- Email: [email protected]
Cardiac Resynchronization Therapy (CRT) in Algeria, result of ESC CRT Survey II
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Rhythmology and stimulation
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Aims To assess the feasibility/safety of UGVP for complex cardiac devices implantation including CRT/ICD. Methods Consecutive patients eligible for a pacemaker or ICD implantation were included. All procedures were performed by three operators (one experienced and two fellows). Guidewires insertion time (from lidocaïne administration), and complications were systematically studied. A group of patients implanted with alternative techniques was used for comparison (cephalic, subclavian). Results In 176 consecutive patients in whom UGVP was used, a total of 68 complex procedures were analyzed (74 ± 8 y, male 73%) with 138 leads implanted including 42 ICD, 48 CRT and 16 upgrade procedures. A majority (83%) was under anti-thrombotic therapy. UGAVP was successful in 96.8%. Mean insertion time for 2.02 guidewires per patient was 4.4 ± 4.4 min. Guidewires insertion time reached its plateau after 10 patients. One pocket hematoma (1.4%) was drained during a mean follow-up of 12 ± 5 months. The control group included 24 patients (8 subclavian, 16 cephalic; 15 ICD, 14 CRT, 4 upgrade procedures), with a mean insertion time of 10 ± 8 min, for 1.95 guidewires per patient (P < 0.0005). Conclusion UGVP is feasible and safe even for complex device implantations including CRT/ICD and upgrade procedures. Disclosure of interest The authors declare that they have no competing interest.
Cardiac Resynchronization Therapy (CRT) in Algeria, result of ESC CRT Survey II R. Benkouar ∗ , M.S. Ait Messaoudène , Y. Aoudia , A. Boudrifa , K. Bouasria , Y. Tir , O. Kassoul , H. Elnagger , N. Ali Tatar , M.T. Chentir , Y. Bouhouita CHU Mustapha-Pacha, Alger, Algérie ∗ Corresponding author. E-mail address: [email protected] (R. Benkouar) Introduction Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) in ischemic and non-ischemic cardiomyopathy (NIDM) with widened QRS interval, and only being used in Algeria since ten years later. Purpose Describe the current clinical practice regarding CRT in Algeria and compare each data point with the total cohort of patients included in ESC CRT Survey II. Methods From 1st October 2015 to 31 December 2016, all patients admitted for CRT implantation were included, even if unsuccessful procedure; generator replacements or revisions of existing CRT devices were excluded. The ESC web-based e-CRF used for data collection was developed by Institut für Herzinfarktforschung Ludwigshafen (IHF), which also conducted data management and statistical analysis. Results Sixty-six patients (57.8 ± 10.2 years old, 2/3 male, 170 ± 23ms QRS width, 77, 3% non-ischemic cardiomyopathy) were recruited, of which 41% had heart failure hospitalization during past year with 3% being upgrades. Comorbidities reported were hypertension (34, 8%), valvular heart desease(12,1%), diabetes(31.8%), anemia (25,8%) chronic kidney disease (16,7%). The procedures were performed successfully in 90% (60/66) pts, mostly CRT-P in 56, 7% (34/60), and in 96, 7% use of multipolar leads placed in lateral position. The operator was mostly an electro physiologist (96, 7%, 58/60 pts). The main reason of procedure failure was unsuccessful LV lead placement. No death occurred; pneumothorax (3%) and coronary dissection (3%) were the most common complications. Patients discharged were treated with ACE inhibitor/ARB, 97% beta blocker, 90% MRA and 95, 5% loop diuretic. Conclusion Experienced centers in Algeria report high success rate of CRT implants, mostly primo-CRT P implantation with use of multipolar leads, low complication rates. Patients mostly had non ischemic cardiomyopathy, and were less old with fewer co morbidities than ESC survey patients. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.262 181
Ultrasound-guided axillary vein puncture feasibility for complex cardiac devices implantation S. Bun 1,∗ , D.G. Latcu 2 , F. Squara 1 , K. Hasni 2 , F.A. Benaich 2 , P. Gatto 2 , B. Enache 2 , M. Diakite 2 , E. Allouche 3 , D. Scarlatti 1 , N. Saoudi 2 , E. Ferrari 1 1 Cardiologie, Centre Hospitalier Universitaire Pasteur, Nice, France 2 Cardiologie, Centre Hospitalier Princesse-Grace, Monaco 3 Cardiologie, CHU Charles-Nicolle, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (S. Bun) Background The axillary route use for cardiac devices implantation has recently expanded either with fluoroscopy or ultrasounds guidance. Few studies included defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures for ultrasound-guided axillary vein puncture (UGVP).
https://doi.org/10.1016/j.acvdsp.2019.09.263 372
National Tunisian Registry of Atrial Fibrillation (NATURE-AF): Baseline results A. Ben Halima 1,∗ , S. Ouali 2 , S. Chabrak 3 , R. Chettaoui 3 , E. Allouche 4 , S. Marrakchi 1 , M. Ben Halima 2 , M. Hassine 5 , S. Charfeddine 6 , A. Haggui 7 , S. Milouchi 8 , S. Kacem 3 , S. Krichen 3 , K. Sayahi 9 , M. Ben Miled 3 , L. Zakhama 10 , F. Addad 1 , L. Abid 11 1 Cardiologie, Hôpital Abderrahmen-Mami Ariana, Tunisie, Ariana 2 Service de réanimation et d’explorations fonctionnelles Hôpital La Rabta 3 Medecin de libre pratique 4 Service de Cardiologie Hopital Charles-Nicolle, Tunis 5 Service de Cardiologie Hôpital Fattouma-Bourguiba Monastir, Monastir 6 Service de cardiologie CHU Hédi-Chaker, Sfax 7 Hopital Militaire Tunis, Tunis 8 Service de cardiologie Hôpital Mednine, Mednine 9 Service de cardiologie du Kef, Kef 10 Service de cardiologie, Hopital FSI 11 Société tunisienne de cardiolgie et de chirurgie cardio-vasculaire, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (A. Ben Halima) Introduction Atrial fibrillation (AF) is an important health problem in Tunisia. A significant change in the epidemiological pattern of heart disease has been noticed. Aim The purpose of the NATURE-AF registry was to determine the incidence of thrombo-embolic (TE) events and cardiovascular (CV) death at 1 year in patients with newly diagnosed AF. Secondary end points were to determine the incidence of hemorrhagic events and to calculate the mean time in therapeutic range (TTR) in patients receiving Vitamin K antagonists (VKA). Results NATURE AF is a multicenter, prospective study which enrolled 915 patients with AF between March and June 2017. The mean age was 64.2 ± 13.4 years (sex ratio 1.1). Common co morbidities were hypertension (53.4%), valvular disease (25.5%), diabetes (24.9%) and heart failure (HF)(14.4%). At one year the incidence of TE events was 1.64%. Ischemic stroke represented 53.3% of the total TE events. Heart failure (HF) and obstructive sleep apnea were the
Rhythmology and stimulation
520
Aims To assess the feasibility/safety of UGVP for complex cardiac devices implantation including CRT/ICD. Methods Consecutive patients eligible for a pacemaker or ICD implantation were included. All procedures were performed by three operators (one experienced and two fellows). Guidewires insertion time (from lidocaïne administration), and complications were systematically studied. A group of patients implanted with alternative techniques was used for comparison (cephalic, subclavian). Results In 176 consecutive patients in whom UGVP was used, a total of 68 complex procedures were analyzed (74 ± 8 y, male 73%) with 138 leads implanted including 42 ICD, 48 CRT and 16 upgrade procedures. A majority (83%) was under anti-thrombotic therapy. UGAVP was successful in 96.8%. Mean insertion time for 2.02 guidewires per patient was 4.4 ± 4.4 min. Guidewires insertion time reached its plateau after 10 patients. One pocket hematoma (1.4%) was drained during a mean follow-up of 12 ± 5 months. The control group included 24 patients (8 subclavian, 16 cephalic; 15 ICD, 14 CRT, 4 upgrade procedures), with a mean insertion time of 10 ± 8 min, for 1.95 guidewires per patient (P < 0.0005). Conclusion UGVP is feasible and safe even for complex device implantations including CRT/ICD and upgrade procedures. Disclosure of interest The authors declare that they have no competing interest.
Cardiac Resynchronization Therapy (CRT) in Algeria, result of ESC CRT Survey II R. Benkouar ∗ , M.S. Ait Messaoudène , Y. Aoudia , A. Boudrifa , K. Bouasria , Y. Tir , O. Kassoul , H. Elnagger , N. Ali Tatar , M.T. Chentir , Y. Bouhouita CHU Mustapha-Pacha, Alger, Algérie ∗ Corresponding author. E-mail address: [email protected] (R. Benkouar) Introduction Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) in ischemic and non-ischemic cardiomyopathy (NIDM) with widened QRS interval, and only being used in Algeria since ten years later. Purpose Describe the current clinical practice regarding CRT in Algeria and compare each data point with the total cohort of patients included in ESC CRT Survey II. Methods From 1st October 2015 to 31 December 2016, all patients admitted for CRT implantation were included, even if unsuccessful procedure; generator replacements or revisions of existing CRT devices were excluded. The ESC web-based e-CRF used for data collection was developed by Institut für Herzinfarktforschung Ludwigshafen (IHF), which also conducted data management and statistical analysis. Results Sixty-six patients (57.8 ± 10.2 years old, 2/3 male, 170 ± 23ms QRS width, 77, 3% non-ischemic cardiomyopathy) were recruited, of which 41% had heart failure hospitalization during past year with 3% being upgrades. Comorbidities reported were hypertension (34, 8%), valvular heart desease(12,1%), diabetes(31.8%), anemia (25,8%) chronic kidney disease (16,7%). The procedures were performed successfully in 90% (60/66) pts, mostly CRT-P in 56, 7% (34/60), and in 96, 7% use of multipolar leads placed in lateral position. The operator was mostly an electro physiologist (96, 7%, 58/60 pts). The main reason of procedure failure was unsuccessful LV lead placement. No death occurred; pneumothorax (3%) and coronary dissection (3%) were the most common complications. Patients discharged were treated with ACE inhibitor/ARB, 97% beta blocker, 90% MRA and 95, 5% loop diuretic. Conclusion Experienced centers in Algeria report high success rate of CRT implants, mostly primo-CRT P implantation with use of multipolar leads, low complication rates. Patients mostly had non ischemic cardiomyopathy, and were less old with fewer co morbidities than ESC survey patients. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.262 181
Ultrasound-guided axillary vein puncture feasibility for complex cardiac devices implantation S. Bun 1,∗ , D.G. Latcu 2 , F. Squara 1 , K. Hasni 2 , F.A. Benaich 2 , P. Gatto 2 , B. Enache 2 , M. Diakite 2 , E. Allouche 3 , D. Scarlatti 1 , N. Saoudi 2 , E. Ferrari 1 1 Cardiologie, Centre Hospitalier Universitaire Pasteur, Nice, France 2 Cardiologie, Centre Hospitalier Princesse-Grace, Monaco 3 Cardiologie, CHU Charles-Nicolle, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (S. Bun) Background The axillary route use for cardiac devices implantation has recently expanded either with fluoroscopy or ultrasounds guidance. Few studies included defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures for ultrasound-guided axillary vein puncture (UGVP).
https://doi.org/10.1016/j.acvdsp.2019.09.263 372
National Tunisian Registry of Atrial Fibrillation (NATURE-AF): Baseline results A. Ben Halima 1,∗ , S. Ouali 2 , S. Chabrak 3 , R. Chettaoui 3 , E. Allouche 4 , S. Marrakchi 1 , M. Ben Halima 2 , M. Hassine 5 , S. Charfeddine 6 , A. Haggui 7 , S. Milouchi 8 , S. Kacem 3 , S. Krichen 3 , K. Sayahi 9 , M. Ben Miled 3 , L. Zakhama 10 , F. Addad 1 , L. Abid 11 1 Cardiologie, Hôpital Abderrahmen-Mami Ariana, Tunisie, Ariana 2 Service de réanimation et d’explorations fonctionnelles Hôpital La Rabta 3 Medecin de libre pratique 4 Service de Cardiologie Hopital Charles-Nicolle, Tunis 5 Service de Cardiologie Hôpital Fattouma-Bourguiba Monastir, Monastir 6 Service de cardiologie CHU Hédi-Chaker, Sfax 7 Hopital Militaire Tunis, Tunis 8 Service de cardiologie Hôpital Mednine, Mednine 9 Service de cardiologie du Kef, Kef 10 Service de cardiologie, Hopital FSI 11 Société tunisienne de cardiolgie et de chirurgie cardio-vasculaire, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (A. Ben Halima) Introduction Atrial fibrillation (AF) is an important health problem in Tunisia. A significant change in the epidemiological pattern of heart disease has been noticed. Aim The purpose of the NATURE-AF registry was to determine the incidence of thrombo-embolic (TE) events and cardiovascular (CV) death at 1 year in patients with newly diagnosed AF. Secondary end points were to determine the incidence of hemorrhagic events and to calculate the mean time in therapeutic range (TTR) in patients receiving Vitamin K antagonists (VKA). Results NATURE AF is a multicenter, prospective study which enrolled 915 patients with AF between March and June 2017. The mean age was 64.2 ± 13.4 years (sex ratio 1.1). Common co morbidities were hypertension (53.4%), valvular disease (25.5%), diabetes (24.9%) and heart failure (HF)(14.4%). At one year the incidence of TE events was 1.64%. Ischemic stroke represented 53.3% of the total TE events. Heart failure (HF) and obstructive sleep apnea were the