Philippe Ritter

University of Bordeaux, Burdeos, Aquitaine, France

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Publications (152)513.25 Total impact

  • Europace 06/2015; DOI:10.1093/europace/euv233 · 3.05 Impact Factor
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    Europace 06/2015; DOI:10.1093/europace/euv115 · 3.05 Impact Factor
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    ABSTRACT: Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia, but complications associated with conventional transvenous pacing systems are commonly related to the pacing lead and pocket. We describe the early performance of a novel self-contained miniaturized pacemaker. Patients having Class I or II indication for VVI pacing underwent implantation of a Micra transcatheter pacing system, from the femoral vein and fixated in the right ventricle using four protractible nitinol tines. Prespecified objectives were >85% freedom from unanticipated serious adverse device events (safety) and <2 V 3-month mean pacing capture threshold at 0.24 ms pulse width (efficacy). Patients were implanted (n = 140) from 23 centres in 11 countries (61% male, age 77.0 ± 10.2 years) for atrioventricular block (66%) or sinus node dysfunction (29%) indications. During mean follow-up of 1.9 ± 1.8 months, the safety endpoint was met with no unanticipated serious adverse device events. Thirty adverse events related to the system or procedure occurred, mostly due to transient dysrhythmias or femoral access complications. One pericardial effusion without tamponade occurred after 18 device deployments. In 60 patients followed to 3 months, mean pacing threshold was 0.51 ± 0.22 V, and no threshold was ≥2 V, meeting the efficacy endpoint (P < 0.001). Average R-wave was 16.1 ± 5.2 mV and impedance was 650.7 ± 130 ohms. Early assessment shows the transcatheter pacemaker can safely and effectively be applied. Long-term safety and benefit of the pacemaker will further be evaluated in the trial. ID NCT02004873. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.
    European Heart Journal 06/2015; DOI:10.1093/eurheartj/ehv214 · 14.72 Impact Factor
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    ABSTRACT: -Left ventricular assist devices (LVADs) are increasingly used as a bridge to cardiac transplantation or as destination therapy. Patients with LVADs are at high risk for ventricular arrhythmias (VA). This study describes VA characteristics and ablation in patients implanted with a Heart Mate 2 (HM2) device. -All patients with a HM2 device who underwent VA catheter ablation at 9 tertiary centers were included. Thirty-four patients (30 male, age 58 ± 10 years) underwent 39 ablation procedures. The underlying cardiomyopathy etiology was ischemic in 21 and non-ischemic in 13 patients with a mean left ventricular ejection fraction of 17±5% before LVAD implantation. One hundred and ten ventricular tachycardias (VTs) (cycle lengths: 230-740ms, arrhythmic storm n=28) and 2 ventricular fibrillation triggers were targeted (25 transseptal, 14 retrograde aortic approaches). Nine patients required VT ablation <1 month after LVAD implantation due to intractable VT. Only 10/110 (9%) of the targeted VTs were related to the HM2 cannula. During follow-up, 7 patients were transplanted and 10 died. Of the remaining 17 patients, 13 were arrhythmia-free at 25 ± 15 months. In 1 patient with VT recurrence, change of turbine speed from 9400 to 9000 rpm extinguished VT. -Catheter ablation of VT among LVAD recipients is feasible and reasonably safe even soon after LVAD implantation. Intrinsic myocardial scar, rather than the apical cannula, appears to be the dominant substrate.
    Circulation Arrhythmia and Electrophysiology 04/2015; DOI:10.1161/CIRCEP.114.002394 · 5.42 Impact Factor
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    ABSTRACT: Recent advances in miniaturization technologies and battery chemistries have made it possible to develop a pacemaker small enough to implant within the heart while still aiming to provide similar battery longevity to conventional pacemakers. The Micra Transcatheter Pacing System is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein. The pacemaker is implanted directly inside the right ventricle of the heart, eliminating the need for a device pocket and insertion of a pacing lead, thereby potentially avoiding some of the complications associated with traditional pacing systems. The Micra Transcatheter Pacing Study is currently undergoing evaluation in a prospective, multi-site, single-arm study. Approximately 720 patients will be implanted at up to 70 centres around the world. The study is designed to have a continuously growing body of evidence and data analyses are planned at various time points. The primary safety and efficacy objectives at 6-month post-implant are to demonstrate that (i) the percentage of Micra patients free from major complications related to the Micra system or implant procedure is significantly higher than 83% and (ii) the percentage of Micra patients with both low and stable thresholds is significantly higher than 80%. The safety performance benchmark is based on a reference dataset of 977 subjects from 6 recent pacemaker studies. The Micra Transcatheter Pacing Study will assess the safety and efficacy of a miniaturized, totally endocardial pacemaker in patients with an indication for implantation of a single-chamber ventricular pacemaker. NCT02004873. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email:
    Europace 04/2015; 17(5). DOI:10.1093/europace/euv026 · 3.05 Impact Factor
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    ABSTRACT: The aim of this study was to compare left ventricular contraction sequence in patients with hypertrophic cardiomyopathy (HCM) and healthy controls. Normal left ventricular contraction sequence in healthy controls exhibits an apex-to-base delay (ABD) contributing to efficient cardiac mechanics (physiologic asynchrony). Echocardiographic data from 20 controls and 40 HCM patients were prospectively analyzed. Endocardial longitudinal and circumferential strains and ABD were measured using custom-built software. HCM patients had increased circumferential (-36.4 ± 6.0 vs. -32.9 ± 5.0, p < 0.01) and decreased longitudinal (-19.3 ± 6.4 vs. -23.4 ± 5.7, p < 0.01) strains. In controls, physiologic ABD was observed (35.7 ± 18.1 ms). This delay was reduced in HCM patients (5.5 ± 22.7 ms, p < 0.01 vs. controls). There was no interaction between ABD and common clinical or echocardiographic parameters in the HCM population. Left ventricular contraction sequence can be modified in HCM patients, with the loss of the physiologic ABD. This phenomenon is independent from commonly measured parameters. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
    Ultrasound in Medicine & Biology 03/2015; 41(6). DOI:10.1016/j.ultrasmedbio.2015.01.027 · 2.10 Impact Factor
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    ABSTRACT: Pacemaker (PM) infection in pacing-dependent patients is challenging. Following extraction, temporary pacing is usually utilized before delayed re-implantation (after an appropriate course of antibiotics), resulting in prolonged hospital stays. A single combined procedure of epicardial (EPI) PM implantation and system extraction may avoid this. We evaluated the feasibility and safety of these two approaches by comparing clinical outcome for both strategies over one year. In center 1, 80 consecutive PM-dependent patients underwent extraction with an externalized PM and delayed implantation on the contralateral side (ENDO group). In center 2, 80 consecutive patients had 2 epicardial ventricular leads surgically implanted with extraction of the infected PM during the same procedure (EPI group). Patients were followed up for 12 months. 160 pacing-dependent patients were successfully implanted and extracted (ENDO group: 71±13 yrs, vs EPI group: 73±14, P=NS). In the EPI group, 2 patients developed significant pericardial bleeding. In-hospital mortality was 0% in ENDO group and 2.5% in EPI group. Total hospitalization time was 15±7 days ENDO versus 9±6 days in the EPI group (p< 0.001). At 1-year, there were no infection recurrences in either group and mortality was equal (5% in each group). Median 1-year pacing thresholds were lower (0.8±0.6) in ENDO versus (1.1±0.6 volts) in EPI group, p=0.02. The ENDO and EPI strategies had an excellent success rate and low risk of complications. A single procedure employing surgical epicardial lead implantation was associated with a shorter duration of hospital stay. Copyright © 2015. Published by Elsevier Inc.
    Heart rhythm: the official journal of the Heart Rhythm Society 02/2015; 12(6). DOI:10.1016/j.hrthm.2015.02.023 · 4.92 Impact Factor
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    ABSTRACT: The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined. This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome. In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations. Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern. Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    Journal of the American College of Cardiology 01/2015; 65(2):151-9. DOI:10.1016/j.jacc.2014.10.043 · 15.34 Impact Factor
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    ABSTRACT: Cardiac resynchronization therapy (CRT) is an electrical treatment of heart failure with reduced ejection fraction and wide QRS. It aims to correct the electrical dyssynchrony present in 30-50% of patients in this population. Dyssynchrony results in widening of the QRS complex on the electrocardiogram (ECG). CRT was initially developed to treat patients who had left bundle branch block (LBBB) and delayed activation of the lateral left ventricular wall. However, a large proportion of heart failure patients present with a widened QRS that is neither a LBBB nor a right BBB: nonspecific intraventricular conduction delay (NICD). Less studied than RBBB or LBBB, its pathophysiology is both complex and varied yet still reflects intramyocardial conduction delay. NICD is most often associated with cardiomyopathy: e.g. ischemic or hypertensive. Conduction pathways can be either healthy or affected. Results from CRT therapy are contradictory in this patient group, despite a seemingly neutral trend. Unfortunately, prospective studies are lacking. Guidelines recommending implantation of CRT in this group are solely based on analyses of subgroups with small sample size. A dedicated prospective study is therefore warranted in order for this question to be properly answered. The detailed study of the ECG as well as non-invasive study of ventricular electrical activation may enable clinicians to better identify patients with NICD who will respond to CRT. Copyright © 2015. Published by Elsevier Inc.
    Heart rhythm: the official journal of the Heart Rhythm Society 01/2015; 12(5). DOI:10.1016/j.hrthm.2015.01.023 · 4.92 Impact Factor
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    ABSTRACT: Biventricular pacing (BVP) may not achieve complete electrical resynchronization. To assess whether the resynchronizing effect of BVP varies among patients depending on the underlying electrical substrate. High resolution electrocardiographic mapping with invasive measurement of Left Ventricular (LV) dP/dtmax were performed during baseline activation and during BVP in 61 heart failure patients with various conduction delays: 13 narrow QRS (<120ms), 22 nonspecific intraventricular conduction disturbance and 26 left bundle branch block. Electrical dyssynchrony, both during baseline and BVP, was quantified by total and LV activation times (TAT and LVTAT) and by ventricular electrical uncoupling (VEU = mean LV - mean RV activation time). Response to BVP was defined as a ≥10% LVdP/dtmax increase. The electrical activation pattern during BVP was similar for all patient groups and, hence, not dependent on the baseline conduction disturbance. During BVP, TAT, LVTAT and VEU were similar for all groups and correlated not/weakly with the change in LVdP/dtmax. In contrast, the changes in electrical dyssynchrony correlated significantly with the change in LVdP/dtmax: r=0.71, 0.69, and 0.69 for ∆TAT, ∆LVTAT and ∆VEU, respectively (all p<0.001). Responders showed higher baseline dyssynchrony levels and BVP-induced dyssynchrony reduction than nonresponders (all p<0.001); in nonresponders BVP worsened activation times compared to baseline. BVP does not eliminate electrical dyssynchrony but rather brings it to a common level independent of the patient's underlying electrical substrate. Therefore, BVP is of benefit to dyssynchronous patients but not to patients with insufficient electrical dyssynchrony in whom it induces an iatrogenic electropathy. Copyright © 2014. Published by Elsevier Inc.
    Heart rhythm: the official journal of the Heart Rhythm Society 12/2014; 12(4). DOI:10.1016/j.hrthm.2014.12.031 · 4.92 Impact Factor
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    ABSTRACT: Causes for diverse effects of cardiac resynchronization therapy (CRT) are poorly understood. Because CRT is an electrical therapy, it may be best understood by detailed characterization of electrical substrate and its interaction with pacing. Electrocardiogram (ECG) features affect CRT outcomes. However, the surface ECG reports rudimentary electrical data. In contrast, noninvasive electrocardiographic imaging provides high-resolution single-beat ventricular mapping. Several complex characteristics of electrical substrate, not decipherable from the 12-lead ECG, are linked to CRT effect. CRT response may be improved by candidate selection and left ventricular lead placement directed by more precise electrical evaluation, on an individual patient basis. Copyright © 2015 Elsevier Inc. All rights reserved.
    Cardiac electrophysiology clinics 12/2014; 7(1). DOI:10.1016/j.ccep.2014.11.012
  • International Journal of Cardiology 11/2014; 180C:221-222. DOI:10.1016/j.ijcard.2014.11.129 · 6.18 Impact Factor
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    ABSTRACT: Background Left Bundle Branch Block (LBBB) leads to prolonged left ventricular (LV) total activation time (TAT) and ventricular electrical uncoupling (VEU: mean LV activation time minus mean right ventricular (RV) activation time); both have been shown to be preferential targets for cardiac resynchronization therapy (CRT). Whether RV apical pacing (RVAP) produces similar ventricular activation patterns has not been well studied. Objective To compare electrical ventricular activation patterns during RVAP and LBBB. Methods We performed electrocardiographic mapping (ECM) during sinus rhythm, RVAP and CRT in 24 patients with LBBB. Results We observed differences in the electrical activation pattern with RVAP compared to LBBB. During LBBB, RV activation occurred rapidly; in contrast RV activation was prolonged during RVAP (46±21 vs. 69±17 ms, p<0.001). There was no significant difference in LVTAT, however, differences in conduction pattern were observed. During LBBB LV activation was circumferential whereas with RVAP it proceeded from apex-to-base. Differences in the number, size and orientation of lines of slow conduction were also observed. With LBBB, VEU was nearly twice as long as during RVAP (73±12 vs. 38±21ms, p<0.001). CRT resulted in a greater reduction in VEU relative to LBBB activation (p<0.001). Conclusion RVAP produces significant differences in ventricular activation characteristics compared to LBBB. Significantly less VEU occurs with RVAP and as a result CRT produces a smaller relative reduction in VEU. This may explain the finding that CRT appears to be more effective in patients with LBBB than in patients upgraded because of high percentages of RV pacing.
    Heart Rhythm 10/2014; DOI:10.1016/j.hrthm.2014.09.059 · 4.92 Impact Factor
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    ABSTRACT: We describe a family with suspicion of genetic arrhythmia that has benefited from a wide genetic exploration. The eldest of the siblings presented syncope at age 5.5 years and cardiac explorations were normal. A few months later, her elder sister presented a sudden death at age 4.5 years, while she was playing in the garden. The cardiac explorations showed a heart of normal structure but presence of polymorphic premature ventricular complexes. Isoprenaline test was positive. Treatment with beta-blockers (nadolol 50 mg/m2) was introduced. There was no family history of sudden death or other cardiac defects. Because of these two serious rhythmic events occurring in two young children, a genetic study was initiated by next generation sequencing of 42 genes involved in cardiac arrhythmias (long QT, Brugada, cathecholaminergic ventricular tachycardia). Two heterozygous mutations (c.613C > T/p.Gln205* and c.22 + 29 A > G) were identified in the Triadin gene, coding for a protein of the calcium release complex, recently involved in cathecholaminergic ventricular tachycardia in two families (Roux-Buisson et al., 2012). The parents of our two cases were each carriers of a heterozygous mutation and had no cardiac symptoms. Their cardiac assessment did not show any abnormality (ECG Holter, exercise test, Isoprenaline test). The nonsense p.Gln205* mutation was present in one of the published families; however the splicing mutation in intron 1 had never been identified. Minigene experiments helped to confirm its pathogenicity. Presymptomatic testing was then proposed to the third child of the family (age 3), finding the two pathogenic mutations. She was therefore put under the same treatment as her sisters. This is the second report of an autosomal recessive cathecholaminergic ventricular tachycardia due to the Triadin gene. This case illustrates the interest of Next Generation Sequencing exploring simultaneously several candidate genes, in cases of sudden death of unknown origin.
    Archives of Cardiovascular Diseases 09/2014; 107(s 8–9):496. DOI:10.1016/j.acvd.2014.07.029 · 1.66 Impact Factor
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    ABSTRACT: Background Operators who extract cardiac devices are exposed to considerable irradiation and excess risk of radiation-induced disorders. A dedicated radioprotection cabin was developed to offer complete protection against radiation. This randomized study was designed to ascertain the protection against radiation conferred by a radioprotection cabin and the safety during extraction of cardiac devices. Methods 37 consecutive patients presenting with indication for extraction of cardiac device were randomly assigned to standard extraction technique (n=19), versus extraction with the use of a radiation protection cabin (n=18). Fluoroscopic exposure was compared using electronic dosimeters placed on the thorax, back, foot and head of the operator. Results The procedural times and total fluoroscopic exposure times and the complication rates were not significantly different between the 2 groups. The mean dose of radiation delivered to the thorax and back was similar in both groups (p=0.3 and p=0.8, respectively). In contrast, the mean doses of radiation delivered to the head and to the feet were respectively 68 and 390 times lower in the cabin group than in the control group (p<0.001). Conclusion The cabin offers a nearly full body radioprotection and eliminated the need to wear a lead apron, without increasing procedural time or complication rate during cardiac device extraction.
    The Canadian journal of cardiology 08/2014; 30(12). DOI:10.1016/j.cjca.2014.08.011 · 3.94 Impact Factor
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    ABSTRACT: Background-Specific noninvasive signal processing was applied to identify drivers in distinct categories of persistent atrial fibrillation (AF). Methods and Results-In 103 consecutive patients with persistent AF, accurate biatrial geometry relative to an array of 252 body surface electrodes was obtained from a noncontrast computed tomography scan. The reconstructed unipolar AF electrograms acquired at bedside from multiple windows (duration, 9 +/- 1 s) were signal processed to identify the drivers (focal or reentrant activity) and their cumulative density map. The driver domains were catheter ablated by using AF termination as the procedural end point in comparison with the stepwise-ablation control group. The maps showed incessantly changing beat-to-beat wave fronts and varying spatiotemporal behavior of driver activities. Reentries were not sustained (median, 2.6 rotations lasting 449 +/- 89 ms), meandered substantially but recurred repetitively in the same region. In total, 4720 drivers were identified in 103 patients: 3802 (80.5%) reentries and 918 (19.5%) focal breakthroughs; most of them colocalized. Of these, 69% reentries and 71% foci were in the left atrium. Driver ablation alone terminated 75% and 15% of persistent and long-lasting AF, respectively. The number of targeted driver regions increased with the duration of continuous AF: 2 in patients presenting in sinus rhythm, 3 in AF lasting 1 to 3 months, 4 in AF lasting 4 to 6 months, and 6 in AF lasting longer. The termination rate sharply declined after 6 months. The mean radiofrequency delivery to AF termination was 28 +/- 17 minutes versus 65 +/- 33 minutes in the control group (P<0.0001). At 12 months, 85% patients with AF termination were free from AF, similar to the control population (87%,); P=not significant. Conclusions-Persistent AF in early months is maintained predominantly by drivers clustered in a few regions, most of them being unstable reentries.
    Circulation 07/2014; 130(7). DOI:10.1161/CIRCULATIONAHA.113.005421 · 14.95 Impact Factor
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    ABSTRACT: Background-Although the Task Force Criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) have recently been updated, the diagnosis remains challenging in the early stages. The aim of this study was to evaluate the diagnostic value of beta-adrenergic stimulation in ARVC. Methods and Results-We evaluated 412 consecutive patients (213 men, age 41.5+/-16 years) referred for premature ventricular contractions evaluation or suspected ARVC. Isoproterenol testing was performed with continuous infusion of isoproterenol (45 mu g/min) for 3 minutes. It was considered positive if there were either (1) polymorphic premature ventricular contractions with >= 1 couplet or (2) sustained or nonsustained ventricular tachycardia with left bundle branch block excluding right ventricular outflow tract ventricular tachycardia. ARVC was diagnosed in 35 patients at initial evaluation (23 men, aged 42+/-15 years). Isoproterenol testing was positive in 32 of 35 (91.4%) patients with ARVC and in 42 of 377 (11.1%) patients without ARVC (P<0.0001). Sensitivity, specificity, positive, and negative predictive values of isoproterenol testing to diagnose ARVC were 91.4%, 88.9%, 43.2%, and 99.1%, respectively. During a mean follow-up period of 5.6+/-4.4 years, 6 additional patients met diagnostic criteria for ARVC. Importantly, initial isoproterenol testing was positive in 6 of 6 (100%) of these patients. Survival free from ARVC diagnosis was significantly lower in the positive isoproterenol group than in the negative isoproterenol group (P<0.0001, exact log-rank test). Conclusions-Ventricular arrhythmogenicity during isoproterenol testing is highly sensitive (sensitivity, 91.4%) for the diagnosis of ARVC, particularly in its early stages.
    Circulation Arrhythmia and Electrophysiology 06/2014; 7(4). DOI:10.1161/CIRCEP.113.001224 · 5.42 Impact Factor
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    ABSTRACT: Electrical Impact of the Left Ventricular Pacing Site in CRT. Introduction: Recent studies have demonstrated that left ventricular (LV) pacing site is a critical parameter in optimizing cardiac resynchronization therapy (CRT). The present study evaluates the effect of pacing from different LV locations on QRS duration (QRSd) and their relationship to acute hemodynamic response in congestive heart failure patients. Methods and Results: Thirty-five patients with nonischemic dilated cardiomyopathy and left bundle branch block referred for CRT device implantation were studied. Eleven predetermined LV pacing sites were systematically assessed in random order: epicardial: coronary sinus (CS); endocardial: basal and mid-cavity (septal, anterior, lateral, and inferior), apex, and the endocardial site facing the CS pacing site. For each patient QRSd and +dP/dt(max) during baseline (AAI) and DDD LV pacing at 2 atrioventricular delays were compared. Response to CRT was significantly better in patients with wider baseline QRSd (>= 150 milliseconds). Hemodynamic response was inversely correlated to increase of QRSd during LV pacing (short atrioventricular [AV] delay: r = 0.44, P < 0.001; long AV delay: r = 0.59, P < 0.001). Compared to baseline, LV pacing at the site of shortest QRSd significantly improved +dP/dt(max) (+ 18 +/- 25%, P < 0.001) but was not superior to other conventional strategy (lateral wall, CS pacing, and echo-guided) and was inferior to a hemodynamically guided strategy. Conclusions: In our study, we have demonstrated that changes of QRSd during LV pacing correlated with acute hemodynamic response and that LV pacing location was a primary determinant of paced QRSd. Although QRSd did not predict the maximum hemodynamic response, our results confirm the link between electrical activation and hemodynamic response of the LV during CRT.
    Journal of Cardiovascular Electrophysiology 06/2014; 25(9). DOI:10.1111/jce.12464 · 2.88 Impact Factor
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    ABSTRACT: Left pre-ejection period (LPEP), the interval from onset of ventricular depolarization to the beginning of aortic ejection, is shortened with CRT. We studied the effect of altering AV delay on LPEP in patients with CRT.
    Heart (British Cardiac Society) 06/2014; 100(Suppl 3):A22. DOI:10.1136/heartjnl-2014-306118.40 · 6.02 Impact Factor
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    ABSTRACT: Acute haemodynamic measurements can be used for AV delay (AVD) optimisation of cardiac resynchronisation therapy (CRT). It is uncertain whether non-invasive measurements are as reliable as those measured invasively.
    Heart (British Cardiac Society) 06/2014; 100 Suppl 3:A22-3. DOI:10.1136/heartjnl-2014-306118.41 · 6.02 Impact Factor

Publication Stats

4k Citations
513.25 Total Impact Points


  • 2009–2015
    • University of Bordeaux
      Burdeos, Aquitaine, France
    • Université Victor Segalen Bordeaux 2
      Burdeos, Aquitaine, France
  • 2010–2012
    • Centre Hospitalier Universitaire de Bordeaux
      Burdeos, Aquitaine, France
  • 2007–2008
    • University Hospital of Heraklion
      Irákleio, Attica, Greece
  • 2003
    • University of Angers
      Angers, Pays de la Loire, France
    • CHU de Lyon - Hôpital Cardio-vasculaire et Pneumologique Louis Pradel
      Lyons, Rhône-Alpes, France
  • 2002
    • Centre Hospitalier Universitaire de Rennes
      Roazhon, Brittany, France
  • 1994
    • St George's, University of London
      Londinium, England, United Kingdom