Dominique Blommaert

Publications (19)89.27 Total impact

• Article: Transesophageal Echocardiography Before Pulmonary Vein Isolation in Nonvalvular Atrial Fibrillation: A Tentative for Better Evaluation.

  Mariana Floria, Luc DE Roy, Olivier Xhaet, Dominique Blommaert, Erwin Schroeder
  Journal of Cardiovascular Electrophysiology 03/2013; · 3.06 Impact Factor
• Article: Excluding the presence of left atrial thrombus before pulmonary vein isolation.

  Mariana Floria, Luc DE Roy, Dominique Blommaert, Olivier Deceuninck, Erwin Schroeder
  Journal of Cardiovascular Electrophysiology 03/2013; 24(3):E6-7. · 3.06 Impact Factor
• Article: Predictive Value of Thromboembolic Risk Scores Before an Atrial Fibrillation Ablation Procedure.

  Mariana Floria, Luc DE Roy, Olivier Xhaet, Dominique Blommaert, Jacques Jamart, Marina Gerard, Fabien Dormal, Olivier Deceuninck, Valentin Ambarus, Baudouin Marchandise, Erwin Schroeder
  [show abstract] [hide abstract]
  ABSTRACT: Risk Scores for Atrial Fibrillation Ablation Introduction: It is not clear whether transesophageal echocardiography (TEE) should be performed prior to a planned atrial fibrillation (AF) ablation in all patients. Methods and Results: The objectives of this study were to determine in 681 consecutive patients: (i) the relationship between the CHADS2 and CHA2DS2-VASc scores, the presence of a thrombogenic milieu and left atrial (LA) volume; (ii) the need for TEE in patients with low and intermediate thromboembolic risk assessed; and (iii) the predictive accuracy of the these 2 scores for the presence of thrombi in the LA/LAA (LA appendage) before a planned AF ablation. The prevalence of thrombi was 1%. All patients with thrombi had LA dilatation, a CHADS2 score ≥1 and a CHA2DS2-VASc score ≥2. CHADS2 or CHA2DS2-VASc scores <2 had an almost maximal negative predictive capability of excluding the presence of a thrombus (99.8% and 100%, respectively; 95% CI: 99-100). A CHADS2 score ≥2 had a sensitivity and specificity of 86% (95% CI: 42-100) and 82% (95% CI: 79-85), respectively, to predict the presence of a thrombus in the LA/LAA, while a CHA2DS2-VASc score ≥2 had a sensitivity and specificity of 100% (95% CI: 59-100) and 67% (95% CI: 63-70). The area under the curve for CHADS2 and CHA2DS2-VASc scores ≥2 was 0.928 (95% CI: 0.906-0.946) and 0.933 (95% CI: 0.912-0.951), respectively. Conclusion: Not all patients undergoing planned endocardial pulmonary vein isolation need preprocedural TEE. Both scores <2 had an almost maximal negative predictive capability of excluding the presence of a thrombus in the LA/LAA. (J Cardiovasc Electrophysiol, Vol. pp. 1-7).
  Journal of Cardiovascular Electrophysiology 08/2012; · 3.06 Impact Factor
• Article: Exercise intolerance due to sustained atrial bigeminy with short coupling interval.

  Katrijn Jansen, Dominique Blommaert, Olivier Deceuninck
  [show abstract] [hide abstract]
  ABSTRACT: Atrial bigeminy is a supraventricular arrhythmia rarely associated with severe symptoms. We report the case of a 22-year-old woman with no prior cardiac disease presenting with exercise intolerance since several months. No apparent heart disease other than a spontaneous conducted atrial bigeminy with a short coupling interval was found. At bicycle ergometric testing, symptoms occurred, because of an inadequate increase in pulse rate, due to sustained atrial bigeminy. At electrophysiological study, an ectopic atrial focus at the right atrial septum was successfully ablated.
  Acta cardiologica 08/2011; 66(4):515-7. · 0.61 Impact Factor
• Article: Syncope due to idiopathic paroxysmal atrioventricular block: long-term follow-up of a distinct form of atrioventricular block.

  Michele Brignole, Jean-Claude Deharo, Luc De Roy, Carlo Menozzi, Dominique Blommaert, Lara Dabiri, Jean Ruf, Regis Guieu
  [show abstract] [hide abstract]
  ABSTRACT: We present data on patients with syncope due to paroxysmal atrioventricular (AV) block unexplainable in terms of currently known mechanisms. Paroxysmal AV block is known to be due to intrinsic AV conduction disease or to heightened vagal tone. We evaluated 18 patients presenting with unexplained syncope who had: 1) normal baseline standard electrocardiogram (ECG); 2) absence of structural heart disease; and 3) documentation, by means of prolonged ECG monitoring at the time of syncopal relapse, of paroxysmal third-degree AV block with abrupt onset and absence of other rhythm disturbances before or during the block. The study group consisted of 9 men and 9 women, mean age 55 ± 19 years, who had recurrent unexplained syncope for 8 ± 7 years and were subsequently followed up for as long as 14 years (4 ± 4 years on average). The patients had no structural heart disease, standard ECG was normal, and electrophysiological study was negative. In all patients, prolonged ECG monitoring documented paroxysmal complete AV block with 1 or multiple consecutive pauses (mean longest pause: 9 ± 7 s at the time of syncope); AV block occurred without P-P cycle lengthening or PR interval prolongation. During the observation time, no patient had permanent AV block; on permanent cardiac pacing, no patient had further syncopal recurrences. Common clinical and electrophysiological features define a distinct form of syncope due to idiopathic paroxysmal AV block characterized by a long history of recurrent syncope, absence of progression to persistent forms of AV block, and efficacy of cardiac pacing therapy.
  Journal of the American College of Cardiology 04/2011; 58(2):167-73. · 14.16 Impact Factor
• Article: A possible association between takotsubo cardiomyopathy and treatment with flecainide.

  Laurence Gabriel, Patrick Chenu, Antoine Guédès, Vincent Dangoisse, Baudouin Marchandise, Dominique Blommaert, Jacques Jamart, Luc De Roy, Erwin Schroeder
  International journal of cardiology 02/2011; 147(1):173-5. · 7.08 Impact Factor
• Article: Spontaneous migration of a nonfixed RV lead 3 weeks after implantation.

  Caroline Lepièce, Olivier Deceuninck, Dominique Blommaert, Olivier Xhaet
  Journal of Cardiovascular Electrophysiology 02/2011; 22(9):1079. · 3.06 Impact Factor
• Article: Improved patient survival with concomitant Cox Maze III procedure compared with heart surgery alone.

  Yves Louagie, Michel Buche, Philippe Eucher, Jean-Claude Schoevaerdts, Marina Gerard, Jacques Jamart, Dominique Blommaert
  [show abstract] [hide abstract]
  ABSTRACT: The benefit of the Cox Maze procedure combined with heart surgery was evaluated at long-term follow-up. The outcome for 37 patients who underwent a Cox Maze III procedure combined with heart surgery (Maze group) was compared with that of 66 patients who had heart surgery alone (control group). All patients were in persistent atrial fibrillation preoperatively. The two groups had similar preoperative characteristics and were operated upon during the same era (1996 to 2004). Five-year survival, including hospital deaths, was 89% +/- 5% in the Maze group and 60% +/- 7% in the control group (log rank p = 0.008). Causes of death were predominantly related to heart failure (1 of 37 in the Maze group and 12 of 66 in the control group; p = 0.02) and to sudden death (0 of 37 in the Maze group and 9 of 66 in the control group; p = 0.02). After correction for preoperative variables, Cox regression analysis showed that the Maze procedure improved survival independently (p = 0.019). In a subgroup of patients with left atrial diameter of more than 60 mm preoperatively, the 5-year survival estimate was 92% +/- 6% in the Maze group versus 59% +/- 9% in the control group (log rank p = 0.012). The 5-year estimate of conversion to sinus rhythm was 91% +/- 7% in the Maze group and 33% +/- 7% in the control group (log rank p < 0.001). The restoration of sinus rhythm by a Maze procedure combined with heart surgery markedly improved long-term survival in this series.
  The Annals of thoracic surgery 02/2009; 87(2):440-6. · 3.74 Impact Factor
• Article: Assessment of left atrial shape and volume in structural remodeling secondary to atrial fibrillation.

  Mariana Floria, Dominique Blommaert, Marc Lacrosse, Valentin Ambarus, Fabien Dormal, Lara Dabiri Abkenari, Jacques Jamart, Ciprian Rezus, Dragos Cozma, Luc De Roy
  [show abstract] [hide abstract]
  ABSTRACT: Assessment of volume in relation with left atrial (LA) shape alteration before and after PV isolation. We compared trapezoidal modification of LA using echocardiography with the ellipsoid formula (EEL: ) and CT, with both ellipsoid (CTEL: ) and truncated cone formulas (CTTR: ), in 40 patients, before and +/-3 months after AF ablation. A trapezoidal shape was present in 76.3% of patients. The different volume measurements were statistically correlated (r = 0.603-0.837, p < 0.001) irrespective of the formula used. After reverse remodeling, with 77.5% of patients in stable sinus rhythm, correlation coefficient for volume remained significant (p < 0.001). In AF, dilation of the LA is associated with a geometrical trapezoidal change in many cases. The CT truncated cone formula applies best for precise evaluation of trapezoidal shape alteration in dilated AF atria. There is a good correlation between CTTR: and echocardiography which remains a valuable estimation for volume calculation in clinical practice.
  Journal of Interventional Cardiac Electrophysiology 01/2009; 25(3):167-70. · 1.17 Impact Factor
• Article: Images in cardiovascular medicine. Massive air embolism after central venous catheter removal.

  Olivier Deceuninck, Luc De Roy, Simona Moruzi, Dominique Blommaert
  Circulation 12/2007; 116(19):e516-8. · 14.74 Impact Factor
• Article: Variable morphologies of preexcitation due to a concomitant Brugada pattern.

  Luc De Roy, Elena Popescu, Mariana Floria, Dominique Blommaert, Olivier Deceuninck, Benoit Collet, Fabien Dormal, Gladys Alsteen, José Ramos de Olival
  [show abstract] [hide abstract]
  ABSTRACT: Since the first publication of the Brugada syndrome in 1992 several variants of this ECG pattern have been described. We report a very unusual case of preexcitation with changing electrocardiographic morphologies which appeared to be an association of a variable Brugada pattern with a persistent antegrade preexcitation.
  Journal of Interventional Cardiac Electrophysiology 12/2007; 20(1-2):39-41. · 1.17 Impact Factor
• Article: Treatment of lone atrial fibrillation with a right thoracoscopic approach.

  Mark La Meir, Luc De Roy, Dominique Blommaert, Michel Buche
  [show abstract] [hide abstract]
  ABSTRACT: A simplified technique to treat patients in stand-alone atrial fibrillation with a right thoracoscopic approach is described. An electrical isolation of the four pulmonary veins (box lesion) is achieved with a microwave antenna.
  The Annals of thoracic surgery 07/2007; 83(6):2244-5. · 3.74 Impact Factor
• Article: Trans-septal route may be hazardous.

  Luc De Roy, Dominique Blommaert, Frédéric Deprez
  European Heart Journal 07/2006; 27(11):1330. · 10.48 Impact Factor
• Article: An unusual way to diagnose asymptomatic right ventricular perforation by a temporary endocardial pacing electrode.

  Frédéric Deprez, Dominique Blommaert, Luc De Roy
  [show abstract] [hide abstract]
  ABSTRACT: Right ventricular perforation by a temporary endocardial pacing electrode can be fatal and needs to be detected promptly. This usually symptomatic situation is diagnosed by X-ray or echocardiographic findings. We present the case of a patient with an asymptomatic right ventricular perforation, in whom serial electrocardiograms enabled us to detect the displacement of the right ventricular lead.
  European Journal of Emergency Medicine 10/2003; 10(3):250-1. · 0.90 Impact Factor
• Article: Role of pacing mode and algorithms for effective prevention of atrial fibrillation after coronary artery bypass surgery.

  Dominique Blommaert, Laurence Gabriel, Frédéric Deprez
  [show abstract] [hide abstract]
  ABSTRACT: Atrial fibrillation after coronary artery bypass surgery occurs in 30 to 40% of patients. Prophylactic therapy with drugs is not always possible and not always efficient. Atrial pacing may play a role in the prevention of atrial fibrillation. Biatrial pacing with fixed high rate or overdrive and right atrial pacing with overdrive has been demonstrated to reduce the incidence of atrial fibrillation after coronary artery bypass surgery. Avoidance of undersensing and loss of capture with atrial epicardial wires is a technical challenge. Individually tailored and combined approaches are promising future directions for prophylactic therapy.
  Cardiac Electrophysiology Review 07/2003; 7(2):140-2.
• Article: Radiofrequency ablation of atrial flutter combined with closure of atrial septal defect.

  Yves A Louagie, Dominique Blommaert, Luc De Roy
  [show abstract] [hide abstract]
  ABSTRACT: Radiofrequency ablation of atrial flutter combined with patch closure of an atrial septal defect is described. Radiofrequency energy was delivered in the cavo-tricuspid isthmus and from the inferior margin of the atriotomy down to the septal defect using a temperature-controlled multipolar radiofrequency catheter. In addition, cryolesions were applied to the junction of the ablation scar with the tricuspid annulus and with the ostium of the inferior vena cava. Sinus rhythm was restored and an electrophysiologic study conducted 2 months later confirmed the bidirectional conduction block of the cavo-tricuspid isthmus.
  Interactive cardiovascular and thoracic surgery 10/2002; 1(1):38-40.
• Article: Loss of left ventricular epicardial lead capture due to pneumothorax.

  Dominique Blommaert, Frédéric Deprez, Philippe Eucher, Isabelle Mancini, Joseph Mucumbitsi, Benoît Collet, Luc De Roy
  [show abstract] [hide abstract]
  ABSTRACT: Pneumothorax is a rare complication of pacemaker lead insertion by subclavian way. We report a case of temporary ineffective biventricular pacing due to pneumothorax. This complication has to be ruled out before electing to reposition or to replace the lead.
  Pacing and Clinical Electrophysiology 07/2002; 25(6):996-7. · 1.35 Impact Factor
• Article: Prophylaxis of supraventricular and ventricular arrhythmias after coronary artery bypass grafting with low-dose sotalol

  Patrick Evrard, Manuel Gonzalez, Jacques Jamart, Brigitte Malhomme, Dominique Blommaert, Philippe Eucher, Etienne Installé
  [show abstract] [hide abstract]
  ABSTRACT: Background. Supraventricular tachyarrhythmia (SVT) commonly occurs shortly after coronary artery bypass grafting (CABG), but ventricular arrhythmias are less documented.Methods. On the 1st postoperative day, 206 consecutive eligible patients were prospectively randomized to a sotalol group (80 mg b.i.d.; n = 103) or a control group without β-blockade or antiarrhythmic drugs (n = 103).Results. The SVT incidence (predominantly atrial fibrillation) accounted for 16% in the sotalol group versus 48% (p < 0.00001). Multivariate analysis showed that sotalol reduced the SVT incidence (p < 0.00001, odds ratio, 0.20; 95% confidence interval, 0.09 to 0.42), whereas a lower preoperative left ventricular ejection fraction (p = 0.019) and older age (p = 0.031) were independent risk factors of SVT occurrence. The Holter electrocardiographic analysis (24 hours) demonstrated that sotalol (32 versus 92; p = 0.031) decreased the median number of ventricular events, mostly isolated premature ventricular beats. Neither ventricular proarrhythmia effect nor “torsades de pointes” were detected. Despite strict hemodynamic-based selection, sotalol had to be discontinued in 8 patients (7.8%), for reasons related to asthma in 3 or cardiac reasons in 5.Conclusions. Oral low-dose sotalol provided considerable and reliable protection in selected nondepressed cardiac function patients, reducing the occurrence of both supraventricular and ventricular arrhythmias after CABG.
  The Annals of Thoracic Surgery 07/2000; · 3.74 Impact Factor
• Article: Effective prevention of atrial fibrillation by continuous atrial overdrive pacing after coronary artery bypass surgery

  Dominique Blommaert, Manuel Gonzalez, Joseph Mucumbitsi, Olivier Gurné, Patrick Evrard, Michel Buche, Yves Louagie, Philippe Eucher, Jacques Jamart, Etienne Installé, Luc De Roy
  [show abstract] [hide abstract]
  ABSTRACT: OBJECTIVESThe present study was aimed to evaluate the efficacy of a specific algorithm with continuous atrial dynamic overdrive pacing to prevent atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery.BACKGROUNDAtrial fibrillation occurs in 30% to 40% of patients after cardiac surgery with a peak incidence on the second day. It still represents a challenge for postoperative prevention and treatment and may have medical and cost implications.METHODSNinety-six consecutive patients undergoing CABG for severe coronary artery disease and in sinus rhythm without antiarrhythmic therapy on the second postoperative day were randomized to have or not 24 h of atrial pacing through temporary epicardial wires using a permanent dynamic overdrive algorithm. Holter ECGs recorded the same day in both groups were analyzed to detect AF occurrence.RESULTSNo difference was observed in baseline data between the two study groups, particularly for age, male gender, history of AF, ventricular function, severity of coronary artery disease, preoperative beta-adrenergic blocking agent therapy or P-wave duration. The incidence of AF was significantly lower (p = 0.036) in the paced group (10%) compared with control subjects (27%). Multivariate analysis showed AF incidence to increase with age (p = 0.051) but not in patients with pacing (p = 0.078). It decreased with a better left ventricular ejection fraction only in conjunction with atrial pacing (p = 0.018).CONCLUSIONSWe conclude that continuous atrial pacing with an algorithm for dynamic overdrive reduces significantly incidence of AF the second day after CABG surgery, particularly in patients with preserved left ventricular function.
  Journal of the American College of Cardiology 06/2000; · 14.16 Impact Factor