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Publications (9)14.12 Total impact

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    ABSTRACT: Tako-tsubo cardiomyopathy carries good mid- and long-term prognosis. However, the arrhythmic risk is increasingly recognized. On the basis of the available literature, we provide a few criteria for prognostic stratification and some practical suggestions for the management of these “vulnerable” patients.
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    ESC Congress 2012, Munich; 08/2012
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    ABSTRACT: Purpose: “Takotsubo” cardiomyopathy (TTC) is a recently described cardiac syndrome, usually triggered by intense emotional and/or physical stress, characterized by transient severe localized left ventricular dyskinesia and changes of ST segment that can mimic acute myocardial infarction, without significant coronary artery stenoses, Although the prognosis is considered good, TTC is associated with significant alterations of the QT interval that could trigger life-threatening cardiac arrhythmias. The aim of our study was to assess the extent of the alterations of the QT interval and the arrhythmic risk associated with this disease. Methods: From August 2008 to December 2011 we prospectively enrolled all patients (pts) admitted to our Department for TTC. In all pts we examined ECG performed during hospitalization and calculated maximum QT interval (QTmax), maximum corrected QT interval (QTcmax) and maximum QT dispersion (QTdmax). The presence of torsades de pointes (TdP), other hyperkinetic ventricular arrhythmias and sudden death, which occurred within one month of admission, was evaluated. Statistical analysis was performed using Student’s t for unpaired data. Results: The pts (18 women, mean age=63±12 years) had mean values of QTmax = 534±93 msec, Qtcmax = 550 msec±83 msec and QTdmax = 81 msec ± 55 msec.Ventricular arrhythmias occurred in 6 pts (33%). In particular, the presence of TdP was recorded in 1 pt (0.5%), non-sustained ventricular tachycardia in 4 pts (0.7%), sustained ventricular tachycardia in 3 pts (17%), ventricular fibrillation in 2 pts (11%). There was one case of sudden death the day after discharge, in a pts with ventricular fibrillation during the first day of hospitalization.The pts with ventricular arrhythmias had values of QTc max significantly higher than those without arrhythmias (580±80 msec vs 620±70 msec, p<0.05). The values of QTmax and QTdmax showed no statistically significant differences between the two groups. Conclusions: Our study confirmed abnormally prolonged QT intervals and QT dispersion in pts with TTC. We found a significant incidence of ventricular arrhythmias. The pts with ventricular arrhythmias had significantly higher values of QTcmax.
    European Heart Journal Supplements 08/2012; 33(suppl 1):693. DOI:10.1093/eurheartj/ehs283 · 5.64 Impact Factor
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    ABSTRACT: We report the case of a 57-year-old woman with anorexia nervosa showing evidence of "tako-tsubo" cardiomyopathy complicated by several syncopes due to recurrent episodes of torsades de pointes. Prolongation of QT interval and QT dispersion have been reported both in the "tako-tsubo" cardiomyopathy and in anorexia nervosa. The QT prolongation and the QT dispersion has been linked as risk indicators for sudden cardiac death. The combination of "tako-tsubo" cardiomyopathy with a condition associated with the prolongation of QT and/or with an increase of QT dispersion, such as anorexia nervosa, makes the acute and subacute prognosis of this disease much more severe than usual.
    Internal Medicine 01/2010; 49(12):1133-7. DOI:10.2169/internalmedicine.49.3276 · 0.97 Impact Factor
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    ABSTRACT: We report the case of a 71-year-old woman, with a dual chamber pacemaker (PM), in whom a PM syndrome, due to loss of atrial sensing and pacing, was associated with a tako-tsubo cardiomyopathy (TTC). The repositioning of the atrial lead immediately improved symptoms, whereas complete regression of left ventricular wall motion abnormalities occurred after 1 month. We hypothesize that haemodynamic and hormonal responses associated with a PM syndrome, such as increased levels of catecholamines, may account for TTC in our patient.
    Europace 10/2009; 11(12):1712-4. DOI:10.1093/europace/eup281 · 3.05 Impact Factor
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    ABSTRACT: We report the case of a 77-year-old man, in whom accidental hypothermia was secondary to prolonged immobilization and malnutrition. The electrocardiogram showed typical Osborn waves, which disappeared with the rewarming of the patient. The diagnosis of hypothermia is easy in patients with a history of prolonged exposure to a cold environment but accidental hypothermia may also occur as a consequence of prolonged immobilization and malnutrition. ECG analysis is very important for a correct and fast diagnosis.
    Journal of Cardiovascular Medicine 09/2009; 11(7):550-1. DOI:10.2459/JCM.0b013e32833250b1 · 1.41 Impact Factor
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    ABSTRACT: Background: atrioventricular junctional (AVJ) ablation with PM implantation has been shown to improve quality of life (QoL) in selected patients(pts) with drug resistant atrial fibrillation (AF). However,after the procedure,some pts worsen because of asinchronous ventricular stimulation. History: during the last 9 years,among 1986 pts who referred to our Institution for AF, 28 pts underwent ablate and pace procedure by right ventricular single lead.The long term follow up(FU) of 36 months demonstrated an improvement of QoL in all but 4 pts who developed a progressive, irreversible heart failure. Methods: from january 2001 to july 2002, 12 consecutive pts (6F,6M of mean age of 70.2 years) with dilated cardiomyopathy and chronic, non controlled high rate AF, were recruited. Eight pts had chronic persistant AF and 4 pts had chronic paroxismal AF. After AVJ ablation, a biventricular device was implanted : Medtronic Insync in 9 pts and Insync biventricular ICD in 3 pts. The NYHA functional class, the QRS duration, the mean heart rate, left ventricular ejection fraction (LVEF) and LV end diastolic dyameter (LVEDD) by 2D echocardiography, 6 minutes walking test(6'WT), the score of Minnesota questionnaire and the score of palpitation symptoms were evaluated at baseline and at 1, 3, 6 and 12 months FU in every pts. Results: the mean FU was 7.2+/− 4 months.The results have been quite terrific as shown as follow. One pt,3 months after the procedure, in spite of wide clinical improvements, died suddenly on ecg Holter monitoring that demonstrated a ventricular fibrillation as the cause of death. In pts with paoxismal AF, a trend of reduction of numbers and duration of episodes of AF was observed. Conclusions: these results demonstrated that the AVJ ablation combined with biventricular pacing is an effective tecnique to improve QoL in AF in congestive heart failure pts, mostly by relief of symptoms of palpitations and by means of the resinchronization therapy. The clinical results are not correlated to the QRS duration and to the LVEDD.Also the number of episodes of paroxismal AF seems to be lowered by the resnchronization therapy.However, life threatening ventricular arrhythmias have to be considered in pts without previous episodes.
    Europace 05/2005; 7(3):297. DOI:10.1016/j.eupc.2005.02.038 · 3.05 Impact Factor
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    ABSTRACT: Background: atrioventricular junctional (AVJ) ablation with PM implantation has been shown to improve quality of life (QoL) in selected patients(pts) with drug resistant atrial fibrillation (AF). However,after the procedure,some pts worsen because of asinchronous ventricular stim-ulation. History: during the last 9 years,among 1986 pts who referred to our Institution for AF, 28 pts underwent ablate and pace procedure by right ventricular single lead.The long term follow up(FU) of 36 months demonstrated an improvement of QoL in all but 4 pts who developed a progressive, irreversible heart failure. Methods: from january 2001 to july 2002, 12 consecutive pts (6F,6M of mean age of 70.2 years) with dilated cardiomyopathy and chronic, non controlled high rate AF, were recruited. Eight pts had chronic persistant AF and 4 pts had chronic paroxismal AF. After AVJ ablation, a biventricular device was implanted : Medtronic Insync in 9 pts and Insync biventricular ICD in 3 pts. The NYHA functional class, the QRS duration, the mean heart rate, left ventricular ejec-tion fraction (LVEF) and LV end diastolic dyameter (LVEDD) by 2D echocardiography, 6 min-utes walking test(6'WT), the score of Minnesota questionnaire and the score of palpitation symptoms were evaluated at baseline and at 1, 3, 6 and 12 months FU in every pts. Results: the mean FU was 7.2+/-4 months.The results have been quite terrific as shown as fol-low. One pt,3 months after the procedure, in spite of wide clinical improvements, died suddenly on ecg Holter monitoring that demonstrated a ventricular fibrillation as the cause of death. In pts with paoxismal AF, a trend of reduction of numbers and duration of episodes of AF was observed. Conclusions: these results demonstrated that the AVJ ablation combined with biventricular pac-ing is an effective tecnique to improve QoL in AF in congestive heart failure pts, mostly by relief of symptoms of palpitations and by means of the resinchronization therapy.The clinical results are not correlated to the QRS duration and to the LVEDD.Also the number of episodes of paroxismal AF seems to be lowered by the resnchronization therapy.However, life threaten-ing ventricular arrhythmias have to be considered in pts without previous episodes. Europace Supplements, Vol. 7, May 2005 297

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20 Citations
14.12 Total Impact Points

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