- Email: [email protected]
c mutation carriers
02 — Heart failure and cardiomyopathies
33
Fig. 1 Malignant ventricular arrhythmias according to the number of risk factors. Fig. 1 Diastolic dysfunction classification before and after sacubitril/valsartan administration. Disclosure of interest peting interest.
The authors declare that they have no com-
Disclosure of interest peting interest.
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2018.10.067
https://doi.org/10.1016/j.acvdsp.2018.10.066
473
384
Challenges in cardiac pacing activities in a subsaharan tertiairy centre
External validation of risk factors for malignant ventricular arrhythmias in lamin a/c mutation carriers C. Maupain 1,∗ , M. Thuillot 1,2 , Estelle Gandjbakhch 1 , Xavier. Waintraub 1 , F. Hidden-Lucet 1 , Richard Isnard 1 , E. Villard 3 , F. Ader 3 , Pascale Richard 3 , Philippe Charron 3 1 Cardiologie, Pitié-salpetrière 2 Département de cardiologie, hôpital européen Georges-Pompidou 3 Département de génétique, Pitié-Salpetrière, Paris, France ∗ Corresponding author. E-mail address: [email protected] (C. Maupain) Background International recommendations state that implantable cardiovertor defibrillator should be considered early in patients with a confirmed disease-causing LMNA mutation with clinical risk factors, especially in the presence of non-sustained ventricular tachycardia, LVEF < 45%, male sex or non-missense mutations. The prognostic model derived from these recommendations hasn’t been validated on a separate external sample of patients. Objective To evaluate the performance of the 4 prognosis factors on a separate external cohort of LMNA patients. Methods We identified 101 consecutive LMNA mutation carriers who have been managed and genotyped in our center between 2004 and 2015. We recorded for all patients the values of the 4 previous identified predictive factors and whether they experienced a malignant ventricular aarhythmia (MVA) or not. Results The mean follow-up was 4.7 years. MVA was oberserved in 16 patients. Four risk groups were defined from the four previous predictive factors and log-rank test showed statistical significance (P < 0,001) of MVA occurrence rates between groups (See Fig. 1). Conclusion The 4 risk factors (non-sustained ventricular tachycardia, LVEF < 45%, male sex and non-missense mutations) derived from a previous work showed good performance on predicting malignant ventricular arrhythmia on an external cohort. Further studies are needed to identify other potential risk factors that could be even more accurate to predict sudden cardiac death.
J. Tantchou Tchoumi ∗ , J.C. Ambassa , C. Mvondo , G. Butera Centre cardiaque Shisong, Kumbo, Cameroun ∗ Corresponding author. E-mail address: [email protected] (J.T. Tchoumi) Background In sub-Saharan countries except South Africa, cardiac pacing activity is poorly developed due to shortage of qualified personnel and lack of appropriate infrastructures. The Cardiac Centre Shisong inaugurated in 2009 is a well-equipped with ultra-modern technologies institution offering a wide range of non-invasive, invasive procedures and open-heart surgery with extracorporeal circulation. Purpose The objective of the study is to report the cardiac pacing activities of the centre, the follow-up of implanted cases and challenges encountered from the 10th November 2009 till the 10th March 2016. Patients and methods From the 10th November 2010 till 10th March 2016, 130 patients underwent a device implantation in the Cardiac Centre Shisong. Data were extracted from the records of implanted patients. Results In the Cardiac Centre Shisong, for bradypacing were implanted 124 pace makers. Ten patients having atrial fibrillation with low ventricular response benefited from a single chambered pace maker. Sick sinus node was diagnosed in 36 patients; 32 cases benefited from a dual chambered pace maker and 4 from a single chambered pace maker. Seventy-eight cases had complete a trioventricular block and were implanted 5—patients single chambered and 73 dual chambered pace makers. In this group were 5 children, 3 with sick sinus disease and 2 had post-surgical complete atrioventricular block. Four intracardiac cardioverter defibrillators were implanted in 4 males, 3 single chamber and 1 double chamber. The resynchronization therapy was performed in two ladies fulfilling the criterias. Complications seen postoperatively and during the follow-up were: pocket infection — 4 cases, 4 leads displacements. Conclusion Bradypacing, tachypacing and cardiac resynchronization therapy are procedures done in the Cardiac Centre Shisong with good results. Our governments should create and sustain centres for the invasive management of cardiovascular diseases.
33
Fig. 1 Malignant ventricular arrhythmias according to the number of risk factors. Fig. 1 Diastolic dysfunction classification before and after sacubitril/valsartan administration. Disclosure of interest peting interest.
The authors declare that they have no com-
Disclosure of interest peting interest.
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2018.10.067
https://doi.org/10.1016/j.acvdsp.2018.10.066
473
384
Challenges in cardiac pacing activities in a subsaharan tertiairy centre
External validation of risk factors for malignant ventricular arrhythmias in lamin a/c mutation carriers C. Maupain 1,∗ , M. Thuillot 1,2 , Estelle Gandjbakhch 1 , Xavier. Waintraub 1 , F. Hidden-Lucet 1 , Richard Isnard 1 , E. Villard 3 , F. Ader 3 , Pascale Richard 3 , Philippe Charron 3 1 Cardiologie, Pitié-salpetrière 2 Département de cardiologie, hôpital européen Georges-Pompidou 3 Département de génétique, Pitié-Salpetrière, Paris, France ∗ Corresponding author. E-mail address: [email protected] (C. Maupain) Background International recommendations state that implantable cardiovertor defibrillator should be considered early in patients with a confirmed disease-causing LMNA mutation with clinical risk factors, especially in the presence of non-sustained ventricular tachycardia, LVEF < 45%, male sex or non-missense mutations. The prognostic model derived from these recommendations hasn’t been validated on a separate external sample of patients. Objective To evaluate the performance of the 4 prognosis factors on a separate external cohort of LMNA patients. Methods We identified 101 consecutive LMNA mutation carriers who have been managed and genotyped in our center between 2004 and 2015. We recorded for all patients the values of the 4 previous identified predictive factors and whether they experienced a malignant ventricular aarhythmia (MVA) or not. Results The mean follow-up was 4.7 years. MVA was oberserved in 16 patients. Four risk groups were defined from the four previous predictive factors and log-rank test showed statistical significance (P < 0,001) of MVA occurrence rates between groups (See Fig. 1). Conclusion The 4 risk factors (non-sustained ventricular tachycardia, LVEF < 45%, male sex and non-missense mutations) derived from a previous work showed good performance on predicting malignant ventricular arrhythmia on an external cohort. Further studies are needed to identify other potential risk factors that could be even more accurate to predict sudden cardiac death.
J. Tantchou Tchoumi ∗ , J.C. Ambassa , C. Mvondo , G. Butera Centre cardiaque Shisong, Kumbo, Cameroun ∗ Corresponding author. E-mail address: [email protected] (J.T. Tchoumi) Background In sub-Saharan countries except South Africa, cardiac pacing activity is poorly developed due to shortage of qualified personnel and lack of appropriate infrastructures. The Cardiac Centre Shisong inaugurated in 2009 is a well-equipped with ultra-modern technologies institution offering a wide range of non-invasive, invasive procedures and open-heart surgery with extracorporeal circulation. Purpose The objective of the study is to report the cardiac pacing activities of the centre, the follow-up of implanted cases and challenges encountered from the 10th November 2009 till the 10th March 2016. Patients and methods From the 10th November 2010 till 10th March 2016, 130 patients underwent a device implantation in the Cardiac Centre Shisong. Data were extracted from the records of implanted patients. Results In the Cardiac Centre Shisong, for bradypacing were implanted 124 pace makers. Ten patients having atrial fibrillation with low ventricular response benefited from a single chambered pace maker. Sick sinus node was diagnosed in 36 patients; 32 cases benefited from a dual chambered pace maker and 4 from a single chambered pace maker. Seventy-eight cases had complete a trioventricular block and were implanted 5—patients single chambered and 73 dual chambered pace makers. In this group were 5 children, 3 with sick sinus disease and 2 had post-surgical complete atrioventricular block. Four intracardiac cardioverter defibrillators were implanted in 4 males, 3 single chamber and 1 double chamber. The resynchronization therapy was performed in two ladies fulfilling the criterias. Complications seen postoperatively and during the follow-up were: pocket infection — 4 cases, 4 leads displacements. Conclusion Bradypacing, tachypacing and cardiac resynchronization therapy are procedures done in the Cardiac Centre Shisong with good results. Our governments should create and sustain centres for the invasive management of cardiovascular diseases.