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1.
Autoantibodies against β1‐Adrenergic Receptors: Response to Cardiac Resynchronization Therapy and Renal Function
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ANTONIO MICHELUCCI M.D. MARIO MILCO D'ELIOS M.D. ELENA STICCHI Ph.D. PAOLO PIERAGNOLI M.D. GIUSEPPE RICCIARDI M.D. CINZIA FATINI Ph.D. MARISA BENAGIANO Ph.D. ELENA NICCOLAI Ph.D. ALESSIA GRASSI M.Sc. PAOLA ATTANÀ M.D. MARTINA NESTI M.D. GINO GRIFONI M.D. LUIGI PADELETTI M.D. ROSANNA ABBATE M.D. DOMENICO PRISCO M.D. 《Pacing and clinical electrophysiology : PACE》2016,39(1):65-72
2.
M. BODDI F. BARBANI† R. ABBATE‡ M. BONIZZOLI† S. BATACCHI† E. LUCENTE M. CHIOSTRI G. F. GENSINI A. PERIS† 《Journal of thrombosis and haemostasis》2010,8(1):121-128
Summary. Background : Deep vein thrombosis (DVT) is a major complication in intensive care units (ICU) but dedicated guidelines on its management are still lacking. Objectives and Methods : This study investigated the effect of a 1-year educational program for the implementation of DVT prophylaxis on the incidence of inferior limb DVT in a mixed-bed ICU that admits high-risk surgical and trauma patients, investigated during a first retrospective phase [126 patients, SAPS II score 42 (28–54)] and a following prospective phase [264 patients, SAPS II score II 41 (27–55)]. The role of baseline and time-dependent DVT risk factors in DVT occurrence was also investigated during the prospective phase. Results : The educational program on implementation of DVT prophylaxis was associated with a significant decrease in DVT incidence from 11.9% to 4.5% ( P < 0.01) and in the mean length of ICU stay ( P < 0.01). Combined with pharmacological prophylaxis, the use of elastic compressive stockings significantly also increased in the prospective phase ( P < 0.01). The duration of mechanical ventilation, vasopressor administration and neuromuscular block were significantly different between DVT-positive and DVT-negative patients ( P < 0.01). Multivariate analysis identified neuromuscular block as the strongest independent predictor for DVT incidence. Conclusion : One-year ICU-based educational programs on implementation of DVT prophylaxis were associated with a significant decrease in the incidence of DVT and also in the length of stay in ICU. 相似文献
3.
Pacing for Carotid Sinus Syndrome and Sick Sinus Syndrome 总被引:2,自引:0,他引:2
MICHELE BRIGNOLE CARLO MENOZZI GINO LOLLI DANIELE ODDONE LORELLA GIANFRANCHI ANTONIO BERTULLA 《Pacing and clinical electrophysiology : PACE》1990,13(12):2071-2075
BRIGNOLE, M., ET AL: Pacing for Carotid Sinus Syndrome and Sick Sinus Syndrome. The real incidence of pacemaker implants for carotid sinus syndrome (CSS) and the relation between CSS and sick sinus syndrome (SSS) is not precisely known. Patients who needed pacing therapy because of atrial bradyarrhythmias were investigated by means of carotid sinus massage, dynamic ECG, and invasive electrophysiological sinus node evaluation. Of 298 consecutive patients receiving a pacemaker implant, 36 (12%) had a severe cardioinhibitory carotid sinus reflex with reproducible spontaneous symptoms (CSS), 33 (11%) had sinus bradycardia < 50 beat/min or an abnormal electrophysiological evaluation (SSS) and 24 (8%) had both (CSS + SSS). The annual incidence was 40, 37, and 26, respectively, implants per year/million of inhabitants (total incidence 325). Patients affected by CSS, if compared with those affected by SSS, showed: a higher prevalence of syncope (97% vs 42%); more syncopal, episodes per patient (2.9 ± 2 vs 1.8 ± 0.9); a lower prevalence of associated cardiac diseases (53% vs 100%); cardiac enlargement (36% vs 88%); heart failure (6% vs 36%) and paroxysmal atrial fibrillation (0% vs 42%); and a more frequent indication for VVI pacing (75% vs 3%). In patients with CSS + SSS, intermediate characteristics were present. In conclusion, CSS is as frequent an indication to cardiac pacing as SSS; clinical differences justify a distinction between them, even if they are associated in 26% of cases. 相似文献
4.
DANIELE ODDONE MICHELE BRIGNOLE CARLO MENOZZI LORELLA GIANFRANCHI GINO LOLLI 《Pacing and clinical electrophysiology : PACE》1991,14(3):415-419
ECG recording of spontaneous, neurally-mediated syncope is rare. We have observed ten patients who sustained 70 syncopal episodes in whom: (1) ECG monitoring recorded syncope caused by ventricular asystole (AV block, three patients; sinus arrest; seven patients); (2) syncope and the spontaneously observed arrhythmias were reproducible by carotid sinus massage, upright tilt test, or eyeball pressure; and (3) no discernable cause of precipitating factors were detected. Two patients had a history of cardiac disease and four patients had only mild nonclinical ECG or echocardiographic abnormalities. Syncopal episodes recorded during Holter monitoring were of sudden onset in four patients and preceded by prodromal symptoms in six patients. The maximum RR pause was 9.4 +/- 3.7 seconds (range 4.5-15). Electrophysiological evaluation was normal in seven patients. Slight sinus node dysfunction or atrioventricular conduction abnormalities were noted in three others. The clinical characteristics of spontaneous and induced episodes strongly suggest that increased vagal tone played a role in causing the spontaneous events. Vagal stimulation tests are useful for the diagnosis of syncope of unknown origin. 相似文献
5.
MICHELE BRIGNOLE BRUNO SARTORE MAURO BARRA CARLO MENOZZI GINO LOLLI 《Pacing and clinical electrophysiology : PACE》1989,12(4):582-590
Thirty-nine consecutive patients with recurrent syncope and either cardioinhibitory or mixed type carotid sinus syndrome were studied to determine the efficacy of ventricular (VVI) pacing in 16, and dual chamber (DDD/DVI) in 23 patients. Only those patients affected by the isolated vasodepressor form were excluded. Follow-up lasted 12 ± 5 months. Symptoms were totally eliminated in 67% of patients and ameliorated with persistence of minor symptoms in 33%. All patients underwent an initial 2-month follow-up in the VVI mode. Evaluation of the 19 patients who remained symptomatic and the 20 who became asymptomatic with VVI pacing demonstrated that factors observed prior to pacemaker implant were related to failure of the VVI mode. These included symptomatic pacemaker effect (42% vs 0%), mixed carotid sinus syndrome (95% vs 65%), orthostatic hypotension (47% vs 15%), or ventriculoatrial conduction (68% vs 38%). In the 23 patients with dual chamber pacing, random 2 month comparisons were performed between VVI and DVI/DDD pacing. The dual chamber mode was preferred by 14 patients, none preferred the VVI mode and nine noted no difference. Comparison of the two groups found that the factors linked to DVI/DDD preference were symptomatic pacemaker effect (50% vs 0%), ventriculoatrial conduction (78% vs 44%), or orthostatic hypotension (50% vs 11 %). VVI pacing is efficacious in a high proportion of patients affected by cardioinhibitory or mixed carotid sinus syndrome. The identification of causes of VVI pacing failure allows determination of those who will benefit from VVI pacing and those who should have DVI/DDD. VVI pacing is suggested for the cardioinhihitory type with no symptomatic pacemaker effect and for the mixed type with no symptomatic pacemaker effect or orthostatic hypotension or ventriculoatrial conduction. Dual chamber pacing should be used in all other instances. 相似文献
6.
Intrapatient Comparison Between Chronic VVIR and DDD Pacing 'In Patients Affected by High Degree AV Block Without Heart Failure 总被引:2,自引:0,他引:2
CARLO MENOZZI MICHELE BRIGNOLE PIER VITTORIO MORACCHINI† GINO LOLLI MIRKA BACCHI MARIA CRISTINA TESORIERI† GIAN DOMENICO TOSONI† ROBERTO BOLLINI 《Pacing and clinical electrophysiology : PACE》1990,13(12):1816-1822
MENOZZI, C., ET AL.: Intrapatient Comparison Between Chronic VVIR and DDD Pacing in Patients Affected by High Degree AV Block Without Heart Failure. In patients affected by high degree AV block without preexisting congestive heart failure there is no definite demonstration that DDD pacing gives real clinical advantages in respect to VVIR pacing. We performed an intrapatient, long-term study between the two pacing modes in 14 high degree AV block patients, using the Medtronic Synergyst 7027 dual chamber pacemaker, who could be programmed alternatively in DDD or VVIR mode. After a 4-week run-in period following the pacemaker implant, patients completed a randomized, double-blind, cross-over study to compare the effect of 6-week period VVIR and DDD pacing on symptoms and cardiovascular parameters. A semiquantitative score scale was used to quantify the symptoms of general well-being, palpitations, dizziness, pulsating sensation in the neck or abdomen, shortness of breath at rest and during effort, chest pain, and NYHA classification. The sum of symptom scores was 10.4 ± 6.7 in VVIR period and 4.6 ± 2.7 in DDD period (p < 0.001); five patients (36%) crossed over early from VVIR to DDD because of intolerable symptoms; overall, eight patients preferred the DDD mode and no one preferred the VVIR. Cardiac output at rest (echo-Doppler method) was 4.7 ± 1.4 versus 5.7 ± 1.6 liter/min (p < 0.01), body weight was 65.9 ± 6.6 versus 64.9 ± 6.1 kg (p < 0.02), atrial natriuretic peptide was 236 ± 112 versus 198 ± 110 pg/mL (p < 0.01), respectively, during VVIR and DDD modes. Effort tolerance was similar with the two modes of pacing (68 ± 15 vs 70 ± 18 watt/min). In conclusion, hemodynamic advantages of atrial synchronization reflect a better quality of life for the patients even if an individual variability exists. 相似文献
7.
CARLO MENOZZI MICHELE BRICNOLE PAOLO PAGANI GINO LOLLI GIUSEPPE CASALI 《Pacing and clinical electrophysiology : PACE》1988,11(11):1641-1646
In this study, we used Holter pacemakers in a group of 13 patients affected by severe carotid sinus syndrome in order to evaluate its evolution. All the patients had one to three syncopal episodes and frequent other symptoms such as fainting, dizziness, lightheadedness and pre-syncope interferring with their daily activity so that pacemaker therapy was considered necessary. Patient selection criteria were: presence of the isolated cardioinhibitory type, absence of associated sinus dysfunction and absence of symptomatic WI pacemaker effect. All the patients received a Micropacer 1 device; among special functions, bradycardia events counter was activated and programmed so that each sequence of three consecutives beats at a cycle length 1.5 sec (i.e., 4.5 sec total interval) could he recognized and stored in its memory. The follow-up lasted 13±7 months. Brady events occurred in eight out of 13 patients (62%), during this period. Syncope and major symptoms disappeared in ail the patients; mild dizziness recurred rarely in two patients and were not linked to brady-events recording. In conclusion, disappearance of severe symptoms observed after pacemaker implant in cardioinhibitory carotid sinus syndrome seems to depend from pacing therapy, in most cases, yet from the benign natural course of the disease in some other cases. 相似文献
8.
The Effect of Exogenous Adenosine in Patients with Neurally-Mediated Syncope and Sick Sinus Syndrome 总被引:1,自引:0,他引:1
MICHELE BRIGNOLE CARLO MENOZZI PAOLO ALBONI DANIELE ODDONE LORELLA GIANFRANCHI GERMANO GAGGIOLI GINO LOLLI NELLY PAPARELLA 《Pacing and clinical electrophysiology : PACE》1994,17(11):2211-2216
The effects of a 20-mg IV, bolus of adenosine 5'triphosphate (ATP) on the heart rhythm was studied in 79 patients affected by neurally-mediated syncope (26 cases) or sick sinus syndrome (22 cases) or both syndromes (31 cases) and in 31 healthy control subjects in order to examine the sensitivity of cardiac purinoceptors in such circumstances. During ATP infusion, the sinus cycle lengthened to > 2 seconds in no control, in 1 (4%) patient with neurally-mediated syncope, in 5 (23%) patients with sick sinus syndrome, and in 13 (42%) patients with both neurally-mediated and sick sinus syndromes (P = 0.01). Atrioventricular block occurred in 14 (45%) of controls, in 10 (38%) patients with neurally-mediated syncope, in 4 (18%) patients with sick sinus syndrome, and in 13 (42%) patients with both neurally-mediated syncope and sick sinus syndrome (n.s.). Thus, exogenous ATP exerts different effects on patients with neurally-mediated syncope and patients with sick sinus syndrome. In fact, intrisic disease of the sinus node is necessary to modulate an abnormal adenosine-mediated sinus arrest, whereas patients affected by neurally-mediated syncope alone show a normal sensitivity to the drug administration. The effect of ATP on atrioventricular conduction is greater than that on sinus node and is of similar magnitude in patients and controls; thus the clinical meaning of ATP induced atrioventricular block remains uncertain. 相似文献
9.
The Need for a Lengthier Cryolesion Can Predict a Worse Outcome in 3D Cryoablation of AV Nodal Slow Pathway in Children
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10.
CARLO MENOZZI M.D. MICHELE BRIGNOLE M.D. GINO LOLLI M.D. MIRKA BACCHI M.D. IGOR MONDUCCI M.D. BRUNO SARTORE M.D. MAURO BARRA M.D. 《Journal of cardiovascular electrophysiology》1991,2(1):30-36
A total of 73 noninvasive serial electrophysiological studies were carried out in 12 patients with spontaneous sustained ventricular tachycardia, inducible in spite of chronic treatment with amiodarone, in order to verify the effect of this drug on the long-term reproducibility of the test. A ventricular tachycardia was induced in 72 of 73 times; in 59% of cases, the clinical form was induced. In 8 of 12 patients, two or more types or morphologies of ventricular tachycardia could be induced. The induction modes (driving rate and number of extrastimuli) changed considerably in different studies. During a follow-up of 12 ± 6 months, 5 out of 12 patients had spontaneous relapses. We observed no differences between these patients and the others regarding inducibility, types and morphologies of the induced tachycardias, or induction modes. Therefore, when ventricular tachycardia is inducible in spite of chronic amiodarone therapy, it is always inducible during follow-up, even if a great intrapatient change of type and the morphology of induced tachycardias and induction modes is observed. However, since similar electrophysiological features are present in patients with and without spontaneous recurrence of ventricular tachycardia, serial electrophysiological studies are of little value in predicting the clinical outcome. 相似文献