Self-Compassionate Responses to an Imagined Sexual Assault.

This research assesses the relationship between self-compassion and well-being following an imagined trauma (i.e., sexual assault) and shows positive outcomes from a self-compassion induction.

Statistical ranking of electromechanical dyssynchrony parameters for CRT.

Objective: Mechanical evaluation of dyssynchrony by echocardiography has not replaced ECG in routine cardiac resynchronisation therapy (CRT) evaluation because of its complexity and lack of reproducibility. The objective of this study was to evaluate the potential correlations between electromechanical parameters (atrioventricular, interventricular and intraventricular from the dyssynchrony model presented in 2000), their ability to describe dyssynchrony and their potential use in resynchrony.

Methods: 455 sets of the 18 parameters of the model obtained in 91 patients submitted to various pacing configurations were evaluated two by two using a Pearson correlation test and then by groups according to their ability to describe dyssynchrony, using the Column selection method of machine learning.

Variability in obstructive sleep apnea: Analysis of pacemaker-detected respiratory disturbances.

Background: Obstructive sleep apnea (OSA) is associated with several cardiovascular conditions. Some pacemakers feature specific algorithms detecting respiratory cycles and deriving indices well correlated with the identification of polysomnography-confirmed severe OSA.

Objectives: The purposes of this study were to analyze respiratory disturbances measured by a validated algorithm in clinical practice and to describe their variability over time and their association with atrial fibrillation.

Phrenic nerve stimulation in cardiac resynchronization therapy.

In cardiac resynchronization therapy (CRT), the electrical impulse delivered by the left ventricular (LV) lead may incidentally cause phrenic nerve stimulation (PNS). The purpose of this state-of-the-art review is to describe the frequency, risk factors, and clinical consequences of PNS and to present the most recent options to successfully manage PNS. PNS occurs in 2 to 37% of implanted patients and is not always detected in the supine position during implantation.

First experience of intraoperative echocardiography-guided optimization of cardiac resynchronization therapy delivery.

Background: Insufficient correction of mechanical dyssynchrony is a cause of non-response to cardiac resynchronization therapy (CRT).

Aims: To determine if CRT delivery could be optimized during the implantation procedure by choosing the number and location of pacing sites using echocardiography guidance.

Methods: In patients with a QRS ≥ 150 ms or a QRS < 150 ms and criteria for mechanical dyssynchrony, the objective of the implantation procedure was to shorten the left pre-ejection interval (LPEI), measured online, by at least 10 ms compared with standard biventricular configuration, by moving the right ventricular (RV) lead at different locations and, if necessary, by adding a second RV lead.

Detection of occult atrial fibrillation by pacemaker interrogation in cryptogenic stroke.

Purpose: Atrial fibrillation (AF) is a major cause of ischemic strokes, and it is assumed that occult intermittent episodes of AF are responsible for some of the seemingly cryptogenic strokes. Cardiac pacemakers feature rhythm diagnostic capabilities and data storage. We investigated whether pacemaker memory interrogation led to identification of undetected AF episodes prior to cryptogenic strokes.

Femoral vein thrombosis after right-sided electrophysiological procedures.

Purpose: Electrophysiological studies and radiofrequency catheter ablations require single or multiple sheath placements through femoral vein cannulation. The objective of this study was to determine the incidence, predictors, and outcomes of deep vein thrombosis (DVT) following such procedures.

Methods And Results: We prospectively enrolled 220 consecutive patients with a median age of 70 [60-79] years.

Past, present and future of cardiac resynchronization.

The growing interest in dyssynchrony and cardiac resynchronization therapy has opened the field of cardiac stimulation to new haemodynamic indications. French investigators have played a key role in the formulation of new concepts, all arising from clinical observations, and the development (in collaboration with industry) and clinical evaluation of resynchronization devices. This review summarizes recent knowledge and perspectives pertaining to atrial, atrioventricular and ventricular dyssynchrony and resynchronization.

Impact of comorbidity on medication use in elderly patients with cardiovascular diseases: the OCTOCARDIO study.

Background: Recommended medications are under-prescribed in elderly patients with atrial fibrillation (AF), coronary artery disease (CAD), and congestive heart failure (CHF). The relationship between under-prescribing and comorbidity is unclear.

Design: Single-day observational study.

Endocardial acceleration (sonR) vs. ultrasound-derived time intervals in recipients of cardiac resynchronization therapy systems.

Aims: Optimization of cardiac resynchronization therapy (CRT) requires the gathering of cardiac functional information. An accurate timing of the phases of the cardiac cycle is key in the optimization process.

Methods And Results: We compared Doppler echocardiography to an automated system, based on the recording of sonR (formerly endocardial acceleration), in the detection of mitral and aortic valves closures and measurements of the duration of systole and diastole.

Mathematical modeling of electrocardiograms: a numerical study.

This paper deals with the numerical simulation of electrocardiograms (ECG). Our aim is to devise a mathematical model, based on partial differential equations, which is able to provide realistic 12-lead ECGs. The main ingredients of this model are classical: the bidomain equations coupled to a phenomenological ionic model in the heart, and a generalized Laplace equation in the torso.

Responders to cardiac resynchronization therapy with narrow or intermediate QRS complexes identified by simple echocardiographic indices of dyssynchrony: the DESIRE study.

Background: Cardiac resynchronization therapy (CRT) is recommended for patients with NYHA class III-IV refractory heart failure (HF), ejection fraction <35% and a QRS >120 ms. We attempted to identify responders to CRT from echocardiographic (echo) indices of mechanical dyssynchrony in patients with QRS<150 ms.

Methods And Results: The study enrolled 51 men and 9 women (mean age: 64.

Physiological approach to monitor patients in congestive heart failure: application of a new implantable device-based system to monitor daily life activity and ventilation.

Aims: We examine an expert system designed to permanently monitor patients with congestive heart failure (CHF) using data of a dual-sensor pacemaker and to allow warning of significant changes in physiological indices.

Methods And Results: This study included 67 implanted patients divided into two groups: a control group without history of CHF (n = 19) who had received DDDR pacemakers (DDD group) and a test group (n = 48) who had received cardiac resynchronization therapy systems (CRT group) for severe CHF (NYHA III or IV, LVEF <40%). The embedded monitoring system measures minute ventilation (MV) and activity (ACT) at rest and at exercise.

Upgrading from single chamber right ventricular to biventricular pacing in permanently paced patients with worsening heart failure: The RD-CHF Study.

Background: Biventricular (BiV) stimulation lowers morbidity and mortality in patients with drug-refractory congestive heart failure (CHF), depressed left ventricular (LV) function, and ventricular dyssynchrony in absence of indication for permanent cardiac pacing. This pilot, single-blind, randomized, cross-over study examined the safety and efficacy of upgrading conventional pacing systems to BiV stimulation in patients with advanced CHF.

Methods: We included 56 patients in New York Heart Association (NYHA) functional classes III or IV despite optimal drug treatment and ventricular dyssynchrony (interventriclar delay > 40 ms or LV preejection delay > 140 ms) in need of pacemaker replacement.

Left bundle branch block as a risk factor for progression to heart failure.

The prevalence of conduction disturbances, particularly left bundle branch block (LBBB), is strongly correlated with age and with the presence of cardiovascular disease. LBBB has been reported to affect approximately 25% of the heart failure (HF) population and it is likely that the deleterious role of such conduction disorders in the progression to HF has been underestimated. The purpose of this article is to review the data from the literature indicating that LBBB may have a causative role, mediated through the resulting intra-ventricular asynchrony, in the deterioration of cardiac function and the development of cardiac remodelling and HF.

Clinical testing of a new pacemaker function to monitor ventricular capture.

Automatic beat-by-beat capture functions are designed to minimize the pacing energy delivered, while maintaining the highest safety by delivering an immediate back-up stimulus in case of loss of capture. The objective of this study was to estimate the lowering of ventricular pacing amplitude allowed by such a function, compared to amplitudes usually set manually in routine practice. An automatic ventricular pacing threshold test is launched every 6 hours to measure the automatic capture threshold (AT).

Incidence and predictive factors of atrial fibrillation in paced patients.

We have designed a prospective observational study to analyze the incidence and predictive factors of atrial fibrillation (AF) during a long follow-up, in a large population. Atrial fibrillation episodes were documented by the fallback mode switch (FMS) provided by implanted pacemakers. We have included 377 patients (61% men).