Abstract:
BACKGROUND:Epicardial placement of the left ventricular (LV) lead via a video-assisted thoracoscopic (VAT) approach is an alternative to the standard transvenous technique. HYPOTHESIS:Long-term safety and efficacy of VAT and transvenous LV lead implantation are comparable. To test it, we reviewed our experience and we compared the outcomes of patients who underwent implantation with the two techniques. METHODS:The VAT procedure is performed under general anesthesia, with oro-tracheal intubation and right-sided ventilation, and requires two 5 mm and one 15 mm thoracoscopic ports. After pericardiotomy at the spot of the epicardial target area, pacing measurements are taken and a spiral screw electrode is anchored at the final pacing site. The electrode is then tunneled to the pectoral pocket and connected to the device. RESULTS:105 patients were referred to our center for epicardial LV lead implantation. After pre-operative assessment, 5 patients were excluded because of concomitant conditions precluding surgery. The remaining 100 underwent the procedure. LV lead implantation was successful in all patients (median pacing threshold 0.8 ± 0.5 V, no phrenic nerve stimulation) and cardiac resynchronization therapy was established in all but one patient. The median procedure time was 75 min. During a median follow-up of 24 months, there were no differences in terms of death, cardiovascular hospitalizations or device-related complications vs the group of 100 patients who had undergone transvenous implantation. Patients of both groups displayed similar improvements in terms of ventricular reverse remodeling and functional status. CONCLUSIONS:Our VAT approach proved safe and effective, and is a viable alternative in the case of failed transvenous LV implantation.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Marini M,Branzoli S,Moggio P,Martin M,Belotti G,Molon G,Guarracini F,Coser A,Quintarelli S,Pederzolli C,Graffigna A,Penzo D,Valsecchi S,Bottoli MC,Pepi P,Bonmassari R,Droghetti Adoi
10.1002/clc.23300subject
Has Abstractpub_date
2020-03-01 00:00:00pages
284-290issue
3eissn
0160-9289issn
1932-8737journal_volume
43pub_type
杂志文章abstract:BACKGROUND:Primary percutaneous coronary intervention (PCI) is the most common method of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) in the United States. The intersection between processes of care and performance measures such as door-to-balloon (D2B) times and clinical trials evalu...
journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1002/clc.22349
更新日期:2015-01-01 00:00:00
abstract::Subaortic stenosis has been described with increasing frequency as an ominous feature of atrioventricular septal defect (AVSD), especially following surgical correction of the anomaly in non-Down's syndrome patients. In order to study the surgical anatomy of the left ventricular outflow tract in this malformation, 48 ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960140611
更新日期:1991-06-01 00:00:00
abstract::Left ventricular wall motion abnormalities, aneurysm formation, and progression to global hypokinesis have been described in patients with myocarditis and in patients with hypertrophic cardiomyopathy. We document a case of reversible aneurysm formation, cardiogenic shock, and complete recovery in a patient with myocar...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960160317
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is associated with high cardiovascular morbidity and mortality, which is not fully explained by traditional risk factors; hence, the interest in nontraditional risk factors such as inflammation and insulin resistance (IR). Though IR is shown in nondiabetic CKD, its association wi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20901
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Syndrome X is defined as typical angina pectoris, positive treadmill exercise test, negative intravenous ergonovine test, and angiographically normal coronary arteries. HYPOTHESIS:In the present study, we investigated the anti-ischemic and antianginal effects of nisoldipine and ramipril in patients with syn...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960220513
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Hospitalized medically ill patients are at greater risk for venous thromboembolism (VTE). Although pharmacologic prophylaxis regimens have reduced VTE risk in medically ill patients, associations with early postdischarge adverse clinical outcomes among patients with heart failure are unknown. HYPOTHESIS:We ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20986
更新日期:2011-11-01 00:00:00
abstract::The coronary artery thrombus that causes acute myocardial infarction can be lysed, and reperfusion can be achieved, in the first few hours after infarction. However, the infarct vessel will reocclude in 15-30% of patients, and this event is frequently associated with pain, reinfarction, arrhythmias, or death. The risk...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080902
更新日期:1985-09-01 00:00:00
abstract::The Randomized Endo-vein Graft Prospective (REGROUP) trial (ClinicalTrials.gov NCT01850082) is a randomized, intent-to-treat, 2-arm, parallel-design, multicenter study funded by the Cooperative Studies Program (CSP No. 588) of the US Department of Veterans Affairs. Cardiac surgeons at 16 Veterans Affairs (VA) medical ...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22267
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Oxidized low-density lipoprotein (oxLDL) not only plays an important role in plaque formation, but also impairs the endothelium-dependent relaxation. Constrictive remodeling rather than intimal hyperplasia mainly contributes to restenosis after balloon angioplasty. Probucol (powerful antioxidant) reduced res...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260107
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Atherosclerotic cardiovascular disease is prevalent among renal transplant patients. Increase in serum total cholesterol, low-density lipoprotein, and very low-density lipoprotein is common in those patients. Alterations in chylomicron metabolism, however, are also related to atherogenesis and were not studi...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960210608
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:QT interval shortens with exercise. Some of this shortening is due to an increase in heart rate, and some is due to other effects of exercise, probably mostly neuroendocrine effects. Data from subjects with cardiac transplants have suggested that non-heart rate-related changes in QT interval on exercise are ...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960220805
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that viable but stunned myocardium displays contractile reserve and exhibits cardiac cycle-dependent variations of integrated backscatter (CVIB), whereas infarcted myocardium does not. HYPOTHESIS:This study was designed to clarify whether assessment of the acoustic properties of ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960261010
更新日期:2003-10-01 00:00:00
abstract::Coronary collateral perfusion to the completely obstructed coronary artery was evaluated by coronary cineangiography in 32 patients. In 13 patients, there was neither history of severe chest pain of longer than 30-min duration nor electrocardiographic evidence of a transmural myocardial infarction (Group I). Among pat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100705
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:The real-world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. HYPOTHESIS:METHODS: Seventy-seven previously hospitalized outpatients with NYHA class III HF w...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22643
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:There is increasing evidence that chronic atrial fibrillation (AF) is associated with a prothrombotic or hypercoagulable state. HYPOTHESIS:This study was undertaken to determine whether short-term exercise in patients with chronic AF would shift the overall hemostatic balance toward a more prothrombotic sta...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960240512
更新日期:2001-05-01 00:00:00
abstract::Isolated tricuspid insufficiency (TI) is relatively uncommon and mostly of traumatic origin. We report clinical noninvasive and invasive findings and surgical results in 5 cases. All patients had complete clinical, noninvasive and invasive studies including right and left catheterization, and coronary angiographies in...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960070509
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:In the transcatheter aortic valve replacement era, characterization of functional status in older adults with aortic stenosis (AS) is essential. Gait speed (GS) is emerging as a marker of frailty and predictor of outcomes in older adults undergoing cardiovascular intervention. The objective of this study was...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.21974
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Chronic stress is estimated to increase the risk of cardiovascular (CV) events two-fold. Although stress reduction has been linked to a reduction in CV events, little is known regarding its exact mechanism of benefit. HYPOTHESIS:Yoga and meditation will improve parameters of endothelial function. METHODS:W...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960290905
更新日期:2006-09-01 00:00:00
abstract::The majority of older patients who develop heart failure (HF), particularly older women, have a preserved left ventricular ejection fraction (HFpEF). Patients with HFpEF have severe symptoms of exercise intolerance, poor quality-of-life, frequent hospitalizations, and increased mortality. The prevalence of HFpEF is in...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23321
更新日期:2020-02-01 00:00:00
abstract::A method for noninvasive generation of central aortic systolic pressure curves is presented. The method is based on plotting the occlusive pressure values applied at the brachial artery level against the time intervals needed for the aortic pressure wave to equalize and break through the occlusive pressure at the brac...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100402
更新日期:1987-04-01 00:00:00
abstract::We investigated the potential benefit of a preferential pulmonary vasodilatory effect of nifedipine in 4 patients with Eisenmenger syndrome complicating ventricular septal defect. First-pass radionuclide scan was performed at rest to measure intracardiac shunting before and after nifedipine. Two hours after 20 mg subl...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960141205
更新日期:1991-12-01 00:00:00
abstract::The cardiokymograph, a relatively new noninvasive device capable of recording anterior left ventricular segmental wall motion, was used to evaluate the frequency and type of wall motion abnormalities in 25 normal patients and in 109 patients with ischemic heart disease. Of the 25 patients with normal coronary arteries...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960030605
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:When used in appropriately selected heart failure (HF) patients, cardiac resynchronization therapy (CRT) reduces mortality and hospitalization. It is not understood whether CRT implantation during hospitalization for HF is associated with similar benefits. HYPOTHESIS:Timing of CRT implantation relative to h...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.23135
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The poor clinical outcome in acute myocardial infarction (AMI) patients undergoing primary percutaneous coronary intervention (PCI) has been attributed to myocardial ischemia-reperfusion injury (MIRI). OBJECTIVE:This study aimed to identify the predictive factors of MIRI during PCI in Chinese AMI patients w...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20294
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:In patients with stable angina pectoris, eccentric stenoses have a greater potential for dynamic changes of caliber in response to vasoactive stimuli than concentric lesions. It is not known whether in patients with coronary artery spasm the degree of coronary vasoconstriction differs in eccen...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960210907
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:While depressed left ventricular ejection fraction is clearly associated with poor long-term outcome in heart failure (HF), the effect of ejection fraction on short-term outcomes and resource utilization following hospitalization for HF remains unclear. HYPOTHESIS:We evaluated the independent effect of depr...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960220306
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI. METHOD AND RESULTS:A total of 259 consecutive p...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20060
更新日期:2007-03-01 00:00:00
abstract::The purpose of this study is to describe the use of angioscopes in flowing bloodstreams of animals and humans, to demonstrate the ability to precisely deliver laser energy to an intravascular target using visual guidance and to determine the information content and spatial content of angioscopy. Angioscopy was perform...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960080202
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:Although suppression of premature ventricular contractions (PVCs) is not a predictor of mortality over the long term, the extent of PVC suppression is an important characteristic of any antiarrhythmic drug. HYPOTHESIS:This study was undertaken to determine whether intravenous (i.v.) dofetilide has the abili...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960230607
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Syncope is a common clinical problem with a variety of underlying mechanisms, some of which occur more frequently in 1 of the sexes or at a certain age. HYPOTHESIS:There may be clinically significant age- and gender-related differences in patients with unexplained syncope. METHODS:Five hundred seventy pati...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22300
更新日期:2014-10-01 00:00:00