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1.
HUBERT COCHET M.D. YUKI KOMATSU M.D. FREDERIC SACHER M.D. AMIR SHERWAN JADIDI M.D. DANIEL SCHERR M.D. MATTHIEU RIFFAUD M.D. NICOLAS DERVAL M.D. ASHOK SHAH M.D. LAURENT ROTEN M.D PATRIZIO PASCALE M.D. JATIN RELAN Ph.D. MAXIME SERMESANT Ph.D. NICHOLAS AYACHE Ph.D. MICHEL MONTAUDON M.D. Ph.D. FRANÇOIS LAURENT M.D. MÉLÈZE HOCINI M.D. MICHEL HAÏSSAGUERRE M.D. PIERRE JAÏS M.D. Ph.D . 《Journal of cardiovascular electrophysiology》2013,24(4):419-426
MDCT/MRI Fusion for the Guidance of VT Ablation . Background: Delayed enhancement (DE) MRI can assess the fibrotic substrate of scar‐related VT. MDCT has the advantage of inframillimetric spatial resolution and better 3D reconstructions. We sought to evaluate the feasibility and usefulness of integrating merged MDCT/MRI data in 3D‐mapping systems for structure–function assessment and multimodal guidance of VT mapping and ablation. Methods: Nine patients, including 3 ischemic cardiomyopathy (ICM), 3 nonischemic cardiomyopathy (NICM), 2 myocarditis, and 1 redo procedure for idiopathic VT, underwent MRI and MDCT before VT ablation. Merged MRI/MDCT data were integrated in 3D‐mapping systems and registered to high‐density endocardial and epicardial maps. Low‐voltage areas (<1.5 mV) and local abnormal ventricular activities (LAVA) during sinus rhythm were correlated to DE at MRI, and wall‐thinning (WT) at MDCT. Results: Endocardium and epicardium were mapped with 391 ± 388 and 1098 ± 734 points per map, respectively. Registration of MDCT allowed visualization of coronary arteries during epicardial mapping/ablation. In the idiopathic patient, integration of MRI data identified previously ablated regions. In ICM patients, both DE at MRI and WT at MDCT matched areas of low voltage (overlap 94 ± 6% and 79 ± 5%, respectively). In NICM patients, wall‐thinning areas matched areas of low voltage (overlap 63 ± 21%). In patients with myocarditis, subepicardial DE matched areas of epicardial low voltage (overlap 92 ± 12%). A total number of 266 LAVA sites were found in 7/9 patients. All LAVA sites were associated to structural substrate at imaging (90% inside, 100% within 18 mm). Conclusion: The integration of merged MDCT and DEMRI data is feasible and allows combining substrate assessment with high‐spatial resolution to better define structure–function relationship in scar‐related VT. (J Cardiovasc Electrophysiol, Vol. 24, pp. 419‐426, April 2013) 相似文献
2.
Endless-Loop Tachycardias: Description and First Clinical Results of a New Fully Automatic Protection Algorithm 总被引:1,自引:0,他引:1
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ZHONG CHEN M.B.B.S ROCIO CABRERA‐LOZOYA Ph.D. JATIN RELAN Ph.D. MANAV SOHAL M.B.B.S ANOOP SHETTY M.D. RASHED KARIM Ph.D. HERVE DELINGETTE Ph.D. JASWINDER GILL M.D. KAWAL RHODE Ph.D. NICHOLAS AYACHE Ph.D. PETER TAGGART D.Sc. CHRISTOPHER ALDO RINALDI M.D. MAXIME SERMESANT Ph.D. REZA RAZAVI M.D. 《Journal of cardiovascular electrophysiology》2016,27(7):851-860
4.
MAXIME DE GUILLEBON M.D. JEAN‐BENOIT THAMBO M.D. SYLVAIN PLOUX M.D. ANTOINE DEPLAGNE M.D. FREDERIC SACHER M.D. PIERRE JAIS M.D. MICHEL HAISSAGUERRE M.D. PHILIPPE RITTER M.D. JACQUES CLEMENTY M.D. PIERRE BORDACHAR M.D. 《Journal of cardiovascular electrophysiology》2010,21(8):890-892
Reliability and Reproducibility of QRS Duration . Background: A QRS >120 ms remains the recommended criterion for the selection of cardiac resynchronization therapy (CRT) candidates. However, the reproducibility of this measurement has not been studied thoroughly. Methods: QRS duration was measured by 3 experienced cardiologists and by automatic measurement on 228 electrocardiograms (ECGs) randomly collected from 188 subjects, including neonates, healthy adults, patients with complete and incomplete bundle branch block, and CRT candidates. All ECGs were recorded at a 25 mm/s sweep speed. Forty recordings were duplicated and 50 ECGs were recorded at both 25 and 50 mm/s. Results: Significant interobserver differences (P < 0.001) were found between each combination of paired observers, with an up to 50‐ms absolute variability between cardiologists and low concordance with computerized measurements. Intraobserver absolute variability was also significant (P < 0.01) for the 3 observers. These significant differences persisted (P < 0.01) when focusing our interest on the ECGs in the 100–140 ms range (defined as at least one out of the 4 measures in this range). Considering the 120 ms limit, 22 (27.5%) ECGs were differently classified by at least one of the cardiologists. We observed similar interobserver differences between each combination of paired observers with a 50 mm/s sweep speed. Conclusion: Manual QRS duration measurements were associated with significant inter‐ and intraobserver variability and low concordance with computerized measurements. The measurement of QRS is, therefore, operator‐dependent and a reevaluation of the measurement methods may be essential to develop clinical and investigative standards. (J Cardiovasc Electrophysiol, Vol. 21, pp. 890‐892, August 2010) 相似文献
5.
Reducing Radiation Exposure in the Electrophysiology Laboratory: It is More Than Just Fluoroscopy Times!
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EYAL NOF M.D. CHRISTOPHER LANE M.D. MAXIME CAZALAS M.Sc. ELISABETH CUCHET‐SOUBELET Ph.D. GREGORY F. MICHAUD M.D. ROY M. JOHN M.D. Ph.D. USHA TEDROW M.D. M.B.A. BRUCE A. KOPLAN M.D. M.B.A. WILLIAM G. STEVENSON M.D. LAURENCE M. EPSTEIN M.D. 《Pacing and clinical electrophysiology : PACE》2015,38(1):136-145
6.
Sleep fragmentation is present in numerous sleep pathologies and constitutes a major feature of patients with obstructive sleep apnea. A prevalence of metabolic syndrome, diabetes and obesity has been shown to be associated to obstructive sleep apnea. While sleep fragmentation has been shown to impact sleep homeostasis, its specific effects on metabolic variables are only beginning to emerge. In this context, it is important to develop realistic animal models that would account for chronic metabolic effects of sleep fragmentation. We developed a 14‐day model of instrumental sleep fragmentation in mice, and show an impact on both brain‐specific and general metabolism. We first report that sleep fragmentation increases food intake without affecting body weight. This imbalance was accompanied by the inability to adequately decrease brain temperature during fragmented sleep. In addition, we report that sleep‐fragmented mice develop glucose intolerance. We also observe that sleep fragmentation slightly increases the circadian peak level of glucocorticoids, a factor that may be involved in the observed metabolic effects. Our results confirm that poor‐quality sleep with sustained sleep fragmentation has similar effects on general metabolism as actual sleep loss. Altogether, these results strongly suggest that sleep fragmentation is an aggravating factor for the development of metabolic dysfunctions that may be relevant for sleep disorders such as obstructive sleep apnea. 相似文献
7.
Chronic Left Main Coronary Artery Occlusion: A Complication of Radiofrequency Ablation of Idiopathic Left Ventricular Tachycardia 总被引:8,自引:0,他引:8
MAXIME PONS LIONEL BECK FLORENCE LECLERCQ MARC FERRIERE BERNARD ALBAT JEAN-MARC DAVY 《Pacing and clinical electrophysiology : PACE》1997,20(7):1874-1876
We describe in this report the development of chronic left main coronary artery (LMCA) occlusion in a young patient 2 years after an uncomplicated, successful ablation of idiophic left ventricular tachycardia. This complication appears to be a late consequence of trauma to the LMCA during the procedure rather than an acute or subacute embolic event. 相似文献
8.
MAXIME TREMBLAY‐GRAVEL M.D. MICHEL WHITE M.D. DENIS ROY M.D. HUGUES LEDUC M.Sc. D. GEORGE WYSE M.D. Ph.D. JULIA CADRIN‐TOURIGNY M.D. AZADEH SHOHOUDI Ph.D. LAURENT MACLE M.D. MARC DUBUC M.D. JASON ANDRADE M.D. LENA RIVARD M.D. PETER G. GUERRA M.D. BERNARD THIBAULT M.D. MARIO TALAJIC M.D. PAUL KHAIRY M.D. Ph.D. 《Journal of cardiovascular electrophysiology》2015,26(5):509-514
9.
LIONEL BECK MAXIME PONS CHRISTOPHE PIOT FLORENCE LECLERCQ PATRICK MESSNER-PELLENC MARC FERRIÈRE JEAN-MARC DAVY 《Pacing and clinical electrophysiology : PACE》1999,22(7):1004-1012
The characteristics of neurocardiogenic syncope (NCS) in elderly patients remain unclear. We compared the hemodynamic profiles of young and older patients with consecutive and positive head-up tilt tests (HUT). Continuous, noninvasive, and reliable monitoring of arterial pressure (AP) and heart rate (HR) was done throughout 46 consecutive positive HUTs of symptomatic patients. The population (12-82 years old) was divided into two groups: younger patients, Y (n = 25, < or = 65 years), and older patients, O (n = 21). Changes in AP and HR after the first minute of tilting, during the stable orthostatic phase and during syncope were compared. Except for systolic pressure, baseline hemodynamic parameters were similar in Y and O. No difference appeared in the mean time elapsed before syncope (19+/-9 vs 22+/-2 min). Asymptomatic hypotension was observed, only in O, 1 minute after tilting, followed by a progressive fall in the mean AP before syncope (0+/-0.9 vs -1+/-0.7 mmHg/min) without HR increase (0.7+/-1 vs 0+/-0.6 beats/min). This pressure slope was strongly related to age (r = 0.54, P < 0.001). Hemodynamic recording during HUT identifies a dysautonomic pattern in elderly patients with NCS and the abnormal AP/HR responses to orthostasis may be a feature specific to this population. Although the central mechanism of NCS is common to all ages, the age-related characteristics of the trigger event may indicate the need for specific management at different ages. 相似文献