: Patients with P/LP DSP variants at 9 institutions undergoing VT ablation were included. Demographic, clinical, and instrumental data as well as all ventricular arrhythmia (VA) events were collected. Sustained VAs after the index procedure were the primary outcome. A per-patient before and after ablation comparison of rates of VA episodes per year was performed as well. Results: Twenty-four DSP-ACM patients (39.3 ± 12.1 years of age, 62.5% male, median 6,116 [Q1-Q3: 3,362-7,760] premature ventricular complexes [PVCs] per 24 hours, median 4 [Q1-Q3: 2-11] previous VA episodes per patient at ablation) were included. Index procedure was most commonly endocardial/epicardial (19/24) The endocardium of the right ventricle (RV), the left ventricle (LV), or both ventricles were mapped in 8 (33.3%), 9 (37.5%), and 7 (29.2%) cases, respectively. Low voltage potentials were found in 10 of 15 patients in the RV and 11 of 16 in the LV. Endocardial ablation was performed in 18 patients (75.0%). Epicardial mapping in 19 patients (79.2%) identified low voltage potentials in 17, and 16 received epicardial ablation. Over the following 2.9 years (Q1-Q3: 1.8-5.5 years), 13 patients (54.2%) experienced VA recurrences. A significant reduction in per-patient event/year before and after ablation was observed (1.4 [Q1-Q3: 0.5-2.4] to 0.1 [Q1-Q3: 0.0-0.4]; P = 0.009). 2 patients needed heart transplantation, and 4 died (3 of heart failure and 1 noncardiac death). Conclusions: VT ablation in DSP-ACM is effective in reducing the VA burden of the disease, but recurrences are common. Most VT circuits are epicardial, with both LV and RV low voltage abnormalities. Heart failure complicates clinical course and is an important cause of mortality.
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Clinical outcomes and predictors of success with Impella weaning in cardiogenic shock: a single-center experience
Anno: 2023
Rivista: FRONTIERS IN CARDIOVASCULAR MEDICINE
Autori/autrici: Matassini, M. V.; Marini, M.; Angelozzi, A.; Angelini, L.; Shkoza, M.; Compagnucci, P.; Falanga, U.; Battistoni, I.; Pongetti, G.; Francioni, M.; Piva, T.; Mucaj, A.; Nicolini, E.; Maolo, A.; Di Eusanio, M.; Munch, C.; Dello Russo, A.; Perna, G.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327768
Citazioni:
Clinical outcomes and predictors of success with Impella weaning in cardiogenic shock: a single-center experience / Matassini, M.V., Marini, M., Angelozzi, A., Angelini, L., Shkoza, M., Compagnucci, P., Falanga, U., Battistoni, I., Pongetti, G., Francioni, M., Piva, T., Mucaj, A., Nicolini, E., Maolo, A., Di Eusanio, M., Munch, C., Dello Russo, A., Perna, G.. - In: FRONTIERS IN CARDIOVASCULAR MEDICINE. - ISSN 2297-055X. - 10:(2023). [10.3389/fcvm.2023.1171956]
Abstract:
Introduction: Cardiogenic shock (CS) is a severe syndrome with poor prognosis. Short-term mechanical circulatory support with Impella devices has emerged as an increasingly therapeutic option, unloading the failing left ventricle (LV) and improving hemodynamic status of affected patients. Impella de...vices should be used for the shortest time necessary to allow LV recovery because of time-dependent device-related adverse events. The weaning from Impella, however, is mostly performed in the absence of established guidelines, mainly based on the experience of the individual centres. Methods: The aim of this single center study was to retrospectively evaluate whether a multiparametrical assessment before and during Impella weaning could predict successful weaning. The primary study outcome was death occurring during Impella weaning and secondary endpoints included assessment of in-hospital outcomes. ResultsOf a total of 45 patients (median age, 60 [51-66] years, 73% male) treated with an Impella device, 37 patients underwent impella weaning/removal and 9 patients (20%) died after the weaning. Non-survivors patients after impella weaning more commonly had a previous history of known heart failure (p = 0.054) and an implanted ICD-CRT (p = 0.01), and were more frequently treated with continuous renal replacement therapy (p = 0.02). In univariable logistic regression analysis, lactates variation (%) during the first 12-24 h of weaning, lactate value after 24 h of weaning, left ventricular ejection fraction (LVEF) at the beginning of weaning, and inotropic score after 24 h from weaning beginning were associated with death. Stepwise multivariable logistic regression identified LVEF at the beginning of weaning and lactates variation (%) in the first 12-24 h from weaning beginning as the most accurate predictors of death after weaning. The ROC analysis indicated 80% accuracy (95% confidence interval = 64%-96%) using the two variables in combination to predict death after weaning from Impella. Conclusions: This single-center experience on Impella weaning in CS showed that two easily accessible parameters as LVEF at the beginning of weaning and lactates variation (%) in the first 12-24 h from weaning begin were the most accurate predictors of death after weaning.
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Effectiveness and safety of implantable loop recorder and clinical utility of remote monitoring in patients with unexplained, recurrent, traumatic syncope
Anno: 2023
Rivista: EXPERT REVIEW OF MEDICAL DEVICES
Autori/autrici: Palmisano, Pietro; Guerra, Federico; Aspromonte, Vittorio; Dell'Era, Gabriele; Pellegrino, Pier Luigi; Laffi, Mattia; Uran, Carlo; De Bonis, Silvana; Accogli, Michele; Dello Russo, Antonio; Patti, Giuseppe; Santoro, Francesco; Torriglia, Antonella; Nigro, Gerardo; Bisignani, Antonio; Coluccia, Giovanni; Stronati, Giulia; Russo, Vincenzo; Ammendola, Ernesto
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/315556
Citazioni:
Effectiveness and safety of implantable loop recorder and clinical utility of remote monitoring in patients with unexplained, recurrent, traumatic syncope / Palmisano, P., Guerra, F., Aspromonte, V., Dell'Era, G., Pellegrino, P.L., Laffi, M., Uran, C., De Bonis, S., Accogli, M., Dello Russo, A., Patti, G., Santoro, F., Torriglia, A., Nigro, G., Bisignani, A., Coluccia, G., Stronati, G., Russo, V., Ammendola, E.. - In: EXPERT REVIEW OF MEDICAL DEVICES. - ISSN 1743-4440. - 20:1(2023), pp. 45-54. [10.1080/17434440.2023.2168189]
Abstract:
BackgroundImplantable loop recorder (ILR) is still underutilized in clinical practice, especially in the setting of elderly patients with recurrent, traumatic, unexplained syncope. Data on the actual risk of traumatic syncopal recurrence during ILR monitoring in this specific patient setting are lac...king.Research design and methodsProspective, multicentre registry enrolling consecutive patients undergoing ILR insertion for unexplained, recurrent, traumatic syncope. In a proportion of enrolled patients, remote monitoring (RM) was used for device follow-up. The risk of traumatic and non-traumatic syncopal recurrences during ILR observation were prospectively assessed.ResultsA total of 483 consecutive patients (68 +/- 14 years, 59% male) were enrolled. During a median follow-up of 18 months, a final diagnosis was reached in 270 patients (55.9%). The risk of syncopal and traumatic syncopal recurrence was of 26.5 and 9.3%, respectively. RM significantly reduced the time to diagnosis (19.7 +/- 10.3 vs. 22.1 +/- 10.8 months; p=0.015) and was associated with a significant reduction in the risk of syncope recurrence of 48% (p<0.001), and of traumatic syncope recurrence of 49% (p=0.018).ConclusionsILR monitoring is effective and safe in patients with unexplained, recurrent, traumatic syncope. RM reduces the time to diagnosis and significantly reduces the risk of traumatic and non-traumatic syncopal relapses.
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Characteristics of patients with recurrent acute myocardial infarction after MINOCA
Anno: 2023
Rivista: PROGRESS IN CARDIOVASCULAR DISEASES
Autori/autrici: Ciliberti, Giuseppe; Guerra, Federico; Pizzi, Carmine; Merlo, Marco; Zilio, Filippo; Bianco, Francesco; Mancone, Massimo; Zaffalon, Denise; Gioscia, Rocco; Bergamaschi, Luca; Compagnucci, Paolo; Armillotta, Matteo; Casella, Michela; Sansonetti, Angelo; Marini, Marco; Paolisso, Pasquale; Stronati, Giulia; Gallina, Sabina; Dello Russo, Antonio; Perna, Gian Piero; Fedele, Francesco; Bonmassari, Roberto; De Luca, Giuseppe; Tritto, Isabella; Piva, Tommaso; Sinagra, Gianfranco; Ambrosio, Giuseppe; Kaski, Juan Carlos; Verdoia, Monica
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327543
Citazioni:
Characteristics of patients with recurrent acute myocardial infarction after MINOCA / Ciliberti, G., Guerra, F., Pizzi, C., Merlo, M., Zilio, F., Bianco, F., Mancone, M., Zaffalon, D., Gioscia, R., Bergamaschi, L., Compagnucci, P., Armillotta, M., Casella, M., Sansonetti, A., Marini, M., Paolisso, P., Stronati, G., Gallina, S., Dello Russo, A., Perna, G.P., et al.. - In: PROGRESS IN CARDIOVASCULAR DISEASES. - ISSN 0033-0620. - 81:(2023), pp. 42-47. [10.1016/j.pcad.2023.10.006]
Abstract:
Background: Myocardial infarction (MI) with non-obstructed coronary arteries (MINOCA) is an increasingly recognized condition with challenging management. Some MINOCA patients ultimately experience recurrent acute MI (re-AMI) during follow-up; however, clinical and angiographic factors predisposing ...to re-AMI are still poorly defined.Methods: In this retrospective multicenter cohort study we enrolled consecutive patients fulfilling diagnostic criteria of MINOCA according to the IV universal definition of myocardial infarction; characteristics of patients experiencing re-AMI during the follow-up were compared to a group of MINOCA patients without re-AMI.Results: 54 patients (mean age 66 +/- 13) experienced a subsequent re-AMI after MINOCA and follow-up was available in 44 (81%). Compared to MINOCA patients without re-AMI (n = 695), on first invasive coronary angiography (ICA) MINOCA patients with re-AMI showed less frequent angiographically normal coronaries (37 versus 53%, p = 0.032) and had a higher prevalence of atherosclerosis involving 3 vessels or left main stem (17% versus 8%, p = 0.049).Twenty-four patients (44%) with re-AMI underwent a new ICA: 25% had normal coronary arteries, 12.5% had mild luminal irregularities (<30%), 20.8% had moderate coronary atherosclerosis (30-49%), and 41.7% showed obstructive coronary atherosclerosis (>= 50% stenosis).Among patients undergoing new ICA, atherosclerosis progression was observed in 11 (45.8%), 37.5% received revascularization, only 4.5% had low-density lipoprotein cholesterol (LDL_C) under 55 mg/dL and 33% experienced a new cardiovascular disease (CVD) event (death, AMI, heart failure, stroke) at subsequent follow-up.Conclusions: In the present study, only a minority of MINOCA patients with re-AMI underwent a repeated ICA, nearly one out of two showed atherosclerosis progression, often requiring revascularization. Recommended LDL-C levels were achieved only in a minority of the cases, indicating a possible underestimation of CVD risk in this population.
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Technological advances in ventricular tachycardia catheter ablation: the relentless quest for novel solutions to old problems
Anno: 2023
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Compagnucci, Paolo; Valeri, Yari; Conti, Sergio; Volpato, Giovanni; Cipolletta, Laura; Parisi, Quintino; D’Angelo, Leonardo; Campanelli, Francesca; Carboni, Laura; Sgarito, Giuseppe; Natale, Andrea; Casella, Michela; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327547
Citazioni:
Technological advances in ventricular tachycardia catheter ablation: the relentless quest for novel solutions to old problems / Compagnucci, P., Valeri, Y., Conti, S., Volpato, G., Cipolletta, L., Parisi, Q., D’Angelo, L., Campanelli, F., Carboni, L., Sgarito, G., Natale, A., Casella, M., Dello Russo, A.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - (2023). [10.1007/s10840-023-01705-7]
Abstract:
BackgroundSeveral novel technologies allowing catheter ablation (CA) with a favorable safety/efficacy profile have been recently developed, but not yet extensively clinically tested in the setting of ventricular tachycardia CA.MethodsIn this technical report, we overview technical aspects and precli...nical/clinical information concerning the application of three novel CA technologies in the ventricular milieu: a pulsed field ablation (PFA) generator (CENTAURI (TM), Galaxy Medical) to be used with linear, contact force-sensing radiofrequency ablation catheters; a contact force-sensing radiofrequency ablation catheter equipped with six thermocouples and three microelectrodes (QDOT Micro (TM), Biosense-Webster), allowing high-resolution mapping and temperature-controlled CA; and a flexible and mesh-shaped irrigation tip, contact force-sensing radiofrequency ablation catheter (Tactiflex, Abbott). We also report three challenging VT cases in which CA was performed using these technologies.ResultsThe CENTAURI system was used with the Tacticath (TM) (Abbott) ablation catheter to perform ventricular PFA in a patient with advanced heart failure, electrical storm, and a deep intramural septal substrate. Microelectrode mapping using QDOT Micro (TM) helped to refine substrate assessment in a VT patient with congenitally corrected transposition of the great arteries, and allowed the identification of the critical components of the VT circuit, which were successfully ablated. Tactiflex (TM) was used in two challenging CA cases (one endocardial and one epicardial), allowing acute and mid-term control of VT episodes without adverse events.ConclusionThe ideation and development of novel technologies initially intended to treat atrial arrhythmias and successfully implemented in the ventricular milieu is contributing to the progressive improvement in the clinical benefits derived from VT CA, making this procedure key for successful management of increasingly complex patients.
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Immunological Aspects of Von Hippel-Lindau Disease: A Focus on Neuro-Oncology and Myasthenia Gravis
Anno: 2023
Rivista: DIAGNOSTICS
Autori/autrici: Norata, Davide; Peri, Marta; Giammalva, Giuseppe Roberto; Lupica, Antonino; Paolini, Federica; Incorvaia, Lorena; Badalamenti, Giuseppe; Gristina, Valerio; Galvano, Antonio; Russo, Antonio; Iacopino, Domenico Gerardo; Silvestrini, Mauro; Bazan, Viviana; Brighina, Filippo; Di Stefano, Vincenzo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/309787
Citazioni:
Immunological Aspects of Von Hippel-Lindau Disease: A Focus on Neuro-Oncology and Myasthenia Gravis / Norata, D., Peri, M., Giammalva, G.R., Lupica, A., Paolini, F., Incorvaia, L., Badalamenti, G., Gristina, V., Galvano, A., Russo, A., Iacopino, D.G., Silvestrini, M., Bazan, V., Brighina, F., Di Stefano, V.. - In: DIAGNOSTICS. - ISSN 2075-4418. - ELETTRONICO. - 13:1(2023). [10.3390/diagnostics13010144]
Abstract:
Von Hippel-Lindau (VHL) disease is an autosomal dominant condition that predisposes affected individuals to a variety of malignant and benign neoplasms. The pathogenetic turning point of this illness is the accumulation of hypoxia-inducible factor (HIF)-1α, a transcription factor of several ge...nes involved in oncogenesis, angiogenesis, tissue regeneration, metabolic regulation, hematopoiesis, and inflammatory responses. From an oncological perspective, increased awareness of the molecular pathways underlying this disease is bringing us closer to the development of specific and targeted therapies. Meanwhile, on the surgical side, improved understanding can help to better identify the patients to be treated and the surgical timing. Overall, pathogenesis research is crucial for developing patient-tailored therapies. One of the actual key topics of interest is the link between the VHL/HIF axis and inflammation. The present study aims to outline the fundamental mechanisms that link VHL disease and immune disorders, as well as to explore the details of the overlap between VHL disease and myasthenia gravis (MG) pathogenetic pathways. As a result, MG becomes a paradigm for autoimmune disorders that might be related with VHL disease.
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The Diagnostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy
Anno: 2023
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Calò, Leonardo; Crescenzi, Cinzia; Martino, Annamaria; Casella, Michela; Romeo, Fabiana; Cappelletto, Chiara; Bressi, Edoardo; Panattoni, Germana; Stolfo, Davide; Targetti, Mattia; Toso, Elisabetta; Musumeci, Maria Beatrice; Tini, Giacomo; Ciabatti, Michele; Stefanini, Matteo; Silvetti, Elisa; Stazi, Alessandra; Danza, Maria Ludovica; Rebecchi, Marco; Canestrelli, Stefano; Fedele, Elisa; Lanzillo, Chiara; Fusco, Armando; Sangiuolo, Federica Carla; Oliviero, Giada; Radesich, Cinzia; Perotto, Maria; Pieroni, Maurizio; Golia, Paolo; Mango, Ruggiero; Gasperetti, Alessio; Autore, Camillo; Merlo, Marco; de Ruvo, Ermenegildo; Russo, Antonio Dello; Olivotto, Iacopo; Sinagra, Gianfranco; Gaita, Fiorenzo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327541
Citazioni:
The Diagnostic Value of the 12-Lead ECG in Arrhythmogenic Left Ventricular Cardiomyopathy / Calò, L., Crescenzi, C., Martino, A., Casella, M., Romeo, F., Cappelletto, C., Bressi, E., Panattoni, G., Stolfo, D., Targetti, M., Toso, E., Musumeci, M.B., Tini, G., Ciabatti, M., Stefanini, M., Silvetti, E., Stazi, A., Danza, M.L., Rebecchi, M., Canestrelli, S., et al.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 9:12(2023), pp. 2615-2627. [10.1016/j.jacep.2023.08.020]
Abstract:
Background: Electrocardiographic (ECG) findings in arrhythmogenic left ventricular cardiomyopathy (ALVC) are limited to small case series.Objectives: This study aimed to analyze the ECG characteristics of ALVC patients and to correlate ECG with cardiac magnetic resonance and genotype data.Methods: W...e reviewed data of 54 consecutive ALVC patients (32 men, age 39 +/- 15 years) and compared them with 84 healthy controls with normal cardiac magnetic resonance.Results: T-wave inversion was often noted (57.4%), particularly in the inferior and lateral leads. Low QRS voltages in limb leads were observed in 22.2% of patients. The following novel ECG findings were identified: left posterior fascicular block (LPFB) (20.4%), pathological Q waves (33.3%), and a prominent R-wave in V-1 with a R/S ratio &gt;= 0.5 (24.1%). The QRS voltages were lower in ALVC compared with controls, particularly in lead I and II. At receiver-operating characteristic analysis, the sum of the R-wave in I to II &lt;= 8 mm (AUC: 0.909; P &lt; 0.0001) and S-wave in V-1 plus R-wave in V-6 &lt;= 12 mm (AUC: 0.784; P &lt; 0.0001) effectively discriminated ALVC patients from controls. It is noteworthy that 4 of the 8 patients with an apparently normal ECG were recognized by these new signs. Transmural late gadolinium enhancement was associated to LPFB, a R/S ratio &gt;= 0.5 in V-1, and inferolateral T-wave inversion, and a ringlike pattern correlated to fragmented QRS, SV1+RV6 &lt;= 12 mm, low QRS voltage, and desmoplakin alterations.Conclusions: Pathological Q waves, LPFB, and a prominent R-wave in V-1 were common ECG signs in ALVC. An R-wave sum in I to II &lt;= 8 mm and SV1+RV6 &lt;= 12 mm were specific findings for ALVC phenotypes compared with controls.
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Characteristics and Prognosis of a Contemporary Cohort with Myocardial Infarction with Non-Obstructed Coronary Arteries (MINOCA) Presenting Different Patterns of Late Gadolinium Enhancements in Cardiac Magnetic Resonance Imaging
Anno: 2023
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Bucciarelli, Valentina; Bianco, Francesco; Di Francesco, Alessia; Vitulli, Piergiusto; Biasi, Annaclara; Primavera, Martina; Belleggia, Sara; Ciliberti, Giuseppe; Guerra, Federico; Seferovic, Jelena; Dello Russo, Antonio; Gallina, Sabina
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/315551
Citazioni:
Characteristics and Prognosis of a Contemporary Cohort with Myocardial Infarction with Non-Obstructed Coronary Arteries (MINOCA) Presenting Different Patterns of Late Gadolinium Enhancements in Cardiac Magnetic Resonance Imaging / Bucciarelli, V., Bianco, F., Di Francesco, A., Vitulli, P., Biasi, A., Primavera, M., Belleggia, S., Ciliberti, G., Guerra, F., Seferovic, J., Dello Russo, A., Gallina, S.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:6(2023). [10.3390/jcm12062266]
Abstract:
Background: To analyze the characteristics and prognosis of a contemporary cohort of patients with myocardial infarction with non-obstructed coronaries (MINOCA) were referred for cardiac magnetic resonance (CMR) imaging, focusing on late gadolinium enhancement (LGE) patterns. Methods: We retrospecti...vely examined and prospectively followed up with 135 patients (49 ± 21 years old, 48% female) undergoing CMR imaging due to a MINOCA diagnosis from 2014 to 2016. We grouped and analyzed the sample according to ischemic (focal or transmural) and non-ischemic LGE patterns. The primary outcome was cardiac-related death; the secondary outcome was a composite of cardiac-related rehospitalizations, the new occurrence of acute myocardial infarction (AMI), heart failure (HF), or arrhythmias. Results: CMR exams were performed after a median of 28 days from the acute event. One-third of the ischemic MINOCA were first managed as myocarditis, while CMR helped to adopt a different therapy regimen in 22% of patients (30/135). After a median follow-up of 2.3 years, more cardiac-related deaths occurred in the ischemic than non-ischemic group (2 vs. 1, p = 0.36), but it was not statistically significant. The ischemic group also experienced more cardiac-related-rehospitalizations (42%, p &lt; 0.001). In a multivariable Cox regression model, dyslipidemia, reduced left ventricular ejection fraction, ST-elevation at the hospitalization, and the LGE transmural pattern were the independent predictors of cardiac-related rehospitalizations. Conclusions: In a contemporary cohort of MINOCA patients who underwent CMR, ischemic and non-ischemic patterns had distinct features and outcomes. Among the MINOCA patients, CMR can identify patients at higher risk who require more aggressive therapeutic approached and strict follow-up.
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Intracardiac echocardiography-guided pulsed-field ablation for successful ablation of atrial fibrillation: a propensity-matched analysis from a large nationwide multicenter experience
Anno: 2023
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Dello Russo, Antonio; Tondo, Claudio; Schillaci, Vincenzo; Casella, Michela; Iacopino, Saverio; Bianchi, Stefano; Fassini, Gaetano; Rossillo, Antonio; Compagnucci, Paolo; Schiavone, Marco; Salito, Armando; Maggio, Ruggero; Cipolletta, Laura; Themistoclakis, Sakis; Pandozi, Claudio; Filannino, Pasquale; Rossi, Pietro; Bonanno, Carlo; Parisi, Quintino; Malacrida, Maurizio; Solimene, Francesco
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327545
Citazioni:
Intracardiac echocardiography-guided pulsed-field ablation for successful ablation of atrial fibrillation: a propensity-matched analysis from a large nationwide multicenter experience / Dello Russo, A., Tondo, C., Schillaci, V., Casella, M., Iacopino, S., Bianchi, S., Fassini, G., Rossillo, A., Compagnucci, P., Schiavone, M., Salito, A., Maggio, R., Cipolletta, L., Themistoclakis, S., Pandozi, C., Filannino, P., Rossi, P., Bonanno, C., Parisi, Q., Malacrida, M., et al.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - (2023). [10.1007/s10840-023-01699-2]
Abstract:
Background: Intracardiac echocardiography (ICE) is increasingly employed in atrial fibrillation (AF) ablation procedures, with the potential to enhance procedural efficacy. Nevertheless, there is currently a lack of evidence assessing the impact of ICE on the efficiency, effectiveness, and safety ou...tcomes in the context of novel pulsed-field ablation (PFA) for AF. Purpose: We aimed to assess whether the use of ICE could improve procedural parameters in a large population undergoing AF ablation with FARAPULSE™ catheter. Methods: Consecutive patients who had undergone PFA of AF from nine Italian centers were included. In procedures where the ICE catheter was employed for guidance (ICE-guided group), it was used to maneuver the PFA catheter within the left atrium to achieve optimal contact with atrial structures. Results: We analyzed 556 patients: 357 (66%) with paroxysmal AF, 499 (89.7%) de novo PVI. ICE-guided procedures (n = 138) were propensity matched with patients with a standard approach (n = 138), and their outcomes were compared. During ICE-guided procedures, no improvement in procedural metrics was recorded (ICE vs Standard, 23 ± 6 min vs 18.5 ± 9 min for time to PVI, p < 0.0001; 38.8 ± 7 vs 32.5 ± 5 number of PFA deliveries to achieve PVI, p < 0.0001; 68.8 ± 19 min vs 71.8 ± 29 min for primary operator time, p = 0.5301; 16.1 ± 8 min vs 18.2 ± 10 min for fluoroscopy time, p = 0.5476) except for support time (76.8 ± 26 min vs 91.4 ± 37 min, p = 0.0046). No major procedure-related adverse events were reported. Conclusion: Our findings confirmed that PFA could be consistently performed in a rapid, safe, and efficacious manner. The use of ICE to guide PFA was not associated with an improvement in procedural metrics.
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Incidence of ventricular arrhythmias related to COVID infection and vaccination in patients with Brugada syndrome: Insights from a large Italian multicenter registry based on continuous rhythm monitoring
Anno: 2023
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Casella, Michela; Conti, Sergio; Compagnucci, Paolo; Ribatti, Valentina; Narducci, Maria Lucia; Marcon, Lorenzo; Massara, Francesca; Valeri, Yari; De Francesco, Luca; Martino, Anna Maria; Ghiglieno, Chiara; Schiavone, Marco; Balla, Cristina; Dell'Era, Gabriele; Pelargonio, Gemma; Forleo, Giovanni Battista; Iacopino, Saverio; Sgarito, Giuseppe; Calò, Leonardo; Tondo, Claudio; Russo, Antonio Dello; Patti, Giuseppe
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327535
Citazioni:
Incidence of ventricular arrhythmias related to COVID infection and vaccination in patients with Brugada syndrome: Insights from a large Italian multicenter registry based on continuous rhythm monitoring / Casella, M., Conti, S., Compagnucci, P., Ribatti, V., Narducci, M.L., Marcon, L., Massara, F., Valeri, Y., De Francesco, L., Martino, A.M., Ghiglieno, C., Schiavone, M., Balla, C., Dell'Era, G., Pelargonio, G., Forleo, G.B., Iacopino, S., Sgarito, G., Calò, L., Tondo, C., et al.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 34:6(2023), pp. 1386-1394. [10.1111/jce.15929]
Abstract:
IntroductionBrugada syndrome (BrS) has a dynamic ECG pattern that might be revealed by certain conditions such as fever. We evaluated the incidence and management of ventricular arrhythmias (VAs) related to COVID-19 infection and vaccination among BrS patients carriers of an implantable loop recorde...r (ILR) or implantable cardioverter-defibrillator (ICD) and followed by remote monitoring. MethodsThis was a multicenter retrospective study. Patients were carriers of devices with remote monitoring follow-up. We recorded VAs 6 months before COVID-19 infection or vaccination, during infection, at each vaccination, and up to 6-month post-COVID-19 or 1 month after the last vaccination. In ICD carriers, we documented any device intervention. ResultsWe included 326 patients, 202 with an ICD and 124 with an ILR. One hundred and nine patients (33.4%) had COVID-19, 55% of whom developed fever. Hospitalization rate due to COVID-19 infection was 2.76%. After infection, we recorded only two ventricular tachycardias (VTs). After the first, second, and third vaccines, the incidence of non-sustained ventricular tachycardia (NSVT) was 1.5%, 2%, and 1%, respectively. The incidence of VT was 1% after the second dose. Six-month post-COVID-19 healing or 1 month after the last vaccine, we documented NSVT in 3.4%, VT in 0.5%, and ventricular fibrillation in 0.5% of patients. Overall, one patient received anti-tachycardia pacing and one a shock. ILR carriers had no VAs. No differences were found in VT before and after infection and before and after each vaccination. ConclusionsFrom this large multicenter study conducted in BrS patients, followed by remote monitoring, the overall incidence of sustained VAs after COVID-19 infection and vaccination is relatively low.
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A sex-informed approach to improve the personalised decision making process in myelodysplastic syndromes: a multicentre, observational cohort study
Anno: 2023
Rivista: THE LANCET. HAEMATOLOGY
Autori/autrici: Maggioni, Giulia; Bersanelli, Matteo; Travaglino, Erica; Alfonso Piérola, Ana; Kasprzak, Annika; Sangerman Montserrat, Arnan; Sauta, Elisabetta; Sala, Claudia; Matteuzzi, Tommaso; Meggendorfer, Manja; Gnocchi, Matteo; Zhao, Lin-Pierre; Tentori, Cristina Astrid; Nachtkamp, Kathrin; Dall'Olio, Daniele; Mosca, Ettore; Ubezio, Marta; Campagna, Alessia; Russo, Antonio; Rivoli, Giulia; Bernardi, Massimo; Borin, Lorenza; Voso, Maria Teresa; Riva, Marta; Oliva, Esther; Zampini, Matteo; Riva, Elena; Saba, Elena; D'Amico, Saverio; Lanino, Luca; Tinterri, Benedetta; Re, Francesca; Bicchieri, Marilena; Giordano, Laura; Angelotti, Giovanni; Morandini, Pierandrea; Kubasch, Anne Sophie; Passamonti, Francesco; Rambaldi, Alessandro; Savevski, Victor; Santoro, Armando; Van De Loosdrecht, Arjan A.; Brogi, Alice; Santini, Valeria; Kordasti, Shahram; Sanz, Guillermo; Sole, Francesc; Gattermann, Norbert; Kern, Wolfgang; Platzbecker, Uwe; Ades, Lionel; Fenaux, Pierre; Haferlach, Torsten; Castellani, Gastone; Germing, Ulrich; Diez-Campelo, Maria; Della Porta, Matteo G.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/316354
Citazioni:
A sex-informed approach to improve the personalised decision making process in myelodysplastic syndromes: a multicentre, observational cohort study / Maggioni, G., Bersanelli, M., Travaglino, E., Alfonso Piérola, A., Kasprzak, A., Sangerman Montserrat, A., Sauta, E., Sala, C., Matteuzzi, T., Meggendorfer, M., Gnocchi, M., Zhao, L., Tentori, C.A., Nachtkamp, K., Dall'Olio, D., Mosca, E., Ubezio, M., Campagna, A., Russo, A., Rivoli, G., et al.. - In: THE LANCET. HAEMATOLOGY. - ISSN 2352-3026. - 10:2(2023), pp. 117-128. [10.1016/S2352-3026(22)00323-4]
Abstract:
Background Sex is a major source of diversity among patients and a sex-informed approach is becoming a new paradigm in precision medicine. We aimed to describe sex diversity in myelodysplastic syndromes in terms of disease genotype, phenotype, and clinical outcome. Moreover, we sought to incorporate... sex information into the clinical decision-making process as a fundamental component of patient individuality. Methods In this multicentre, observational cohort study, we retrospectively analysed 13 284 patients aged 18 years or older with a diagnosis of myelodysplastic syndrome according to 2016 WHO criteria included in the EuroMDS network (n=2025), International Working Group for Prognosis in MDS (IWG-PM; n=2387), the Spanish Group of Myelodysplastic Syndromes registry (GESMD; n=7687), or the Dusseldorf MDS registry (n=1185). Recruitment periods for these cohorts were between 1990 and 2016. The correlation between sex and genomic features was analysed in the EuroMDS cohort and validated in the IWG-PM cohort. The effect of sex on clinical outcome, with overall survival as the main endpoint, was analysed in the EuroMDS population and validated in the other three cohorts. Finally, novel prognostic models incorporating sex and genomic information were built and validated, and compared to the widely used revised International Prognostic Scoring System (IPSS-R). This study is registered with ClinicalTrials.gov, NCT04889729. Findings The study included 7792 (58middot7%) men and 5492 (41middot3%) women. 10 906 (82middot1%) patients were White, and race was not reported for 2378 (17middot9%) patients. Sex biases were observed at the single-gene level with mutations in seven genes enriched in men (ASXL1, SRSF2, and ZRSR2 p&lt;0middot0001 in both cohorts; DDX41 not available in the EuroMDS cohort vs p=0middot0062 in the IWG-PM cohort; IDH2 p&lt;0middot0001 in EuroMDS vs p=0middot042 in IWG-PM; TET2 p=0middot031 vs p=0middot035; U2AF1 p=0middot033 vs p&lt;0middot0001) and mutations in two genes were enriched in women (DNMT3A p&lt;0middot0001 in EuroMDS vs p=0middot011 in IWG-PM; TP53 p=0middot030 vs p=0middot037). Additionally, sex biases were observed in co-mutational pathways of founding genomic lesions (splicing-related genes, predominantly in men, p&lt;0middot0001 in both the EuroMDS and IWG-PM cohorts), in DNA methylation (predominantly in men, p=0middot046 in EuroMDS vs p&lt;0middot0001 in IWG-PM), and TP53 mutational pathways (predominantly in women, p=0middot0073 in EuroMDS vs p&lt;0middot0001 in IWG-PM). In the retrospective EuroMDS cohort, men had worse median overall survival (81middot3 months, 95% CI 70middot4-95middot0 in men vs 123middot5 months, 104middot5-127middot5 in women; hazard ratio [HR] 1middot40, 95% CI 1middot26-1middot52; p&lt;0middot0001). This result was confirmed in the prospective validation cohorts (median overall survival was 54middot7 months, 95% CI 52middot4-59middot1 in men vs 74middot4 months, 69middot3-81middot2 in women; HR 1middot30, 95% CI 1middot23-1middot35; p&lt;0middot0001 in the GEMSD MDS registry; 40middot0 months, 95% CI 33middot4-43middot7 in men vs 54middot2 months, 38middot6-63middot8 in women; HR 1middot23, 95% CI 1middot08-1middot36; p&lt;0middot0001 in the Dusseldorf MDS registry). We developed new personalised prognostic tools that included sex information (the sex-informed prognostic scoring system and the sex-informed genomic scoring system). Sex maintained independent prognostic power in all prognostic systems; the highest performance was observed in the model that included both sex and genomic information.A five-to-five mapping between the IPSS-R and new score categories resulted in the re-stratification of 871 (43middot0%) of 2025 patients from the EuroMDS cohort and 1003 (42middot0%) of 2387 patients from the IWG-PM cohort by using the sex-informed prognostic scoring system, and of 1134 (56middot0%) patients from the EuroMDS cohort and 1265 (53middot0%) patients from the IWG-PM cohort by using the sex-informed genomic scoring system. We created a web portal that enables outcome predictions based on a sex-informed personalised approach. Interpretation Our results suggest that a sex-informed approach can improve the personalised decision making process in patients with myelodysplastic syndromes and should be considered in the design of clinical trials including low-risk patients. Copyright (c) 2022 Published by Elsevier Ltd. All rights reserved.
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Pulsed-Field Ablation Does Not Worsen Baseline Pulmonary Hypertension Following Prior Radiofrequency Ablations
Anno: 2023
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Mohanty, Sanghamitra; Della Rocca, Domenico Giovanni; Torlapati, Prem Geeta; Chierchia, Gian-Battista; Dello Russo, Antonio; Casella, Michela; Gianni, Carola; Macdonald, Bryan; Mayedo, Angel; La Fazia, Vincenzo Mirco; Bassiouny, Mohamed; Gallinghouse, G. Joseph; Burkhardt, John D.; Horton, Rodney; Al-Ahmad, Amin; Di Biase, Luigi; Pannone, Luigi; de Asmundis, Carlo; Natale, Andrea
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327546
Citazioni:
Pulsed-Field Ablation Does Not Worsen Baseline Pulmonary Hypertension Following Prior Radiofrequency Ablations / Mohanty, S., Della Rocca, D.G., Torlapati, P.G., Chierchia, G., Dello Russo, A., Casella, M., Gianni, C., Macdonald, B., Mayedo, A., La Fazia, V.M., Bassiouny, M., Gallinghouse, G.J., Burkhardt, J.D., Horton, R., Al-Ahmad, A., Di Biase, L., Pannone, L., de Asmundis, C., Natale, A.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - (2023). [10.1016/j.jacep.2023.11.005]
Abstract:
Background: Studies have reported development of pulmonary hypertension (PH) secondary to reduced LA compliance following AF ablation. Objectives: We aimed to compare the risk of worsening of baseline PH between non-paroxysmal AF patients undergoing pulsed-field ablation (PFA) and standard radiofreq...uency ablation (RFA). Methods: This multicenter study included 28 nonparoxysmal AF patients with PH undergoing a PFA-based ablation procedure after >1 failed RFA. A cohort of 28 AF patients with PH, scheduled for repeat RFA, 1:1 propensity-score matched using a multivariable logistic model, were used as the comparator group. Right heart catheterization and echocardiography were performed before and after the procedure to assess the pulmonary artery pressure (PAP). PH was defined as resting mean PAP of >20 mm Hg. Results: The baseline characteristics of the PFA and propensity-matched RFA groups were comparable. The mean PAP assessments at baseline, follow-up, and change from baseline were analyzed. The groups had comparable baseline mean pulmonary artery pressures (mPAP) (P = 0.177). After adjustment for baseline mPAP in an analysis of covariance model, the least-squares means change at 3 months after ablation was -1.71 ± 1.03 mm Hg and 19.67 ± 1.03 mm Hg in PFA and RFA, respectively (P <0.001). Conclusions: In this propensity-matched population, no worsening of mPAP was detected following pulsed-field ablation in patients with pre-existing PH undergoing a repeat procedure for recurrence.
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Implantable defibrillator-detected heart failure status predicts ventricular tachyarrhythmias
Anno: 2023
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Compagnucci, Paolo; Casella, Michela; Bianchi, Valter; Franculli, Fabio; Vitali, Francesco; Santini, Luca; Savarese, Gianluca; Santobuono, Vincenzo Ezio; Chianese, Raffaele; Lavalle, Carlo; Amellone, Claudia; Pecora, Domenico; Calvanese, Raimondo; Stronati, Giulia; Santoro, Amato; Ziacchi, Matteo; Campari, Monica; Valsecchi, Sergio; Calò, Leonardo; Guerra, Federico; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/315559
Citazioni:
Implantable defibrillator-detected heart failure status predicts ventricular tachyarrhythmias / Compagnucci, P., Casella, M., Bianchi, V., Franculli, F., Vitali, F., Santini, L., Savarese, G., Santobuono, V.E., Chianese, R., Lavalle, C., Amellone, C., Pecora, D., Calvanese, R., Stronati, G., Santoro, A., Ziacchi, M., Campari, M., Valsecchi, S., Calò, L., Guerra, F., et al.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1540-8167. - 34:5(2023), pp. 1257-1267. [10.1111/jce.15898]
Abstract:
Introduction: The prediction of ventricular tachyarrhythmias among patients with implantable cardioverter defibrillators is difficult with available clinical tools. We sought to assess whether in patients with heart failure (HF) and reduced ejection fraction with defibrillators, physiological sensor...-based HF status, as summarized by the HeartLogic index, could predict appropriate device therapies. Methods: Five hundred and sixty-eight consecutive HF patients with defibrillators (n = 158, 28%) or cardiac resynchronization therapy-defibrillators (n = 410, 72%) were included in this prospective observational multicenter analysis. The association of both HeartLogic index and its physiological components with defibrillator shocks and overall appropriate therapies was assessed in regression and time-dependent Cox models. Results: Over a follow-up of 25 (15-35) months, 122 (21%) patients received an appropriate device therapy (shock, n = 74, 13%), while the HeartLogic index crossed the threshold value (alert, HeartLogic ≥ 16) 1200 times (0.71 alerts/patient-year) in 370 (65%) subjects. The occurrence of ≥1 HeartLogic alert was significantly associated with both appropriate shocks (Hazard ratios [HR]: 2.44, 95% confidence interval [CI]: 1.49-3.97, p = .003), and any appropriate defibrillator therapies. In multivariable time-dependent Cox models, weekly IN-alert state was the strongest predictor of appropriate defibrillator shocks (HR: 2.94, 95% CI: 1.73-5.01, p &lt; .001) and overall therapies. Compared with stable patients, patients with appropriate shocks had significantly higher values of HeartLogic index, third heart sound amplitude, and resting heart rate 30-60 days before device therapy. Conclusion: The HeartLogic index is an independent dynamic predictor of appropriate defibrillator therapies. The combined index and its individual physiological components change before the arrhythmic event occurs.
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Different Phases of Disease in Lymphocytic Myocarditis: Clinical and Electrophysiological Characteristics
Anno: 2023
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Casella, Michela; Gasperetti, Alessio; Compagnucci, Paolo; Narducci, Maria Lucia; Pelargonio, Gemma; Catto, Valentina; Carbucicchio, Corrado; Bencardino, Gianluigi; Conte, Edoardo; Schicchi, Nicolò; Andreini, Daniele; Pontone, Gianluca; Giovagnoni, Andrea; Rizzo, Stefania; Inzani, Frediano; Basso, Cristina; Natale, Andrea; Tondo, Claudio; Russo, Antonio Dello; Crea, Filippo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/321945
Citazioni:
Different Phases of Disease in Lymphocytic Myocarditis: Clinical and Electrophysiological Characteristics / Casella, M., Gasperetti, A., Compagnucci, P., Narducci, M.L., Pelargonio, G., Catto, V., Carbucicchio, C., Bencardino, G., Conte, E., Schicchi, N., Andreini, D., Pontone, G., Giovagnoni, A., Rizzo, S., Inzani, F., Basso, C., Natale, A., Tondo, C., Russo, A.D., Crea, F.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 9:3(2023), pp. 314-326. [10.1016/j.jacep.2022.10.004]
Abstract:
Background: Endomyocardial biopsy (EMB) is required to make a definite diagnosis of lymphocytic myocarditis (LM), to identify its etiology, and to classify LM into different phases. Objectives: This study aims to characterize and compare clinical and electrophysiological characteristics of different... biopsy-proven LM phases, namely acute myocarditis (AM), chronic active myocarditis (CAM), and healed myocarditis (HM). Methods: All patients with a diagnosis of LM at 3 Italian referral centers were prospectively enrolled. According to EMB findings, LM was classified as AM, CAM, or HM; per-group comparisons of clinical presentations, noninvasive, and invasive findings are reported. Results: Among the 122 enrolled patients (AM, n&nbsp;=&nbsp;44; CAM, n&nbsp;=&nbsp;42; HM, n&nbsp;=&nbsp;36), complex ventricular arrhythmias were very common overall (n&nbsp;=&nbsp;109, 89%), but ventricular fibrillation was slightly more prevalent in AM (P&nbsp;=&nbsp;0.028). Cardiac magnetic resonance imaging showed late gadolinium enhancement in more patients with HM and CAM than AM (94.4% vs 92.9% vs 50%; P&nbsp;&lt; 0.001), whereas edema was more common in AM than in CAM, being absent in HM (90.9% vs 50% vs 0%; P&nbsp;&lt; 0.001). Accordingly, edema was the strongest independent clinical predictor of EMB-proven active inflammation. Electroanatomical mapping revealed a lower prevalence of low-voltage areas in AM than in CAM or HM. We observed a strong association between edema at a specific myocardial segment and normal voltages at that site (odds ratio: 0.24; 95%&nbsp;CI: 0.10-0.54; P&nbsp;&lt; 0.01), as well as between late gadolinium enhancement and low-voltage areas (odds ratio: 2.86; 95%&nbsp;CI: 1.19-6.97; P&nbsp;=&nbsp;0.019). Conclusions: LM is a highly heterogeneous disease, and its different phases are characterized by diverse clinical, morphological, and electrophysiological features. Further research is required to identify electroanatomical markers of inflammation.
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High-power short-duration catheter ablation of atrial fibrillation: is it really a new era? Comparison between new and old radiofrequency contact force–sensing catheters
Anno: 2023
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Dello Russo, Antonio; D’Angelo, Leonardo; Compagnucci, Paolo; Cipolletta, Laura; Parisi, Quintino; Valeri, Yari; Campanelli, Francesca; Volpato, Giovanni; Carboni, Laura; Ciliberti, Giuseppe; Stronati, Giulia Emily; Barbarossa, Alessandro; La Piscopia, Valentina; Bondavalli, Barbara; Guerra, Federico; Natale, Andrea; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327540
Citazioni:
High-power short-duration catheter ablation of atrial fibrillation: is it really a new era? Comparison between new and old radiofrequency contact force–sensing catheters / Dello Russo, A., D’Angelo, L., Compagnucci, P., Cipolletta, L., Parisi, Q., Valeri, Y., Campanelli, F., Volpato, G., Carboni, L., Ciliberti, G., Stronati, G.E., Barbarossa, A., La Piscopia, V., Bondavalli, B., Guerra, F., Natale, A., Casella, M.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1572-8595. - (2023). [10.1007/s10840-023-01612-x]
Abstract:
Background The clinical performance of high-power, short-duration (HPSD) pulmonary vein isolation (PVI) with the novel flexible tip TactiFlex (TM) (TFSE) catheter, as compared to standard-power, long-duration (SPLD) PVI using the TactiCath (TM) (TCSE) catheter among patients undergoing catheter abla...tion (CA) of atrial fibrillation (AF) is currently unknown.Methods We conducted a prospective, observational, single-centre study including 40 consecutive patients undergoing PVI for paroxysmal/persistent AF, using HPSD ablation with the novel TFSE catheter (HPSD/TFSE group). Based on propensity score-matching, forty patients undergoing SPLD PVI with the TCSE catheter were identified (SPLD/TCSE group). In the HPSD/TFSE group, RF lesions were performed by delivering 40-50 W for 10-20 s, while in the SPLD/TCSE group, RF power was 30-35 W, targeting a lesion size index (LSI) of 4.0-5.5. The co-primary study outcomes were time required to complete PVI and first pass isolation (FPI).Results PVI was achieved in 100% of patients in both groups, and no major adverse events were observed. Remarkably, PVI time was shorter in the HPSD/TFSE, compared to the SPLD/TCSE group(9 [7-9] min vs. 50 [37-54] min; p < 0.001), while FPI rate was non-significantly higher in the former group(91% [146/160] vs 83% [134/160]; p = 0.063). Shorter procedural (108 [91-120] min vs. 173 [139-187] min, p < 0.001), total RF (9 [7-11] min vs. 43 [32-53] min, p < 0.001), fluoroscopy times(15 [10-19] min vs. 18 [13-26] min, p = 0.014), and lower DAP (1461 [860-2181] vs. 7200 [3400-20,800], p < 0.001) were recorded in the HPSD/TFSE group. A higher average impedance drop was obtained with HPSD/TFSE CA(17[17-18]O vs. 16 [15-17]O, p < 0.001).Conclusions In our initial clinical experience, HPSD PVI with the TFSE catheter proved faster than SPLD PVI with the TCSE catheter, at least equally effective in terms of FPI, and it was associated with greater impedance drop.[GRAPHICS]
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Inflammation on Endomyocardial Biopsy Predicts Risk of MACE in Undefined Left Ventricular Arrhythmogenic Cardiomyopathy
Anno: 2023
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Peretto, Giovanni; Casella, Michela; Merlo, Marco; Benedetti, Sara; Rizzo, Stefania; Cappelletto, Chiara; Di Resta, Chiara; Compagnucci, Paolo; De Gaspari, Monica; Dello Russo, Antonio; Casari, Giorgio; Basso, Cristina; Sala, Simone; Sinagra, Gianfranco; Della Bella, Paolo; Cooper, Leslie T.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/327533
Citazioni:
Inflammation on Endomyocardial Biopsy Predicts Risk of MACE in Undefined Left Ventricular Arrhythmogenic Cardiomyopathy / Peretto, G., Casella, M., Merlo, M., Benedetti, S., Rizzo, S., Cappelletto, C., Di Resta, C., Compagnucci, P., De Gaspari, M., Dello Russo, A., Casari, G., Basso, C., Sala, S., Sinagra, G., Della Bella, P., Cooper, L.T.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 9:7, Part 1(2023), pp. 951-961. [10.1016/j.jacep.2022.10.032]
Abstract:
Background: Predictors of major adverse cardiovascular events (MACE) in patients with undefined left ventricular arrhythmogenic cardiomyopathy (ULVACM) have not been described. Objectives: The purpose of this study was to investigate the prognostic value of genetic testing and histology in a cohort ...of ULVACM patients. Methods: We identified 313 patients with ULVACM defined by new-onset ventricular arrhythmia (VA), nonischemic pattern of late gadolinium enhancement limited to the left ventricle (LV), and no severe dilated cardiomyopathy (LV ejection fraction ≥40%) from a retrospective multicenter registry. Patients undergoing next generation sequencing (NGS) for cardiomyopathy genes and endomyocardial biopsy (EMB) were compared with subjects without these studies. The primary endpoint was the occurrence of MACE, defined as the composite of cardiac death, heart transplantation, and malignant VA (ventricular tachycardia, ventricular fibrillation, appropriate implantable cardioverter-defibrillator treatment), at 60 months after clinical presentation. Results: Of the whole cohort (age 46 ± 14 years, 63% men, LV ejection fraction 55% ± 7%), 160 (51%) and 198 patients (63%), respectively, underwent NGS and EMB. NGS identified pathogenic or likely-pathogenic cardiomyopathy variants (pathogenic variants/likely pathogenic variants) in 25 of 160 cases (16%). EMB showed active myocardial inflammation (AM) in 102 of 198 patients (52%), 47 of whom (46%) received immunosuppressive therapy. After 58-month median follow-up, 93 of 313 patients (30%) experienced MACE. On multivariable analysis, presentation with malignant VA and EMB-proven AM were positively associated with the primary endpoint (HR: 2.8; 95% CI: 1.4-5.5; P = 0.003; and HR: 3.9; 95% CI: 1.9-7.5; P &lt; 0.001, respectively), whereas immunosuppressive therapy showed a reverse association with MACE at 60 months (HR: 0.10; 95% CI: 0.05-0.40; P &lt; 0.001). Conclusions: Presentation with malignant VA or AM associates with MACE in ULVACM patients.
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The need for a subsequent transvenous system in patients implanted with subcutaneous implantable cardioverter-defibrillator
Anno: 2022
Rivista: HEART RHYTHM
Autori/autrici: Gasperetti, Alessio; Schiavone, Marco; Vogler, Julia; Laredo, Mikael; Fastenrath, Fabian; Palmisano, Pietro; Ziacchi, Matteo; Angeletti, Andrea; Mitacchione, Gianfranco; Kaiser, Lukas; Compagnucci, Paolo; Breitenstein, Alexander; Arosio, Roberto; Vitali, Francesco; De Bonis, Silvana; Picarelli, Francesco; Casella, Michela; Santini, Luca; Pignalberi, Carlo; Lavalle, Carlo; Pisanò, Ennio; Ricciardi, Danilo; Calò, Leonardo; Curnis, Antonio; Bertini, Matteo; Gulletta, Simone; Dello Russo, Antonio; Badenco, Nicolas; Tondo, Claudio; Kuschyk, Jürgen; Tilz, Roland; Forleo, Giovanni B; Biffi, Mauro
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305279
Citazioni:
The need for a subsequent transvenous system in patients implanted with subcutaneous implantable cardioverter-defibrillator / Gasperetti, A., Schiavone, M., Vogler, J., Laredo, M., Fastenrath, F., Palmisano, P., Ziacchi, M., Angeletti, A., Mitacchione, G., Kaiser, L., Compagnucci, P., Breitenstein, A., Arosio, R., Vitali, F., De Bonis, S., Picarelli, F., Casella, M., Santini, L., Pignalberi, C., Lavalle, C., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - (2022). [10.1016/j.hrthm.2022.06.030]
Abstract:
The absence of pacing capabilities may reduce the appeal of subcutaneous implantable cardioverter-defibrillator (S-ICD) devices for patients at risk for conduction disorders or with antitachycardia pacing (ATP)/cardiac resynchronization (CRT) requirements. Reports of rates of S-ICD to transvenous im...plantable cardioverter-defibrillator (TV-ICD) system switch in real-world scenarios are limited.
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Association of Premature Ventricular Contraction Burden on Serial Holter Monitoring With Arrhythmic Risk in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy
Anno: 2022
Rivista: JAMA CARDIOLOGY
Autori/autrici: Gasperetti, Alessio; Cappelletto, Chiara; Carrick, Richard; Targetti, Mattia; Tichnell, Crystal; Martino, Annamaria; Murray, Brittney; Compagnucci, Paolo; Stolfo, Davide; Bisson, Jasmine; Gilotra, Nisha; Carbucicchio, Corrado; Olivotto, Iacopo; Tandri, Harikrishna; Dello Russo, Antonio; Cadrin-Tourigny, Julia; Calò, Leonardo; Tondo, Claudio; Sinagra, Gianfranco; James, Cynthia A; Casella, Michela; Calkins, Hugh
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305286
Citazioni:
Association of Premature Ventricular Contraction Burden on Serial Holter Monitoring With Arrhythmic Risk in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy / Gasperetti, A., Cappelletto, C., Carrick, R., Targetti, M., Tichnell, C., Martino, A., Murray, B., Compagnucci, P., Stolfo, D., Bisson, J., Gilotra, N., Carbucicchio, C., Olivotto, I., Tandri, H., Dello Russo, A., Cadrin-Tourigny, J., Calò, L., Tondo, C., Sinagra, G., James, C.A., et al.. - In: JAMA CARDIOLOGY. - ISSN 2380-6583. - 7:4(2022), pp. 378-385. [10.1001/jamacardio.2021.6016]
Abstract:
A high burden of premature ventricular contractions (PVCs) at disease diagnosis has been associated with an overall higher risk of ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). Data regarding dynamic modification of PVC burden at follow-up with Holter monitoring ...and its impact on arrhythmic risk in ARVC are scarce.
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Angina in 2022: Current Perspectives
Anno: 2022
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Manfredi, Roberto; Verdoia, Monica; Compagnucci, Paolo; Barbarossa, Alessandro; Stronati, Giulia; Casella, Michela; Dello Russo, Antonio; Guerra, Federico; Ciliberti, Giuseppe
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/315554
Citazioni:
Angina in 2022: Current Perspectives / Manfredi, R., Verdoia, M., Compagnucci, P., Barbarossa, A., Stronati, G., Casella, M., Dello Russo, A., Guerra, F., Ciliberti, G.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 11:23(2022), p. 6891. [10.3390/jcm11236891]
Abstract:
Angina is the main symptom of ischemic heart disease; mirroring a mismatch between oxygen supply and demand. Epicardial coronary stenoses are only responsible for nearly half of the patients presenting with angina; whereas in several cases; symptoms may underlie coronary vasomotor disorders; such as... microvascular dysfunction or epicardial spasm. Various medications have been proven to improve the prognosis and quality of life; representing the treatment of choice in stable angina and leaving revascularization only in particular coronary anatomies or poorly controlled symptoms despite optimal medical therapy. Antianginal medications aim to reduce the oxygen supply-demand mismatch and are generally effective in improving symptoms; quality of life; effort tolerance and time to ischemia onset and may improve prognosis in selected populations. Since antianginal medications have different mechanisms of action and side effects; their use should be tailored according to patient history and potential drug-drug interactions. Angina with non-obstructed coronary arteries patients should be phenotyped with invasive assessment and treated accordingly. Patients with refractory angina represent a higher-risk population in which some therapeutic options are available to reduce symptoms and improve quality of life; but robust data from large randomized controlled trials are still lacking.
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Age-related differences and associated mid-term outcomes of subcutaneous implantable cardioverter-defibrillators: A propensity-matched analysis from a multicenter European registry
Anno: 2022
Rivista: HEART RHYTHM
Autori/autrici: Gulletta, Simone; Gasperetti, Alessio; Schiavone, Marco; Vogler, Julia; Fastenrath, Fabian; Breitenstein, Alexander; Laredo, Mikael; Palmisano, Pietro; Mitacchione, Gianfranco; Compagnucci, Paolo; Kaiser, Lukas; Hakmi, Samer; Angeletti, Andrea; De Bonis, Silvana; Picarelli, Francesco; Arosio, Roberto; Casella, Michela; Steffel, Jan; Fierro, Nicolai; Guarracini, Fabrizio; Santini, Luca; Pignalberi, Carlo; Piro, Agostino; Lavalle, Carlo; Pisanò, Ennio; Viecca, Maurizio; Curnis, Antonio; Badenco, Nicolas; Ricciardi, Danilo; Dello Russo, Antonio; Tondo, Claudio; Kuschyk, Jürgen; Della Bella, Paolo; Biffi, Mauro; Forleo, Giovanni B; Tilz, Roland
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305289
Citazioni:
Age-related differences and associated mid-term outcomes of subcutaneous implantable cardioverter-defibrillators: A propensity-matched analysis from a multicenter European registry / Gulletta, S., Gasperetti, A., Schiavone, M., Vogler, J., Fastenrath, F., Breitenstein, A., Laredo, M., Palmisano, P., Mitacchione, G., Compagnucci, P., Kaiser, L., Hakmi, S., Angeletti, A., De Bonis, S., Picarelli, F., Arosio, R., Casella, M., Steffel, J., Fierro, N., Guarracini, F., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - 19:7(2022), pp. 1109-1115. [10.1016/j.hrthm.2022.02.029]
Abstract:
A few limited case series have shown that the subcutaneous implantable cardioverter-defibrillator (S-ICD) system is safe for teenagers and young adults, but a large-scale analysis currently is lacking.

Arrhythmic risk prediction in arrhythmogenic right ventricular cardiomyopathy: external validation of the arrhythmogenic right ventricular cardiomyopathy risk calculator
Anno: 2022
Rivista: EUROPEAN HEART JOURNAL
Autori/autrici: Jordà, Paloma; Bosman, Laurens P; Gasperetti, Alessio; Mazzanti, Andrea; Gourraud, Jean Baptiste; Davies, Brianna; Frederiksen, Tanja Charlotte; Moreno Weidmann, Zoraida; Di Marco, Andrea; Roberts, Jason D; Macintyre, Ciorsti; Seifer, Colette; Delinière, Antoine; Alqarawi, Wael; Kukavica, Deni; Minois, Damien; Trancuccio, Alessandro; Arnaud, Marine; Targetti, Mattia; Martino, Annamaria; Oliviero, Giada; Pipilas, Daniel C; Carbucicchio, Corrado; Compagnucci, Paolo; Dello Russo, Antonio; Olivotto, Iacopo; Calò, Leonardo; Lubitz, Steven A; Cutler, Michael J; Chevalier, Philippe; Arbelo, Elena; Priori, Silvia Giuliana; Healey, Jeffrey S; Calkins, Hugh; Casella, Michela; Jensen, Henrik Kjærulf; Tondo, Claudio; Tadros, Rafik; James, Cynthia A; Krahn, Andrew D; Cadrin-Tourigny, Julia
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305293
Citazioni:
Arrhythmic risk prediction in arrhythmogenic right ventricular cardiomyopathy: external validation of the arrhythmogenic right ventricular cardiomyopathy risk calculator / Jordà, P., Bosman, L.P., Gasperetti, A., Mazzanti, A., Gourraud, J.B., Davies, B., Frederiksen, T.C., Moreno Weidmann, Z., Di Marco, A., Roberts, J.D., Macintyre, C., Seifer, C., Delinière, A., Alqarawi, W., Kukavica, D., Minois, D., Trancuccio, A., Arnaud, M., Targetti, M., Martino, A., et al.. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 43:32(2022), pp. 3041-3052. [10.1093/eurheartj/ehac289]
Abstract:
Arrhythmogenic right ventricular cardiomyopathy (ARVC) causes ventricular arrhythmias (VAs) and sudden cardiac death (SCD). In 2019, a risk prediction model that estimates the 5-year risk of incident VAs in ARVC was developed (ARVCrisk.com). This study aimed to externally validate this prediction mo...del in a large international multicentre cohort and to compare its performance with the risk factor approach recommended for implantable cardioverter-defibrillator (ICD) use by published guidelines and expert consensus.
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Peri-procedural and mid-term follow-up age-related differences in leadless pacemaker implantation: Insights from a multicenter European registry
Anno: 2022
Rivista: INTERNATIONAL JOURNAL OF CARDIOLOGY
Autori/autrici: Gulletta, Simone; Schiavone, Marco; Gasperetti, Alessio; Breitenstein, Alexander; Palmisano, Pietro; Mitacchione, Gianfranco; Chierchia, Gian Battista; Montemerlo, Elisabetta; Statuto, Giovanni; Russo, Giulia; Casella, Michela; Vitali, Francesco; Mazzone, Patrizio; Hofer, Daniel; Arabia, Gianmarco; Moltrasio, Massimo; Lipartiti, Felicia; Fierro, Nicolai; Bertini, Matteo; Dello Russo, Antonio; Pisanò, Ennio C L; Biffi, Mauro; Rovaris, Giovanni; de Asmundis, Carlo; Tondo, Claudio; Curnis, Antonio; Della Bella, Paolo; Saguner, Ardan M; Forleo, Giovanni B
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/306562
Citazioni:
Peri-procedural and mid-term follow-up age-related differences in leadless pacemaker implantation: Insights from a multicenter European registry / Gulletta, S., Schiavone, M., Gasperetti, A., Breitenstein, A., Palmisano, P., Mitacchione, G., Chierchia, G.B., Montemerlo, E., Statuto, G., Russo, G., Casella, M., Vitali, F., Mazzone, P., Hofer, D., Arabia, G., Moltrasio, M., Lipartiti, F., Fierro, N., Bertini, M., Dello Russo, A., et al.. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - (2022). [10.1016/j.ijcard.2022.09.026]
Abstract:
Age-related differences on leadless pacemaker (LP) are poorly described. Aim of this study was to compare clinical indications, periprocedural and mid-term device-associated outcomes in a large real-world cohort of LP patients, stratified by age at implantation.

Safety and Efficacy of Stereotactic Arrhythmia Radioablation for the Treatment of Ventricular Tachycardia: A Systematic Review
Anno: 2022
Rivista: FRONTIERS IN CARDIOVASCULAR MEDICINE
Autori/autrici: Volpato, Giovanni; Compagnucci, Paolo; Cipolletta, Laura; Parisi, Quintino; Valeri, Yari; Carboni, Laura; Giovagnoni, Andrea; Dello Russo, Antonio; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/306561
Citazioni:
Safety and Efficacy of Stereotactic Arrhythmia Radioablation for the Treatment of Ventricular Tachycardia: A Systematic Review / Volpato, G., Compagnucci, P., Cipolletta, L., Parisi, Q., Valeri, Y., Carboni, L., Giovagnoni, A., Dello Russo, A., Casella, M.. - In: FRONTIERS IN CARDIOVASCULAR MEDICINE. - ISSN 2297-055X. - 9:(2022). [10.3389/fcvm.2022.870001]
Abstract:
Catheter ablation (CA) is a fundamental therapeutic option for the treatment of recurrent ventricular arrhythmias. Notwithstanding the tremendous improvements in the available technology and the increasing amount of evidence in support of CA, in some patients the procedure fails, or is absolutely co...ntraindicated due to technical or clinical issues. In these cases, the clinical management of patients is highly challenging, and mainly involves antiarrhythmic drugs escalation. Over the last 5 years, stereotactic arrhythmia radioablation (STAR) has been introduced into clinical practice, with several small studies reporting favorable arrhythmia-free outcomes, without severe side effects at a short to mid-term follow-up. In the present systematic review, we provide an overview of the available studies on stereotactic arrhythmia radioablation, by describing the potential indications and technical aspects of this promising therapy.
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Management of older patients with unexplained, recurrent, traumatic syncope and bifascicular block: Implantable loop recorder versus empiric pacemaker implantation-Results of a propensity-matched analysis
Anno: 2022
Rivista: HEART RHYTHM
Autori/autrici: Palmisano, Pietro; Guerra, Federico; Aspromonte, Vittorio; Dell'Era, Gabriele; Pellegrino, Pier Luigi; Laffi, Mattia; Uran, Carlo; De Bonis, Silvana; Accogli, Michele; Dello Russo, Antonio; Patti, Giuseppe; Santoro, Francesco; Torriglia, Antonella; Nigro, Gerardo; Bisignani, Antonio; Coluccia, Giovanni; Stronati, Giulia; Russo, Vincenzo; Ammendola, Ernesto
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/314230
Citazioni:
Management of older patients with unexplained, recurrent, traumatic syncope and bifascicular block: Implantable loop recorder versus empiric pacemaker implantation-Results of a propensity-matched analysis / Palmisano, P., Guerra, F., Aspromonte, V., Dell'Era, G., Pellegrino, P.L., Laffi, M., Uran, C., De Bonis, S., Accogli, M., Dello Russo, A., Patti, G., Santoro, F., Torriglia, A., Nigro, G., Bisignani, A., Coluccia, G., Stronati, G., Russo, V., Ammendola, E.. - In: HEART RHYTHM. - ISSN 1547-5271. - 19:10(2022), pp. 1696-1703. [10.1016/j.hrthm.2022.05.023]
Abstract:
BACKGROUND In patients with unexplained syncope and bifascicular block (BFB), syncope may be caused by intermittent atrioventricular (AV) block. When a correlation between syncope and bradyarrhythmia is not documented in these patients, 2 alternative management strategies can be adopted: (1) empiric... pacemaker (PM) implantation or (2) long-term continuous electrocardio-graphic monitoring by implantable loop recorder (ILR).OBJECTIVE The purpose of this study was to compare the risk of syncope recurrence associated with empiric PM implantation or ILR monitoring.METHODS A prospective, multicenter, observational study enrolled consecutive patients with unexplained, recurrent, traumatic syncope and BFB who underwent ILR monitoring or empiric PM implantation. The risk and causes of syncope recurrence were assessed and compared between the 2 groups. Individual 1:1 propensity matching of baseline characteristics was performed.RESULTS A total of 309 consecutive patients (age 77.2 +/- 12.2 years; 60.8% male) were enrolled. Propensity matching yielded 89 matched pairs. After median follow-up of 33 months, empiric PM implantation was associated with a significantly lower risk of syncope recurrence than ILR monitoring (19.1 vs 46.1%; P <.001). A total of 35 patients (39.3%) who underwent ILR monitoring developed bradyarrhythmias (68.6% paroxysmal AV block) requiring PM implantation during follow-up. Excluding bradyarrhythmic syncope, the most frequent causes of syncope recurrence in both study groups were reflex syncope and orthostatic hypotension.CONCLUSION In patients with unexplained, recurrent, traumatic syncope and BFB, empiric PM implantation significantly reduced the risk of syncope recurrence in comparison with ILR monitoring. A high rate of patients who underwent ILR monitoring developed bradyarrhythmias requiring PM implantation.
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In vivo Lesion Index (LSI) validation in percutaneous radiofrequency catheter ablation
Anno: 2022
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Themistoclakis, Sakis; Calzolari, Vittorio; De Mattia, Luca; China, Paolo; Dello Russo, Antonio; Fassini, Gaetano; Casella, Michela; Caporaso, Igor; Indiani, Stefano; Addis, Alessandro; Basso, Cristina; Della Barbera, Mila; Thiene, Gaetano; Tondo, Claudio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305290
Citazioni:
In vivo Lesion Index (LSI) validation in percutaneous radiofrequency catheter ablation / Themistoclakis, S., Calzolari, V., De Mattia, L., China, P., Dello Russo, A., Fassini, G., Casella, M., Caporaso, I., Indiani, S., Addis, A., Basso, C., Della Barbera, M., Thiene, G., Tondo, C.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1540-8167. - 33:5(2022), pp. 874-882. [10.1111/jce.15442]
Abstract:
Lesion Index (LSI) has been developed to predict lesion efficacy during radiofrequency (RF) catheter ablation. However, its value in predicting lesions size has still to be established. The aim of our study was to assess the lesions size reproducibility for prespecified values of LSI reached during ...RF delivery in an in vivo beating heart.
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Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study
Anno: 2022
Rivista: JOURNAL OF CLINICAL MEDICINE
Autori/autrici: Compagnucci, Paolo; Dello Russo, Antonio; Bergonti, Marco; Anselmino, Matteo; Zucchelli, Giulio; Gasperetti, Alessio; Cipolletta, Laura; Volpato, Giovanni; Ascione, Ciro; Ferraris, Federico; Valeri, Yari; Bongiorni, Maria Grazia; Natale, Andrea; Tondo, Claudio; De Ferrari, Gaetano Maria; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305291
Citazioni:
Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study / Compagnucci, P., Dello Russo, A., Bergonti, M., Anselmino, M., Zucchelli, G., Gasperetti, A., Cipolletta, L., Volpato, G., Ascione, C., Ferraris, F., Valeri, Y., Bongiorni, M.G., Natale, A., Tondo, C., De Ferrari, G.M., Casella, M.. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 11:7(2022), p. 1802. [10.3390/jcm11071802]
Abstract:
A radiofrequency energy lesion transmurality marker incorporating power, contact force, and time (Ablation Index, AI) was shown to be associated with outcomes of catheter ablation (CA) of multiple arrhythmias, but was never systematically assessed in the CA of focal atrial tachycardias (AT). We aime...d to evaluate the role of AI as a predictor of outcomes in focal AT CA, and therefore, retrospectively included 45 consecutive patients undergoing CA for focal AT in four referral electrophysiology laboratories. Clinical and procedural information were collected. For each patient, maximum and mean (by averaging maximum AI values for each radiofrequency ablation lesion) AI were measured. The primary outcome was focal AT-free survival, and was systematically assessed with periodical Holter monitors or cardiac implantable electronic devices. CA was acutely effective in each case; however, 20% (n = 9) of the study population experienced a focal AT recurrence over a median follow-up of 288 days. Both maximum and mean AI values were significantly higher among patients without AT recurrences (maximum AI = 568 ± 91, mean AI = 426 ± 105) than in patients with AT relapses (maximum AI = 447 ± 142, mean AI = 352 ± 76, p = 0.036, and p = 0.028, respectively). The optimal cutoffs associated with freedom from recurrences were 461 for maximum AI (sensitivity, 0.89; specificity, 0.56) and 301 for mean AI (sensitivity, 0.97; specificity, 0.44). In a time-to-event analysis, maximum AI was significantly associated with survival free from AT recurrence (p = 0.001), whereas mean AI was not (p = 0.08). In summary, maximum AI is the best procedural parameter associated with the outcomes of CA for focal AT, and may help standardize the procedural approach.
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Recurrence of atrial fibrillation post-ablation: which is the most effective approach for detection?
Anno: 2022
Rivista: MINERVA CARDIOLOGY AND ANGIOLOGY
Autori/autrici: Casella, Michela; Compagnucci, Paolo; Conti, Manuel A; Falanga, Umberto; Volpato, Giovanni; Fogante, Marco; Cipolletta, Laura; Misiani, Agostino; Molini, Silvano; Giovagnoni, Andrea; Dello Russo, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305287
Citazioni:
Recurrence of atrial fibrillation post-ablation: which is the most effective approach for detection? / Casella, M., Compagnucci, P., Conti, M.A., Falanga, U., Volpato, G., Fogante, M., Cipolletta, L., Misiani, A., Molini, S., Giovagnoni, A., Dello Russo, A.. - In: MINERVA CARDIOLOGY AND ANGIOLOGY. - ISSN 2724-5772. - (2022). [10.23736/S2724-5683.22.05859-8]
Abstract:
Over the last 20 years, catheter ablation of atrial fibrillation (AF) has evolved from a research tool into a fundamental therapeutic measure, with the potential to improve symptoms, quality of life, and even risk of major adverse cardiac events (among patients with heart failure and a reduced eject...ion fraction). Notwithstanding the tremendous evolution in techniques and tools, risk of AF recurrences post-ablation is not negligible, and a comprehensive structured follow-up is highly needed to deliver optimal patient care. In this follow-up process, monitoring of heart rhythm is quintessential to detect recurrences, and may be accomplished by means of symptoms-triggered, intermittent, or continuous monitors. In recent years, the development and widespread adoption of implantable cardiac monitors, by allowing continuous long-term rhythm assessment, has surged to become the gold-standard strategy, both in research settings and in clinical practice. In this review, we both summarize the present state-of-the art on the detection of post-ablation AF recurrences, and provide future perspectives on this emerging yet often neglected topic, aiming to give practical hints for evidence-based, personalized patient care.
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Pathophysiology of Typical Atrial Flutter
Anno: 2022
Rivista: CARDIAC ELECTROPHYSIOLOGY CLINICS
Autori/autrici: Valeri, Y.; Bagliani, G.; Compagnucci, P.; Volpato, G.; Cipolletta, L.; Parisi, Q.; Misiani, A.; Fogante, M.; Molini, S.; Dello Russo, A.; Casella, M.
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305702
Citazioni:
Pathophysiology of Typical Atrial Flutter / Valeri, Y., Bagliani, G., Compagnucci, P., Volpato, G., Cipolletta, L., Parisi, Q., Misiani, A., Fogante, M., Molini, S., Dello Russo, A., Casella, M.. - In: CARDIAC ELECTROPHYSIOLOGY CLINICS. - ISSN 1877-9182. - (2022). [10.1016/j.ccep.2022.05.003]

The Role of Cardiac Resynchronization Therapy for the Management of Functional Mitral Regurgitation
Anno: 2022
Rivista: CELLS
Autori/autrici: Russo, Eleonora; Russo, Giulio; Cassese, Mauro; Braccio, Maurizio; Carella, Massimo; Compagnucci, Paolo; Dello Russo, Antonio; Casella, Michela
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305294
Citazioni:
The Role of Cardiac Resynchronization Therapy for the Management of Functional Mitral Regurgitation / Russo, E., Russo, G., Cassese, M., Braccio, M., Carella, M., Compagnucci, P., Dello Russo, A., Casella, M.. - In: CELLS. - ISSN 2073-4409. - 11:15(2022), p. 2407. [10.3390/cells11152407]
Abstract:
Valve leaflets and chordae structurally normal characterize functional mitral regurgitation (FMR), which in heart failure (HF) setting results from an imbalance between closing and tethering forces secondary to alterations in the left ventricle (LV) and left atrium geometry. In this context, FMR imp...acts the quality of life and increases mortality. Despite multiple medical and surgical attempts to treat FMR, to date, there is no univocal treatment for many patients. The pathophysiology of FMR is highly complex and involves several underlying mechanisms. Left ventricle dyssynchrony may contribute to FMR onset and worsening and represents an important target for FMR management. In this article, we discuss the mechanisms of FMR and review the potential therapeutic role of CRT, providing a comprehensive review of the available data coming from clinical studies and trials.
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Atrial Flutters in Adults with Congenital Heart Disease
Anno: 2022
Rivista: CARDIAC ELECTROPHYSIOLOGY CLINICS
Autori/autrici: Capestro, A.; Soura, E.; Compagnucci, P.; Casella, M.; Marzullo, R.; Dello Russo, A.
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305699
Citazioni:
Atrial Flutters in Adults with Congenital Heart Disease / Capestro, A., Soura, E., Compagnucci, P., Casella, M., Marzullo, R., Dello Russo, A.. - In: CARDIAC ELECTROPHYSIOLOGY CLINICS. - ISSN 1877-9182. - (2022). [10.1016/j.ccep.2022.05.008]

Derivation and Validation of a Clinical Score for Predicting Postoperative Atrial Fibrillation in Noncardiac Elective Surgery (the HART Score)
Anno: 2022
Rivista: THE AMERICAN JOURNAL OF CARDIOLOGY
Autori/autrici: Stronati, Giulia; Mondelli, Carlo; Urbinati, Alessia; Ciliberti, Giuseppe; Barbarossa, Alessandro; Compagnucci, Paolo; Casella, Michela; Dello Russo, Antonio; Guerra, Federico
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/305288
Citazioni:
Derivation and Validation of a Clinical Score for Predicting Postoperative Atrial Fibrillation in Noncardiac Elective Surgery (the HART Score) / Stronati, G., Mondelli, C., Urbinati, A., Ciliberti, G., Barbarossa, A., Compagnucci, P., Casella, M., Dello Russo, A., Guerra, F.. - In: THE AMERICAN JOURNAL OF CARDIOLOGY. - ISSN 0002-9149. - 170:(2022), pp. 56-62. [10.1016/j.amjcard.2022.01.020]
Abstract:
Postoperative atrial fibrillation (POAF) represents the most frequent cardiac arrhythmia in the surgical setting. It affects almost 3% of all patients over 45 years old who underwent noncardiovascular surgery and is associated with a higher risk of stroke, heart failure, myocardial infarction, and c...ardiac arrest. The study aimed to assess independent predictors of POAF and derive and validate a score for risk prediction in clinical practice. This was a retrospective cohort study including all consecutive candidates to all types of noncardiac elective surgery attending a cardiological preoperative assessment from 2016 to 2019. Exclusion criteria were a previous diagnosis of AF and the cancelation of the planned surgery. A total of 2,048 patients were enrolled (1350 men, aged 72 ± 12 years). A total of 44 patients experienced POAF (2.1%) - median 3 days (first to third quartile 2 to 4 days). Age (odds ratio [OR] 1.03 for each year, 95% confidence interval [CI] 1.01 to 1.07), hypertension (OR 3.43, 95% CI 1.22 to 9.63), thyroid dysfunction (OR 2.47, 95% CI 1.22 to 5.01), and intermediate or high-risk surgery (OR 18.28, 95% CI 2.51 to 33.09) resulted as independent predictors of POAF (all p <0.05). The Hypertension, Age, surgery Risk, and Thyroid dysfunction score (OR 2.59 for each point, 95% CI 1.79 to 3.75, p <0.001) was then created based on those 4 items. A cut-off score ≥6 had a 70% sensitivity and a 72% specificity in detecting POAF (area under the curve 0.76). Bootstrapping for internal validation confirmed the overall results (area under the curve 0.72). In conclusion, POAF complicates around 2% of all noncardiac surgery. A 4-item risk score, such as the Hypertension, Age, surgery Risk, and Thyroid dysfunction score, could be effective in implementing POAF screening and improving management.
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Decongestive treatment adjustments in heart failure patients remotely monitored with a multiparametric implantable defibrillators algorithm
Anno: 2022
Rivista: CLINICAL CARDIOLOGY
Autori/autrici: Guerra, F.; D'Onofrio, A.; De Ruvo, E.; Manzo, M.; Santini, L.; Giubilato, G.; La Greca, C.; Petracci, B.; Stronati, G.; Bianchi, V.; Martino, A.; Franculli, F.; Compagnucci, P.; Campari, M.; Valsecchi, S.; Dello Russo, A.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/313891
Citazioni:
Decongestive treatment adjustments in heart failure patients remotely monitored with a multiparametric implantable defibrillators algorithm / Guerra, F., D'Onofrio, A., De Ruvo, E., Manzo, M., Santini, L., Giubilato, G., La Greca, C., Petracci, B., Stronati, G., Bianchi, V., Martino, A., Franculli, F., Compagnucci, P., Campari, M., Valsecchi, S., Dello Russo, A.. - In: CLINICAL CARDIOLOGY. - ISSN 0160-9289. - 45:6(2022), pp. 670-678. [10.1002/clc.23832]
Abstract:
Aims: HeartLogic algorithm combines data from multiple implantable defibrillators (ICD)-based sensors to predict impending heart failure (HF) decompensation. A treatment protocol to manage algorithm alerts is not yet known, although decongestive treatment adjustments are the most frequent alert-trig...gered actions reported in clinical practice. We describe the implementation of HeartLogic for remote monitoring of HF patients, and we evaluate the approach to diuretic dosing and timing of the intervention in patients with device alerts. Methods: The algorithm was activated in 229 ICD patients at eight centers. The median follow-up was 17 months (25th–75th percentile: 11–24). Remote data reviews and patient phone contacts were undertaken at the time of HeartLogic alerts, to assess the patient's status and to prevent HF worsening. We analyzed alert-triggered augmented HF treatments, consisting of isolated increases in diuretics dosage. Results: We reported 242 alerts (0.8 alerts/patient-year) in 123 patients, 137 (56%) alerts triggered clinical actions to treat HF. The HeartLogic index decreased after the 56 actions consisting of diuretics increase. Specifically, alerts resolved more quickly when the increases in dosing of diuretics were early rather than late: 28 days versus 62 days, p <.001. The need of hospitalization for further treatments to resolve the alert condition was associated with higher HeartLogic index values on the day of the diuretics increase (odds ratio: 1.11, 95% CI: 1.02–1.20, p =.013) and with late interventions (odds ratio: 5.11, 95% CI: 1.09–24.48, p =.041). No complications were reported after drug adjustments. Conclusions: Decongestive treatment adjustments triggered by alerts seem safe and effective. The early use of decongestive treatment and the use of high doses of diuretics seem to be associated with more favorable outcomes.
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Impact of atrioventricular junction ablation and CRT-D on long-term mortality in patients with left ventricular dysfunction, permanent, refractory atrial fibrillation, and narrow QRS: Results of a propensity-matched analysis
Anno: 2022
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Palmisano, Pietro; Ziacchi, Matteo; Ammendola, Ernesto; Dell'Era, Gabriele; Guerra, Federico; Donateo, Paolo; Del Giorno, Giuseppe; Laffi, Mattia; Coluccia, Giovanni; Bartoli, Lorenzo; Gaggioli, Germano; Carbone, Angelo; Senes, Jacopo; Dello Russo, Antonio; Patti, Giuseppe; Nigro, Gerardo; Biffi, Mauro; Accogli, Michele
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/314233
Citazioni:
Impact of atrioventricular junction ablation and CRT-D on long-term mortality in patients with left ventricular dysfunction, permanent, refractory atrial fibrillation, and narrow QRS: Results of a propensity-matched analysis / Palmisano, P., Ziacchi, M., Ammendola, E., Dell'Era, G., Guerra, F., Donateo, P., Del Giorno, G., Laffi, M., Coluccia, G., Bartoli, L., Gaggioli, G., Carbone, A., Senes, J., Dello Russo, A., Patti, G., Nigro, G., Biffi, M., Accogli, M.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 33:11(2022), pp. 2288-2296. [10.1111/jce.15645]
Abstract:
Introduction In patients with symptomatic permanent atrial fibrillation (PEAF) and narrow QRS, atrio-ventricular junction ablation (AVJA) plus cardiac resynchronization therapy (CRT) is superior to medical therapy in reducing heart failure (HF) hospitalization and all-cause mortality. To compare the... mortality of a population of patients with HF, reduced EF (rEF), and PEAF treated with AVJA plus CRT with that of a contemporary cohort of patients in sinus rhythm (SR) with similar baseline characteristics. Methods and Results In this prospective, multicentre, observational study, all-cause mortality in a group of consecutive patients undergoing AVJA and implantable cardioverter-defibrillator (ICD) combined with CRT implantation for HFrEF, narrow QRS, and PEAF with uncontrolled ventricular rate was compared with that of a contemporary cohort of patients in SR undergoing ICD implantation (not combined with CRT) for HFrEF and narrow QRS. Individual 1:1 propensity matching of baseline characteristics was performed. A total of 824 patients were enrolled. Propensity matching yielded 107 matched pairs. After a median follow-up of 52 months, all-cause mortality was similar in patients treated with AVJA plus CRT and in the control group (p = .434). In AVJA plus CRT patients, mortality was significantly lower than in control group patients with a history of paroxysmal/persistent AF (n = 45, p = .020), and similar to that of patients without a history of AF (n = 62, p = .459). Conclusions After adjustment for patient characteristics, the long-term prognosis of patients with HFrEF, narrow QRS, and PEAF who underwent AVJA plus CRT was similar to that of a population of patients in SR with similar characteristics.
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Long-term complications in patients implanted with subcutaneous implantable cardioverter-defibrillators: Real-world data from the extended ELISIR experience
Anno: 2021
Rivista: HEART RHYTHM
Autori/autrici: Gasperetti, A.; Schiavone, M.; Ziacchi, M.; Vogler, J.; Breitenstein, A.; Laredo, M.; Palmisano, P.; Ricciardi, D.; Mitacchione, G.; Compagnucci, P.; Bisignani, A.; Angeletti, A.; Casella, M.; Picarelli, F.; Fink, T.; Kaiser, L.; Hakmi, S.; Calo, L.; Pignalberi, C.; Santini, L.; Lavalle, C.; Pisano, E.; Olivotto, I.; Tondo, C.; Curnis, A.; Dello Russo, A.; Badenco, N.; Steffel, J.; Love, C. J.; Tilz, R.; Forleo, G.; Biffi, M.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293148
Citazioni:
Long-term complications in patients implanted with subcutaneous implantable cardioverter-defibrillators: Real-world data from the extended ELISIR experience / Gasperetti, A., Schiavone, M., Ziacchi, M., Vogler, J., Breitenstein, A., Laredo, M., Palmisano, P., Ricciardi, D., Mitacchione, G., Compagnucci, P., Bisignani, A., Angeletti, A., Casella, M., Picarelli, F., Fink, T., Kaiser, L., Hakmi, S., Calo, L., Pignalberi, C., Santini, L., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - 18:12(2021), pp. 2050-2058. [10.1016/j.hrthm.2021.07.008]
Abstract:
Background: Recently, the Food and Drug Administration issued a recall for the subcutaneous implantable cardioverter-defibrillator (S-ICD) because of the possibility of lead ruptures and accelerated battery depletion. Objective: The aim of this study was to evaluate device-related complications over... time in a large real-world multicenter S-ICD cohort. Methods: Patients implanted with an S-ICD from January 2015 to June 2020 were enrolled from a 19-institution European registry (Experience from the Long-term Italian S-ICD registry [ELISIR]; ClinicalTrials.gov identifier NCT0473876). Device-related complication rates over follow-up were collected. Last follow-up of patients was performed after the Boston Scientific recall issue. Results: A total of 1254 patients (median age 52.0 [interquartile range 41.0–62.2] years; 973 (77.6%) men; 387 (30.9%) ischemic) was enrolled. Over a follow-up of 23.2 (12.8–37.8) months, complications were observed in 117 patients (9.3%) for a total of 127 device-related complications (23.6% managed conservatively and 76.4% required reintervention). Twenty-seven patients (2.2%) had unanticipated generator replacement after 3.6 (3.3–3.9) years, while 4 (0.3%) had lead rupture. Body mass index (hazard ratio [HR] 1.063 [95% confidence interval 1.028–1.100]; P < .001), chronic kidney disease (HR 1.960 [1.191–3.225]; P = .008), and oral anticoagulation (HR 1.437 [1.010–2.045]; P = .043) were associated with an increase in overall complications, whereas older age (HR 0.980 [0.967–0.994]; P = .007) and procedure performed in high-volume centers (HR 0.463 [0.300–0.715]; P = .001) were protective factors. Conclusion: The overall complication rate over 23.2 months of follow-up in a multicenter S-ICD cohort was 9.3%. Early unanticipated device battery depletions occurred in 2.2% of patients, while lead fracture was observed in 0.3%, which is in line with the expected rates reported by Boston Scientific.
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Endomyocardial biopsy in the hands of the electrophysiologist: the ‘one-stop shop’ for arrhythmic non-ischaemic cardiomyopathy. Letter regarding the article ‘Heart Failure Association of the ESC, Heart Failure Society of America and Japanese Heart Failure Society Position statement on endomyocardial biopsy’
Anno: 2021
Rivista: EUROPEAN JOURNAL OF HEART FAILURE
Autori/autrici: Compagnucci, P.; Dello Russo, A.; Casella, M.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293110
Citazioni:
Endomyocardial biopsy in the hands of the electrophysiologist: the ‘one-stop shop’ for arrhythmic non-ischaemic cardiomyopathy. Letter regarding the article ‘Heart Failure Association of the ESC, Heart Failure Society of America and Japanese Heart Failure Society Position statement on endomyocardial biopsy’ / Compagnucci, P., Dello Russo, A., Casella, M.. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - (2021). [10.1002/ejhf.2340]

Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases
Anno: 2021
Rivista: MEDICINA
Autori/autrici: Volpato, Giovanni; Falanga, Umberto; Cipolletta, Laura; Conti, Manuel Antonio; Grifoni, Gino; Ciliberti, Giuseppe; Urbinati, Alessia; Barbarossa, Alessandro; Stronati, Giulia; Fogante, Marco; Bergonti, Marco; Catto, Valentina; Guerra, Federico; Giovagnoni, Andrea; Dello Russo, Antonio; Casella, Michela; Compagnucci, Paolo
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293103
Citazioni:
Sports Activity and Arrhythmic Risk in Cardiomyopathies and Channelopathies: A Critical Review of European Guidelines on Sports Cardiology in Patients with Cardiovascular Diseases / Volpato, G., Falanga, U., Cipolletta, L., Conti, M.A., Grifoni, G., Ciliberti, G., Urbinati, A., Barbarossa, A., Stronati, G., Fogante, M., Bergonti, M., Catto, V., Guerra, F., Giovagnoni, A., Dello Russo, A., Casella, M., Compagnucci, P.. - In: MEDICINA. - ISSN 1648-9144. - 57:4(2021). [10.3390/medicina57040308]
Abstract:
The prediction and prevention of sudden cardiac death is the philosopher's stone of clinical cardiac electrophysiology. Sports can act as triggers of fatal arrhythmias and therefore it is essential to promptly frame the athlete at risk and to carefully evaluate the suitability for both competit...ive and recreational sports activity. A history of syncope or palpitations, the presence of premature ventricular complexes or more complex arrhythmias, a reduced left ventricular systolic function, or the presence of known or familiar heart disease should prompt a thorough evaluation with second level examinations. In this regard, cardiac magnetic resonance and electrophysiological study play important roles in the diagnostic work-up. The role of genetics is increasing both in cardiomyopathies and in channelopathies, and a careful evaluation must be focused on genotype positive/phenotype negative subjects. In addition to being a trigger for fatal arrhythmias in certain cardiomyopathies, sports also play a role in the progression of the disease itself, especially in the case arrhythmogenic right ventricular cardiomyopathy. In this paper, we review the latest European guidelines on sport cardiology in patients with cardiovascular diseases, focusing on arrhythmic risk stratification and the management of cardiomyopathies and channelopathies.
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Worldwide Survey of COVID-19-Associated Arrhythmias
Anno: 2021
Rivista: CIRCULATION. ARRHYTHMIA AND ELECTROPHYSIOLOGY
Autori/autrici: Coromilas, E. J.; Kochav, S.; Goldenthal, I.; Biviano, A.; Garan, H.; Goldbarg, S.; Kim, J. -H.; Yeo, I.; Tracy, C.; Ayanian, S.; Akar, J.; Singh, A.; Jain, S.; Zimerman, L.; Pimentel, M.; Osswald, S.; Twerenbold, R.; Schaerli, N.; Crotti, L.; Fabbri, D.; Parati, G.; Li, Y.; Atienza, F.; Zatarain, E.; Tse, G.; Leung, K. S. K.; Guevara-Valdivia, M. E.; Rivera-Santiago, C. A.; Soejima, K.; De Filippo, P.; Ferrari, P.; Malanchini, G.; Kanagaratnam, P.; Khawaja, S.; Mikhail, G. W.; Scanavacca, M.; Abrahao Hajjar, L.; Rizerio, B.; Sacilotto, L.; Mollazadeh, R.; Eslami, M.; Laleh Far, V.; Mattioli, A. V.; Boriani, G.; Migliore, F.; Cipriani, A.; Donato, F.; Compagnucci, P.; Casella, M.; Dello Russo, A.; Coromilas, J.; Aboyme, A.; O'Brien, C. G.; Rodriguez, F.; Wang, P. J.; Naniwadekar, A.; Moey, M.; Kow, C. S.; Cheah, W. K.; Auricchio, A.; Conte, G.; Hwang, J.; Han, S.; Lazzerini, P. E.; Franchi, F.; Santoro, A.; Capecchi, P. L.; Joglar, J. A.; Rosenblatt, A. G.; Zardini, M.; Bricoli, S.; Bonura, R.; Echarte-Morales, J.; Benito-Gonzalez, T.; Minguito-Carazo, C.; Fernandez-Vazquez, F.; Wan, E. Y.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293081
Citazioni:
Worldwide Survey of COVID-19-Associated Arrhythmias / Coromilas, E.J., Kochav, S., Goldenthal, I., Biviano, A., Garan, H., Goldbarg, S., Kim, J.-H., Yeo, I., Tracy, C., Ayanian, S., Akar, J., Singh, A., Jain, S., Zimerman, L., Pimentel, M., Osswald, S., Twerenbold, R., Schaerli, N., Crotti, L., Fabbri, D., et al.. - In: CIRCULATION. ARRHYTHMIA AND ELECTROPHYSIOLOGY. - ISSN 1941-3149. - 14:3(2021), pp. 285-295. [10.1161/CIRCEP.120.009458]
Abstract:
Background: Coronavirus disease 2019 (COVID-19) has led to over 1 million deaths worldwide and has been associated with cardiac complications including cardiac arrhythmias. The incidence and pathophysiology of these manifestations remain elusive. In this worldwide survey of patients hospitalized wit...h COVID-19 who developed cardiac arrhythmias, we describe clinical characteristics associated with various arrhythmias, as well as global differences in modulations of routine electrophysiology practice during the pandemic. Methods: We conducted a retrospective analysis of patients hospitalized with COVID-19 infection worldwide with and without incident cardiac arrhythmias. Patients with documented atrial fibrillation, atrial flutter, supraventricular tachycardia, nonsustained or sustained ventricular tachycardia, ventricular fibrillation, atrioventricular block, or marked sinus bradycardia (heart rate<40 bpm) were classified as having arrhythmia. Deidentified data was provided by each institution and analyzed. Results: Data were collected for 4526 patients across 4 continents and 12 countries, 827 of whom had an arrhythmia. Cardiac comorbidities were common in patients with arrhythmia: 69% had hypertension, 42% diabetes, 30% had heart failure, and 24% had coronary artery disease. Most had no prior history of arrhythmia. Of those who did develop an arrhythmia, the majority (81.8%) developed atrial arrhythmias, 20.7% developed ventricular arrhythmias, and 22.6% had bradyarrhythmia. Regional differences suggested a lower incidence of atrial fibrillation in Asia compared with other continents (34% versus 63%). Most patients in North America and Europe received hydroxychloroquine, although the frequency of hydroxychloroquine therapy was constant across arrhythmia types. Forty-three percent of patients who developed arrhythmia were mechanically ventilated and 51% survived to hospital discharge. Many institutions reported drastic decreases in electrophysiology procedures performed. Conclusions: Cardiac arrhythmias are common and associated with high morbidity and mortality among patients hospitalized with COVID-19 infection. There were significant regional variations in the types of arrhythmias and treatment approaches.
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Cryoablation for pulmonary veins isolation in obese patients with atrial fibrillation compared to nonobese patients
Anno: 2021
Rivista: PACING AND CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Malaspina, Daniele; Brasca, Francesco; Iacopino, Saverio; Arena, Giuseppe; Molon, Giulio; Pieragnoli, Paolo; Tondo, Claudio; Manfrin, Massimiliano; Rovaris, Giovanni; Verlato, Roberto; Dello Russo, Antonio; Startari, Umberto; Sgarito, Giuseppe; Perego, Giovanni Battista
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293088
Citazioni:
Cryoablation for pulmonary veins isolation in obese patients with atrial fibrillation compared to nonobese patients / Malaspina, D., Brasca, F., Iacopino, S., Arena, G., Molon, G., Pieragnoli, P., Tondo, C., Manfrin, M., Rovaris, G., Verlato, R., Dello Russo, A., Startari, U., Sgarito, G., Perego, G.B.. - In: PACING AND CLINICAL ELECTROPHYSIOLOGY. - ISSN 0147-8389. - 44:2(2021), p. 306-317. [10.1111/pace.14149]
Abstract:
Pulmonary veins isolation (PVI) by cryoballoon (CB) ablation is marginally represented in clinical studies in obese patients. The aim of this analysis was to evaluate the safety and efficacy of CB-PVI in a large cohort of overweight and obese patients from the 1STOP project.

Multiparametric Implantable Cardioverter-Defibrillator Algorithm for Heart Failure Risk Stratification and Management: An Analysis in Clinical Practice
Anno: 2021
Rivista: CIRCULATION. HEART FAILURE
Autori/autrici: Calò, Leonardo; Bianchi, Valter; Ferraioli, Donatella; Santini, Luca; Dello Russo, Antonio; Carriere, Cosimo; Santobuono, Vincenzo Ezio; Andreoli, Chiara; La Greca, Carmelo; Arena, Giuseppe; Talarico, Antonello; Pisanò, Ennio; Santoro, Amato; Giammaria, Massimo; Ziacchi, Matteo; Viscusi, Miguel; De Ruvo, Ermenegildo; Campari, Monica; Valsecchi, Sergio; D'Onofrio, Antonio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293149
Citazioni:
Multiparametric Implantable Cardioverter-Defibrillator Algorithm for Heart Failure Risk Stratification and Management: An Analysis in Clinical Practice / Calò, L., Bianchi, V., Ferraioli, D., Santini, L., Dello Russo, A., Carriere, C., Santobuono, V.E., Andreoli, C., La Greca, C., Arena, G., Talarico, A., Pisanò, E., Santoro, A., Giammaria, M., Ziacchi, M., Viscusi, M., De Ruvo, E., Campari, M., Valsecchi, S., D'Onofrio, A.. - In: CIRCULATION. HEART FAILURE. - ISSN 1941-3289. - 14:10(2021), pp. e008134-1079. [10.1161/CIRCHEARTFAILURE.120.008134]
Abstract:
BACKGROUND: The HeartLogic algorithm combines multiple implantable cardioverter-defibrillator sensors to identify patients at risk of heart failure (HF) events. We sought to evaluate the risk stratification ability of this algorithm in clinical practice. We also analyzed the alert management strateg...ies adopted in the study group and their association with the occurrence of HF events.METHODS: The HeartLogic feature was activated in 366 implantable cardioverter-defibrillator and cardiac resynchronization therapy implantable cardioverter-defibrillator patients at 22 centers. The median follow-up was 11 months [25th-75th percentile: 6-16]. The HeartLogic algorithm calculates a daily HF index and identifies periods IN alert state on the basis of a configurable threshold.RESULTS: The HeartLogic index crossed the threshold value 273 times (0.76 alerts/patient-year) in 150 patients. The time IN alert state was 11% of the total observation period. Patients experienced 36 HF hospitalizations, and 8 patients died of HF during the observation period. Thirty-five events were associated with the IN alert state (0.92 events/patient-year versus 0.03 events/patient-year in the OUT of alert state). The hazard ratio in the IN/OUT of alert state comparison was (hazard ratio, 24.53 [95% CI, 8.55-70.38], P<0.001), after adjustment for baseline clinical confounders. Alerts followed by clinical actions were associated with less HF events (hazard ratio, 0.37 [95% CI, 0.14-0.99], P=0.047). No differences in event rates were observed between in-office and remote alert management.CONCLUSIONS: This multiparametric algorithm identifies patients during periods of significantly increased risk of HF events. The rate of HF events seemed lower when clinical actions were undertaken in response to alerts. Extra in-office visits did not seem to be required to effectively manage HeartLogic alerts. Registration: URL: ; Unique identifier: NCT02275637.
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One-year outcomes of the Mediterranea technique for longstanding persistent atrial fibrillation
Anno: 2021
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: De Martino, G.; Compagnucci, P.; Dello Russo, A.; Casella, M.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293102
Citazioni:
One-year outcomes of the Mediterranea technique for longstanding persistent atrial fibrillation / De Martino, G., Compagnucci, P., Dello Russo, A., Casella, M.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 32:11(2021), pp. 3108-3108. [10.1111/jce.15225]

Rate and impact on patient outcome and healthcare utilization of complications requiring surgical revision: Subcutaneous versus transvenous implantable defibrillator therapy
Anno: 2021
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Palmisano, P.; Ziacchi, M.; Ammendola, E.; D'Onofrio, A.; Dell'Era, G.; Laffi, M.; Biffi, M.; Nigro, G.; Bianchi, W.; Prenna, E.; Angeletti, A.; Guido, A.; Stronati, G.; Gaggioli, G.; Dello Russo, A.; Accogli, M.; Guerra, F.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293151
Citazioni:
Rate and impact on patient outcome and healthcare utilization of complications requiring surgical revision: Subcutaneous versus transvenous implantable defibrillator therapy / Palmisano, P., Ziacchi, M., Ammendola, E., D'Onofrio, A., Dell'Era, G., Laffi, M., Biffi, M., Nigro, G., Bianchi, W., Prenna, E., Angeletti, A., Guido, A., Stronati, G., Gaggioli, G., Dello Russo, A., Accogli, M., Guerra, F.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 32:6(2021), pp. 1712-1723. [10.1111/jce.15080]
Abstract:
Introduction: Comparison data on management of device-related complications and their impact on patient outcome and healthcare utilization between subcutaneous implantable cardioverter–defibrillator (S-ICD) and transvenous ICD (TV-ICD) are lacking. We designed this prospective, multicentre, ob...servational registry to compare the rate, nature, and impact of long-term device-related complications requiring surgical revision on patient outcome and healthcare utilization between patients undergoing S-ICD or TV-ICD implantation. Methods and Results: A total of 1099 consecutive patients who underwent S-ICD or TV-ICD implantation were enrolled. Propensity matching for baseline characteristics yielded 169 matched pairs. Rate, nature, management, and impact on patient outcome of device-related complications were analyzed and compared between two groups. During a mean follow-up of 30 months, device-related complications requiring surgical revision were observed in 20 patients: 3 in S-ICD group (1.8%) and 17 in TV-ICD group (10.1%; p =.002). Compared with TV-ICD patients, S-ICD patients showed a significantly lower risk of lead-related complications (0% vs. 5.9%; p =.002) and a similar risk of pocket-related complications (0.6 vs. 2.4; p =.215) and device infection (0.6% vs. 1.2%; p = 1.000). Complications observed in S-ICD patients resulted in a significantly lower number of complications-related rehospitalizations (median 0 vs. 1; p =.013) and additional hospital treatment days (1.0 ± 1.0 vs. 6.5 ± 4.4 days; p =.048) compared with TV-ICD patients. Conclusions: Compared with TV-ICD, S-ICD is associated with a lower risk of complications, mainly due to a lower risk of lead-related complications. The management of S-ICD complications requires fewer and shorter rehospitalizations.
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Assessment of patients presenting with life-threatening ventricular arrhythmias and suspected myocarditis: The key role of endomyocardial biopsy
Anno: 2021
Rivista: HEART RHYTHM
Autori/autrici: Narducci, M. L.; La Rosa, G.; Pinnacchio, G.; Inzani, F.; D'Amati, G.; Perna, F.; Bencardino, G.; D'Amario, D.; Pieroni, M.; Dello Russo, A.; Casella, M.; Pelargonio, G.; Crea, F.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293145
Citazioni:
Assessment of patients presenting with life-threatening ventricular arrhythmias and suspected myocarditis: The key role of endomyocardial biopsy / Narducci, M.L., La Rosa, G., Pinnacchio, G., Inzani, F., D'Amati, G., Perna, F., Bencardino, G., D'Amario, D., Pieroni, M., Dello Russo, A., Casella, M., Pelargonio, G., Crea, F.. - In: HEART RHYTHM. - ISSN 1547-5271. - 18:6(2021), pp. 907-915. [10.1016/j.hrthm.2021.01.025]
Abstract:
Background: Life-threatening ventricular tachyarrhythmias (VAs) represent a significant cause of death in myocarditis. Objective: The purpose of this study was to identify predictors of sustained VAs in patients with myocarditis and ventricular phenotype diagnosed by workflow including endomyocardia...l biopsy (EMB) guided by 3D electroanatomic mapping (3D-EAM). Methods: We prospectively enrolled patients with suspected myocarditis and VAs, undergoing cardiac magnetic resonance imaging, coronary angiography, 3D-EAM, and EMB guided by 3D-EAM. At follow-up, sustained VAs were detected by device interrogation and 24-hour electrocardiographic Holter monitoring. Results: We enrolled 54 consecutive patients (mean age 41 ± 14 years; 32(59%) men) with normal ventricular function; left ventricular and right ventricular (RV) late gadolinium enhancement was present, respectively, in 21 (46%) and 6 (13%) of the 46 patients who underwent cardiac magnetic resonance. In 31 patients, the histological diagnosis was myocarditis, while in 14 patients, focal replacement myocardial fibrosis (FRMF); in 9 patients, specimens were inadequate (diagnostic yield of EMB 83%). 3D-EAM showed a larger endocardial scar area for both ventricles in myocarditis than in FRMF (RV bipolar mean scar area 22 ± 16 cm2 vs 3 ± 2 cm2; P =.02; left ventricular bipolar mean scar area 13 ± 5 cm2 vs 4 ± 2 cm2; P =.02, respectively). At a follow-up of 21 months, freedom from sustained VAs was 58% in myocarditis and 92% in FRMF (log-rank, P =.008). Histological diagnosis of myocarditis and RV endocardial scar were independent predictors of sustained VAs (P =.02 for both). Conclusion: Our data highlight the need for 3D-EAM–guided EMB in apparently healthy young patients with suspected myocarditis and VAs.
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Subcutaneous implantable cardioverter-defibrillator and defibrillation testing: A propensity-matched pilot study
Anno: 2021
Rivista: HEART RHYTHM
Autori/autrici: Forleo, G. B.; Gasperetti, A.; Breitenstein, A.; Laredo, M.; Schiavone, M.; Ziacchi, M.; Vogler, J.; Ricciardi, D.; Palmisano, P.; Piro, A.; Compagnucci, P.; Waintraub, X.; Mitacchione, G.; Carrassa, G.; Russo, G.; De Bonis, S.; Angeletti, A.; Bisignani, A.; Picarelli, F.; Casella, M.; Bressi, E.; Rovaris, G.; Calo, L.; Santini, L.; Pignalberi, C.; Lavalle, C.; Viecca, M.; Pisano, E.; Olivotto, I.; Curnis, A.; Dello Russo, A.; Tondo, C.; Love, C. J.; Di Biase, L.; Steffel, J.; Tilz, R.; Badenco, N.; Biffi, M.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293100
Citazioni:
Subcutaneous implantable cardioverter-defibrillator and defibrillation testing: A propensity-matched pilot study / Forleo, G.B., Gasperetti, A., Breitenstein, A., Laredo, M., Schiavone, M., Ziacchi, M., Vogler, J., Ricciardi, D., Palmisano, P., Piro, A., Compagnucci, P., Waintraub, X., Mitacchione, G., Carrassa, G., Russo, G., De Bonis, S., Angeletti, A., Bisignani, A., Picarelli, F., Casella, M., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - (2021). [10.1016/j.hrthm.2021.06.1201]
Abstract:
Background: To date, only a few comparisons between subcutaneous implantable cardioverter-defibrillator (S-ICD) patients undergoing and those not undergoing defibrillation testing (DT) at implantation (DT+ vs DT–) have been reported. Objective: The purpose of this study was to compare long-ter...m clinical outcomes of 2 propensity-matched cohorts of DT+ and DT– patients. Methods: Among consecutive S-ICD patients implanted across 17 centers from January 2015 to October 2020, DT– patients were 1:1 propensity-matched for baseline characteristics with DT+ patients. The primary outcome was a composite of ineffective shocks and cardiovascular mortality. Appropriate and inappropriate shock rates were deemed secondary outcomes. Results: Among 1290 patients, a total of 566 propensity-matched patients (283 DT+; 283 DT–) served as study population. Over median follow-up of 25.3 months, no significant differences in primary outcome event rates were found (10 DT+ vs 14 DT–; P = .404) as well as for ineffective shocks (5 DT– vs 3 DT+; P = .725). At multivariable Cox regression analysis, DT performance was associated with a reduction of neither the primary combined outcome nor ineffective shocks at follow-up. A high PRAETORIAN score was positively associated with both the primary outcome (hazard ratio 3.976; confidence interval 1.339–11.802; P = .013) and ineffective shocks alone at follow-up (hazard ratio 19.030; confidence interval 4.752–76.203; P = .003). Conclusion: In 2 cohorts of strictly propensity-matched patients, DT performance was not associated with significant differences in cardiovascular mortality and ineffective shocks. The PRAETORIAN score is capable of correctly identifying a large percentage of patients at risk for ineffective shock conversion in both cohorts.
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Compassionate drug use for patients with transthyretin amyloid cardiomyopathy
Anno: 2021
Rivista: JOURNAL OF CARDIOVASCULAR MEDICINE
Autori/autrici: Ciliberti, G.; Urbinati, A.; Barbarossa, A.; Stronati, G.; Silenzi, M.; Principi, S.; Falanga, U.; Capucci, A.; Casella, M.; Dello Russo, A.; Guerra, F.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293085
Citazioni:
Compassionate drug use for patients with transthyretin amyloid cardiomyopathy / Ciliberti, G., Urbinati, A., Barbarossa, A., Stronati, G., Silenzi, M., Principi, S., Falanga, U., Capucci, A., Casella, M., Dello Russo, A., Guerra, F.. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2035. - 22:10(2021), pp. 792-794. [10.2459/JCM.0000000000001192]

One-year mortality after implantable defibrillator implantation: do risk stratification models help improving clinical practice?
Anno: 2021
Rivista: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
Autori/autrici: Calvi, V.; Zanotto, G.; D'Onofrio, A.; Bisceglia, C.; Iacopino, S.; Pignalberi, C.; Pisano, E. C.; Solimene, F.; Giammaria, M.; Biffi, M.; Maglia, G.; Marini, M.; Senatore, G.; Pedretti, S.; Forleo, G. B.; Santobuono, V. E.; Curnis, A.; Dello Russo, A.; Rapacciuolo, A.; Quartieri, F.; Bertocchi, P.; Caravati, F.; Manzo, M.; Saporito, D.; Orsida, D.; Santamaria, M.; Bottaro, G.; Giacopelli, D.; Gargaro, A.; Bella, P. D.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293150
Citazioni:
One-year mortality after implantable defibrillator implantation: do risk stratification models help improving clinical practice? / Calvi, V., Zanotto, G., D'Onofrio, A., Bisceglia, C., Iacopino, S., Pignalberi, C., Pisano, E.C., Solimene, F., Giammaria, M., Biffi, M., Maglia, G., Marini, M., Senatore, G., Pedretti, S., Forleo, G.B., Santobuono, V.E., Curnis, A., Dello Russo, A., Rapacciuolo, A., Quartieri, F., et al.. - In: JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY. - ISSN 1383-875X. - (2021). [10.1007/s10840-021-01083-y]
Abstract:
Purpose: The purpose of this study was to assess the available mortality risk stratification models for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) patients. Methods: We conducted a review of mortality risk stratification models and tested... their ability to improve prediction of 1-year survival after implant in a database of patients who received a remotely controlled ICD/CRT-D device during routine care and included in the independent Home Monitoring Expert Alliance registry. Results: We identified ten predicting models published in peer-reviewed journals between 2000 and 2021 (Parkash, PACE, MADIT, aCCI, CHA2DS2-VASc quartiles, CIDS, FADES, Sjoblom, AAACC, and MADIT-ICD non-arrhythmic mortality score) that could be tested in our database as based on common demographic, clinical, echocardiographic, electrocardiographic, and laboratory variables. Our cohort included 1,911 patients with left ventricular dysfunction (median age 71, 18.3% female) from sites not using any risk stratification score for systematic patient screening. Patients received an ICD (53.8%) or CRT-D (46.2%) between 2011 and 2017, after standard physician evaluation. There were 56 deaths within 1-year post-implant, with an all-cause mortality rate of 2.9% (95% confidence interval [CI], 2.3–3.8%). Four predicting models (Parkash, MADIT, AAACC, and MADIT-ICD non-arrhythmic mortality score) were significantly associated with increased risk of 1-year mortality with hazard ratios ranging from 3.75 (CI, 1.31–10.7) to 6.53 (CI 1.52–28.0, p ≤ 0.014 for all four). Positive predictive values of 1-year mortality were below 25% for all models. Conclusion: In our analysis, the models we tested conferred modest incremental predicting power to ordinary screening methods.
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Prior myocarditis and ventricular arrhythmias: the importance of scar pattern
Anno: 2021
Rivista: HEART RHYTHM
Autori/autrici: Casella, Michela; Bergonti, Marco; Narducci, Maria Lucia; Persampieri, Simone; Gasperetti, Alessio; Conte, Edoardo; Catto, Valentina; Carbucicchio, Corrado; Guerra, Federico; Pontone, Gianluca; Andreini, Daniele; Basso, Cristina; Di Biase, Luigi; Santangeli, Pasquale; Natale, Andrea; Pelargonio, Gemma; Russo, Antonio Dello; Tondo, Claudio
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/286070
Citazioni:
Prior myocarditis and ventricular arrhythmias: the importance of scar pattern / Casella, M., Bergonti, M., Narducci, M.L., Persampieri, S., Gasperetti, A., Conte, E., Catto, V., Carbucicchio, C., Guerra, F., Pontone, G., Andreini, D., Basso, C., Di Biase, L., Santangeli, P., Natale, A., Pelargonio, G., Russo, A.D., Tondo, C.. - In: HEART RHYTHM. - ISSN 1547-5271. - (2021). [10.1016/j.hrthm.2020.12.016]
Abstract:
multiple studies have already addressed the importance of anteroseptal scar in patients with non-ischemic cardiomyopathy. However, this pattern has never been fully evaluated in patients with prior myocarditis.

Intraprocedural PRAETORIAN score for early assessment of S-ICD implantation: A proof-of-concept study
Anno: 2021
Rivista: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
Autori/autrici: Gasperetti, A.; Schiavone, M.; Biffi, M.; Casella, M.; Compagnucci, P.; Mitacchione, G.; Angeletti, A.; Vogler, J.; Proietti, R.; Ziacchi, M.; Dello Russo, A.; Natale, A.; Tilz, R. R.; Forleo, G. B.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293104
Citazioni:
Intraprocedural PRAETORIAN score for early assessment of S-ICD implantation: A proof-of-concept study / Gasperetti, A., Schiavone, M., Biffi, M., Casella, M., Compagnucci, P., Mitacchione, G., Angeletti, A., Vogler, J., Proietti, R., Ziacchi, M., Dello Russo, A., Natale, A., Tilz, R.R., Forleo, G.B.. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 32:11(2021), pp. 3035-3041. [10.1111/jce.15254]
Abstract:
Introduction: The PRAETORIAN score (PS) was developed to assess the implant position and predict defibrillation success of the subcutaneous implantable cardioverter defibrillators (S-ICD). The main critique moved to the routine use of PS has been its postprocedural timing, that limits its usefulness... on procedure guidance. The aim of this proof-of-concept study was to assess the feasibility of an intraprocedural use of PS. Methods: Forty consecutive patients undergoing S-ICD implantation were enrolled. Intraprocedural PS (IP-PS) obtained with fluoroscopy before closure of the pocket and postprocedural PS (PP-PS) obtained with two-views chest X-ray were compared. Intraprocedural data and PS were compared with the historic cohorts of the involved institutions. Results: When assessing IP-PS and PP-PS, a complete overall agreement was observed (100%, 1.00-κ; p <.001). When assessing a per-step agreement, a very high-degree of concordance in evaluating Step 1 of the PS was observed (95%, 0.81-κ; p <.001). A complete agreement in Step 2–3 (100%, 1.00-κ; p <.001) of the PS was reported. In comparison with our historical cohort, procedural time in the IP-PS cohort did not increase (45 [41–52] vs. 45 [39–49] min; p =.351) while the expected increase in fluoroscopy time resulted scarce (15 [10–15] s). Conclusion: An IP-PS can be reliably obtained using fluoroscopy guidance during S-ICD implantation, without a significant increase in procedural duration and may serve as guidance for implanting physicians, to avoid postprocedural S-ICD repositioning, leading to patient discomfort and significantly enhancing infective risks. IP-PS showed a very high agreement with the PP-PS obtained from two-views chest X-ray.
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Effect of SAcubitril/Valsartan on left vEntricular ejection fraction and on the potential indication for Implantable Cardioverter Defibrillator in primary prevention: the SAVE-ICD study
Anno: 2021
Rivista: EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
Autori/autrici: Guerra, F.; Ammendola, E.; Ziacchi, M.; Aspromonte, V.; Pellegrino, P. L.; Del Giorno, G.; Dell'Era, G.; Pimpini, L.; Santoro, F.; Floris, R.; Stronati, G.; Nigro, G.; Paolisso, P.; Guido, A.; Maglia, G.; Brunetti, N. D.; Carbone, A.; Gravellone, M.; Antonicelli, R.; Cannone, M.; Accogli, M.; Dello Russo, A.; Palmisano, P.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293146
Citazioni:
Effect of SAcubitril/Valsartan on left vEntricular ejection fraction and on the potential indication for Implantable Cardioverter Defibrillator in primary prevention: the SAVE-ICD study / Guerra, F., Ammendola, E., Ziacchi, M., Aspromonte, V., Pellegrino, P.L., Del Giorno, G., Dell'Era, G., Pimpini, L., Santoro, F., Floris, R., Stronati, G., Nigro, G., Paolisso, P., Guido, A., Maglia, G., Brunetti, N.D., Carbone, A., Gravellone, M., Antonicelli, R., Cannone, M., et al.. - In: EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY. - ISSN 0031-6970. - 77:12(2021), pp. 1835-1842. [10.1007/s00228-021-03189-8]
Abstract:
Purpose: Sacubitril/valsartan has been associated with a positive reverse left ventricular remodelling in patients with heart failure with reduced ejection fraction (HFrEF). These patients may also benefit from an ICD implant. We aimed to assess EF improvement after 6 months of treatment with s...acubitril/valsartan, evaluating when ICD as primary prevention was no longer indicated. Methods: Multicentre, observational, prospective study enrolling all consecutive patients with HFrEF and EF ≤ 35% with an ICD as primary prevention and starting treatment with sacubitril/valsartan (NCT03935087). Resynchronization therapy and patients experiencing appropriate ICD therapies before sacubitril/valsartan were excluded. Results: Two-hundred-and-thirty patients were enrolled (73.9% males, mean age 64.3 ± 12.1 years) After 6 months of treatment, a reduction in left ventricular end-diastolic and end-systolic volumes was noted and LVEF increased from 28.3 ± 5.6% to 32.2 ± 6.5% (p < 0.001). At 6 months, a non-ischemic aetiology of cardiomyopathy and a final dose of sacubitril/valsartan > 24/26 mg twice daily were associated with a higher probability of an absolute increase of > 5% in LVEF. A total of 5.3% of primary prevention patients still had an arrhythmic event in the first 6 months after treatment with sacubitril/valsartan started. Conclusions: Sacubitril/valsartan improves systolic function in HFrEF, mainly due to reverse left ventricular remodelling. Improvement in EF after 6 months of treatment could help prevent ICD implantation in nearly one out of four patients, with important clinical and economic implications. However, the risk of sudden cardiac death in this recovered HFrEF population has not been thoroughly studied, and the present data should be interpreted only as hypothesis-generating.
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Long-Term Outcomes of Near-Zero Radiation Ablation of Paroxysmal Supraventricular Tachycardia: A Comparison With Fluoroscopy-Guided Approach
Anno: 2021
Rivista: JACC. CLINICAL ELECTROPHYSIOLOGY
Autori/autrici: Bergonti, M.; Dello Russo, A.; Sicuso, R.; Ribatti, V.; Compagnucci, P.; Catto, V.; Gasperetti, A.; Zucchetti, M.; Cellucci, S.; Vettor, G.; Dessanai, M. A.; Majocchi, B.; Moltrasio, M.; Russo, E.; Stronati, G.; Guerra, F.; Di Biase, L.; Natale, A.; Tondo, C.; Casella, M.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293109
Citazioni:
Long-Term Outcomes of Near-Zero Radiation Ablation of Paroxysmal Supraventricular Tachycardia: A Comparison With Fluoroscopy-Guided Approach / Bergonti, M., Dello Russo, A., Sicuso, R., Ribatti, V., Compagnucci, P., Catto, V., Gasperetti, A., Zucchetti, M., Cellucci, S., Vettor, G., Dessanai, M.A., Majocchi, B., Moltrasio, M., Russo, E., Stronati, G., Guerra, F., Di Biase, L., Natale, A., Tondo, C., Casella, M.. - In: JACC. CLINICAL ELECTROPHYSIOLOGY. - ISSN 2405-500X. - 7:9(2021), pp. 1108-1117-1117. [10.1016/j.jacep.2021.02.017]
Abstract:
Objectives: This study aimed to assess the long-term outcomes of minimally fluoroscopic approach (MFA) compared with conventional fluoroscopic ablation (ConvA) in terms of recurrences of arrhythmia and long-term complications. Background: Catheter ablation (CA) of supraventricular tachycardia (SVT) ...with an MFA, under the guidance of electroanatomic mapping (EAM) systems, results in a significant reduction in exposure to ionizing radiations without impairing acute procedural success and complication rate. However, data regarding long-term outcomes of MFA compared with ConvA are lacking. Methods: This is a retrospective observational study. All patients undergoing MFA CA of SVT (atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia) between 2010 and 2015 were enrolled and were compared with matched subjects (1 MFA: 2 ConvA) undergoing ConvA during the same period. The 2 co-primary outcomes were recurrence of arrhythmias and long-term complications. Results: Six-hundred eighteen patients (mean age 38 ± 15 years, 60% female) were enrolled. MFA included 206 patients, whereas 412 were treated with ConvA. Acute success (99% vs. 97%; p = 0.10) and acute complications (2.4% vs. 5.3%; p = 0.14) were similar in the 2 groups. During a median follow-up of 4.4 years, 5.9% of patients experienced recurrence of arrhythmias. At multivariate analysis, ConvA (hazard ratio [HR]: 3.03) and procedural success (HR: 0.10) were independently associated with recurrence of arrhythmias. Late complications (i.e., advance atrioventricular block and need for pacemaker implantation) occurred more frequently in ConvA (3.4% vs. 0.5%; p = 0.03) compared with MFA. Conclusions: CA guided by EAM systems with MFA provided better long-term results and reduced risk of complications compared with ConvA.
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Ventricular arrhythmias in athletes: Role of a comprehensive diagnostic workup
Anno: 2021
Rivista: HEART RHYTHM
Autori/autrici: Dello Russo, A.; Compagnucci, P.; Casella, M.; Gasperetti, A.; Riva, S.; Dessanai, M. A.; Pizzamiglio, F.; Catto, V.; Guerra, F.; Stronati, G.; Andreini, D.; Pontone, G.; Bonomi, A.; Rizzo, S.; Di Biase, L.; Capucci, A.; Natale, A.; Basso, C.; Fiorentini, C.; Zeppilli, P.; Tondo, C.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293098
Citazioni:
Ventricular arrhythmias in athletes: Role of a comprehensive diagnostic workup / Dello Russo, A., Compagnucci, P., Casella, M., Gasperetti, A., Riva, S., Dessanai, M.A., Pizzamiglio, F., Catto, V., Guerra, F., Stronati, G., Andreini, D., Pontone, G., Bonomi, A., Rizzo, S., Di Biase, L., Capucci, A., Natale, A., Basso, C., Fiorentini, C., Zeppilli, P., et al.. - In: HEART RHYTHM. - ISSN 1547-5271. - (2021). [10.1016/j.hrthm.2021.09.013]
Abstract:
Background: Ventricular arrhythmias (VAs) represent a critical issue with regard to sports eligibility assessment in athletes. The ideal diagnostic evaluation of competitive and leisure-time athletes with complex VAs has not been clearly defined. Objective: The purpose of this study was to assess th...e clinical implications of invasive electrophysiological assessments and endomyocardial biopsy (EMB) among athletes with VAs. Methods: We evaluated 227 consecutive athletes who presented to our institutions after being disqualified from participating in sports because of VAs. After noninvasive tests, electrophysiological study (EPS), electroanatomic mapping (EAM), and EAM- or cardiac magnetic resonance imaging–guided EMB was performed, following a prespecified protocol. Sports eligibility status was redefined at 6-month follow-up. Results: From our sample, 188 athletes (82.8%) underwent EAM and EPS, and 42 (15.2%) underwent EMB. A diagnosis of heart disease could be formulated in 30% of the study population (67/227; 95% confidence interval [CI] 0.24–0.36) after noninvasive tests; in 37% (83/227; 95% CI 31%–43%) after EPS and EAM; and in 45% (102/227; 95% CI 39%–51%) after EMB. In the subset of athletes undergoing EMB, invasive diagnostic workup allowed diagnostic reclassification of half of the athletes (n = 21 [50%]). Reclassification was particularly common among subjects without definitive findings after noninvasive evaluation (n = 23; 87% reclassified). History of syncope, abnormal echocardiogram, presence of late gadolinium enhancement, and abnormal EAM were linked to sports ineligibility at 6-month follow-up. Conclusion: A comprehensive invasive workup provided additional diagnostic elements and could improve the sports eligibility assessment of athletes presenting with VAs. The extensive invasive evaluation presented could be especially helpful when noninvasive tests show unclear findings.
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Natural history of arrhythmia after successful isolation of pulmonary veins, left atrial posterior wall, and superior vena cava in patients with paroxysmal atrial fibrillation: A multi-center experience
Anno: 2021
Rivista: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE
Autori/autrici: Mohanty, S.; Trivedi, C.; Horton, P.; Rocca, D. G. D.; Gianni, C.; Macdonald, B.; Mayedo, A.; Sanchez, J.; Gallinghouse, G. J.; Al-Ahmad, A.; Horton, R. P.; Burkhardt, J. D.; Dello Russo, A.; Casella, M.; Tondo, C.; Themistoclakis, S.; Forleo, G.; Di Biase, L.; Natale, A.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293147
Citazioni:
Natural history of arrhythmia after successful isolation of pulmonary veins, left atrial posterior wall, and superior vena cava in patients with paroxysmal atrial fibrillation: A multi-center experience / Mohanty, S., Trivedi, C., Horton, P., Rocca, D.G.D., Gianni, C., Macdonald, B., Mayedo, A., Sanchez, J., Gallinghouse, G.J., Al-Ahmad, A., Horton, R.P., Burkhardt, J.D., Dello Russo, A., Casella, M., Tondo, C., Themistoclakis, S., Forleo, G., Di Biase, L., Natale, A.. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 10:11(2021), p. e020563. [10.1161/JAHA.120.020563]
Abstract:
BACKGROUND: We evaluated long-term outcome of isolation of pulmonary veins, left atrial posterior wall, and superior vena cava, including time to recurrence and prevalent triggering foci at repeat ablation in patients with paroxysmal atrial fibrillation with or without cardiovascular comorbidities. ...METHODS AND RESULTS: A total of 1633 consecutive patients with paroxysmal atrial fibrillation that were arrhythmia-free for 2 years following the index ablation were classified into: group 1 (without comorbidities); n=692 and group 2 (with comorbidi-ties); n=941. We excluded patients with documented ablation of areas other than pulmonary veins, the left atrial posterior wall, and the superior vena cava at the index procedure. At 10 years after an average of 1.2 procedures, 215 (31%) and 480 (51%) patients had recurrence with median time to recurrence being 7.4 (interquartile interval [IQI] 4.3–8.5) and 5.6 (IQI 3.8–8.3) years in group 1 and 2, respectively. A total of 201 (93.5%) and 456 (95%) patients from group 1 and 2 underwent redo ablation; 147/201 and 414/456 received left atrial appendage and coronary sinus isolation and 54/201 and 42/456 had left atrial lines and flutter ablation. At 2 years after the redo, 134 (91.1%) and 391 (94.4%) patients from group 1 and 2 receiving left atrial appendage/coronary sinus isolation remained arrhythmia-free whereas sinus rhythm was maintained in 4 (7.4%) and 3 (7.1%) patients in respective groups undergoing empirical lines and flutter ablation (P<0.001). CONCLUSIONS: Very late recurrence of atrial fibrillation after successful isolation of pulmonary veins, regardless of the comorbid-ity profile, was majorly driven by non-pulmonary vein triggers and ablation of these foci resulted in high success rate. However, presence of comorbidities was associated with significantly earlier recurrence.
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Cardiac resynchronization therapy defibrillators in patients with permanent atrial fibrillation
Anno: 2021
Rivista: ESC HEART FAILURE
Autori/autrici: Rapacciuolo, A.; Iacopino, S.; D'Onofrio, A.; Curnis, A.; Pisano, E. C.; Biffi, M.; Della Bella, P.; Dello Russo, A.; Caravati, F.; Zanotto, G.; Calvi, V.; Rovaris, G.; Senatore, G.; Nicolis, D.; Santamaria, M.; Giammaria, M.; Maglia, G.; Duca, A.; Ammirati, G.; Romano, S. A.; Piacenti, M.; Celentano, E.; Bisignani, G.; Vaccaro, P.; Miracapillo, G.; Bertini, M.; Nigro, G.; Giacopelli, D.; Gargaro, A.; Bisceglia, C.
Lingua: ENG
Classificazione IRIS: 1.1 Articolo in rivista
Scheda completa IRIS: https://iris.univpm.it/handle/11566/293090
Citazioni:
Cardiac resynchronization therapy defibrillators in patients with permanent atrial fibrillation / Rapacciuolo, A., Iacopino, S., D'Onofrio, A., Curnis, A., Pisano, E.C., Biffi, M., Della Bella, P., Dello Russo, A., Caravati, F., Zanotto, G., Calvi, V., Rovaris, G., Senatore, G., Nicolis, D., Santamaria, M., Giammaria, M., Maglia, G., Duca, A., Ammirati, G., Romano, S.A., et al.. - In: ESC HEART FAILURE. - ISSN 2055-5822. - (2021). [10.1002/ehf2.13599]
Abstract:
Aims: There are conflicting data on the benefit of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with permanent atrial fibrillation (AF). We aimed to compare patient outcomes according to the presence or absence of permanent AF at device implantation. Methods and results: We... retrospectively analysed remote monitoring data from 1141 CRT defibrillators. Propensity score with inverse-probability weighting method was used to balance AF and sinus rhythm (SR) groups. Analysis endpoints included total mortality, appropriate defibrillation shocks, and CRT percentage. There were 229 patients (20.1%) in the AF group and 912 patients (79.9%) in the SR group. Compared with SR patients, AF patients were older (median age, 77 vs. 72 years, P < 0.001), more frequently male (82.5% vs. 75.5%, P = 0.02), and had higher heart rate (75.7 vs. 71.0 b.p.m., P < 0.001). Of the 229 AF patients, 162 (70.7%) received suboptimal CRT (<98%) and 67 (29.3%) had adequate CRT (≥98%). During a median follow-up of 24 months, total mortality did not differ between AF and SR groups (propensity-score-weighted hazard ratio, HR 1.32 [95% confidence interval, 0.82–2.15], P = 0.25). The risk of appropriate shocks was significantly higher in the AF group with <98% CRT than in the SR group (weighted-HR, 1.99 [1.21–3.26], P = 0.006) and was similar in the AF group with ≥98% CRT versus the SR group (1.29 [0.66–2.53], P = 0.45). During follow-up, sinus rhythm was recovered in 23 patients in the AF group (10%) after a median time of 106 (42–256) days. The rate of sinus rhythm recovery in the AF group was 4.5 (95% CI, 2.8–6.7) per 100 patient-years; the rate of permanent AF occurrence in the SR group was 2.5 (95% CI, 1.9–3.3) per 100 patient-years. Conclusions: Although mortality was similar across patient groups, patients with permanent AF and suboptimal CRT had twofold higher risk of appropriate shocks than SR patients or AF patients with CRT ≥ 98%.
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