Leadless pacemakers as a new alternative for pacemaker lead-related superior vena cava syndrome: A case report.

Superior vena cava (SVC) syndrome is a rare disease induced by thrombosis and consequent occlusion of SVC, negatively affecting morbidity and mortality. The incidence of SVC syndrome from central venous catheters and pacemaker or defibrillator leads is increasing. Optimal treatment of pacemaker or defibrillator-related SVC syndrome is not well defined.

[Management of infections in patients with cardiac implantable electronic devices].

Implantation of pacemakers and cardiac defibrillators is a life-saving treatment but can put our patients at risk of infections, increasing morbidity and mortality and prolonging hospitalization with a significant financial healthcare burden. A preventive strategy is crucial but, while several strategies such as administration of intravenous antibiotic therapy before implantation are well recognized, other uncertainties remain. The main gaps regard the use of periprocedural measures, including antibacterial envelope to prevent device infection, the appropriate management of antithrombotic therapy before and after device implantation and timing of device reimplantation.

Reduction of admissions for urgent and elective pacemaker implant during the COVID-19 outbreak in Northern Italy.

Aims: The coronavirus disease-19 (COVID-19) outbreak has been recently associated with lower hospitalization rates for acute coronary syndromes. Aim of the study was to investigate whether a similar behaviour is observed in admissions for urgent pacemaker implant.

Methods: This retrospective study included 1315 patients from 18 hospitals in Northern Italy with a high number of COVID-19 cases.

[Arrhythmias and sudden death in neuromuscular disorders].

Neuromuscular diseases (NMD) are a broadly defined group of disorders that all involve injury or dysfunction of peripheral nerves, neuromuscular junction or muscle, often with dominant or recessive pattern of inheritance. Cardiac involvement is uncommon, in particular with cardiomyopathies and brady/tachyarrhythmias. The causes of cardiac involvement are unclear: replacement fibrosis, alteration of membrane permeability, sympathetic hyperactivity, or accumulation of toxic metabolites can play a role in the pathogenesis of cardiac disorders.

Impact of COVID-19 lockdown in patients with implantable cardioverter and cardiac resynchronization therapy defibrillators: insights from daily remote monitoring transmissions.

In Italy, a strict lockdown was imposed from 8 March 2020 to stop the spread of the coronavirus disease 2019 (COVID-19). We explored the effect of this lockdown on data transmitted by remote monitoring (RM) of implantable cardioverter and cardiac resynchronization therapy defibrillators (ICDs/CRT-Ds). RM daily transmissions from ICDs and CRT-Ds were analyzed and compared in two consecutive 1 month frames pre and post-lockdown: period I (7 February-7 March 2020) and period II (8 March-7 April 2020).

Remote monitoring temporal trends during COVID-19 pneumonia in patients with implanted defibrillators.

It is unknown whether some of the clinical parameters transmitted by remote monitoring (RM) of cardiac implanted devices could show recurrent patterns caused by COVID-19 infection. Our aim was to describe RM daily temporal trends for implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) recipients during COVID-19 infection. A 65-year-old woman with a CRT-D had a sudden increase of approximately 15 bpm and 10 bpm in nocturnal and mean heart rate, respectively, 11 days before hospitalization for COVID-19 pneumonia.

Impact of prior statin use on clinical outcomes in COVID-19 patients: data from tertiary referral hospitals during COVID-19 pandemic in Italy.

Background: Epidemiological evidence suggests that anti-inflammatory and immunomodulatory properties of statins may reduce the risk of infections and infection-related complications.

Objective: We aimed to assess the impact of prior statin use on coronavirus disease (COVID-19) severity and mortality.

Methods: In this observational multicenter study, consecutive patients hospitalized for COVID-19 were enrolled.

Clinical Discussions in Antithrombotic Therapy Management in Patients With Atrial Fibrillation: A Delphi Consensus Panel.

Background: In recent years, direct-acting oral anticoagulants (DOACs) have entered clinical practice for stroke prevention in non-valvular atrial fibrillation or prevention and treatment of venous thromboembolism. However, remaining uncertainty regarding DOAC use in some clinical scenarios commonly encountered in the real world has not been fully explored in clinical trials.

Methods: We report on use of a Delphi consensus process on DOAC use in non-valvular atrial fibrillation patients.

Redefining the Prognostic Value of High-Sensitivity Troponin in COVID-19 Patients: The Importance of Concomitant Coronary Artery Disease.

Background: Although studies assessing cardiovascular comorbidities and myocardial injury in Coronavirus disease 2019 (COVID-19) patients have been published, no reports focused on clinical outcomes of myocardial injury in patients with and without chronic coronary syndromes (CCS) are currently available.

Methods: In this study, consecutive COVID-19 patients admitted to four different institutions were screened for enrolment. Patients were divided into two groups (CCS vs.

Myocardial Scar on Surface ECG: Selvester Score, but Not Fragmentation, Predicts Response to CRT.

Purpose: Myocardial scar is directly related to the response to CRT after implantation. The extent of myocardial scar can be detected not only by cardiac magnetic resonance but also by two electrocardiographic scores: fragmented QRS (fQRS) and Selvester score (SSc). The aim of our study is to compare the role of baseline SSc and fQRS in predicting response to CRT in a cohort of heart failure patients with true left bundle branch block (LBBB).

Oral anticoagulation and clinical outcomes in COVID-19: An Italian multicenter experience.

Background: Since the body of evidence addressing the coagulation derangements caused by Coronavirus disease (COVID-19) has been constantly growing, we investigated whether pre-hospitalization oral anticoagulation (OAC) or in-hospital heparin treatment could have a protective role among COVID-19 patients.

Method: In this cohort study, consecutive COVID-19 patients admitted to four different Italian Institutions were enrolled. Baseline demographic, clinical, laboratory, and radiological characteristics, as well as in-hospital treatment and outcomes were evaluated.

Second European Society of Cardiology Cardiac Resynchronization Therapy Survey: the Italian cohort.

Aim: Adherence to guidelines was not homogeneous in Europe, according to the survey on cardiac resynchronization therapy conducted in 2008-2009. The aim of our study was to compare the results in the Italian and European cohorts of the Second European Cardiac Resynchronization Therapy Survey.

Methods: Patients' characteristics, procedural data and follow-up were collected.

Use of the new rotating dilator sheath TightRail™ for lead extraction: A bicentric experience.

Aim: The aim of this study is to assess the safety and efficacy of the new bidirectional rotational mechanical sheath TightRail™ (Spectranetics) for lead extraction.

Methods And Results: This is a bicentric prospective study that included patients who underwent a transvenous lead extraction (TLE) in two Italian centers (San Raffaele Hospital and Humanitas Gavazzeni Hospital). From November 2016 to December 2018, 26 patients underwent a TLE procedure in which the TightRail™ was used.

Sleep-disordered breathing and effectiveness of cardiac resynchronization therapy in heart failure patients: gender differences?

Objectives: This study evaluated heart failure (HF) patients who underwent cardiac resynchronization therapy (CRT) and who had device-documented sleep-disordered breathing (SDB). We found gender differences in acute changes in SDB due to CRT impact.

Background: SDB typically occurs in HF patients.

The influence of age on the psychological profile of patients with cardiac implantable electronic devices: results from the Italian population in a multicenter study conducted by the European Heart Rhythm Association.

Background: Cardiac implantable electronic devices (CIEDs) are widely used to treat bradyarrhythmias or improve the prognosis of patients with heart failure (HF).

Aims: To evaluate age-related (≤ 75 vs. > 75 years) attitudes, worries, psychological effects and needs in an Italian CIEDs population.

Severe Spontaneous Echo Contrast/Auricolar Thrombosis in "Nonvalvular" AF: Value of Thromboembolic Risk Scores.

Background: Patients with atrial fibrillation (AF) have an increased thromboembolic risk that can be estimated with risk scores and sometimes require oral anticoagulation therapy (OAT). Despite correct anticoagulation, some patients still develop left atrial spontaneous echo contrast (SEC) or thrombosis. The value of traditional risk scores (R CHADS , CHADS , and CHA DS -VASc) in predicting such events remains controversial.

Magnitude of QRS duration reduction after biventricular pacing identifies responders to cardiac resynchronization therapy.

Background: Several studies have investigated the association between native QRS duration (QRSd) or QRS narrowing and response to biventricular pacing. However, their results have been conflicting. The aim of our study was to determine the association between the relative change in QRS narrowing index (QI) and clinical outcome and prognosis in patients who undergo cardiac resynchronization therapy (CRT) implantation.

Prognostic Impact of QRS Axis Deviation in Patients Treated With Cardiac Resynchronization Therapy.

Introduction: QRS duration and morphology are currently recognized as recommended criteria for the selection of CRT candidates. It has recently been shown that patients with left bundle branch block (LBBB) derive substantial clinical benefit from CRT. The aim of this study is to investigate the prognostic impact of QRS axis deviation (AD) in HF patients with LBBB undergoing CRT.

[Acute results of left ventricular endocardial pacing for cardiac resynchronization therapy obtained with a transapical approach].

Although cardiac resynchronization therapy (CRT) is considered a milestone in the treatment of patients affected with chronic congestive heart failure, reduced left ventricular ejection fraction and enlarged QRS, up to 30% of patients can be considered clinical non-responders to this treatment. In these patients, optimization of atrioventricular and interventricular intervals could be of some help, but results of trials are not univocal on the benefit of this procedure. In the last years, left ventricular endocardial pacing for CRT has emerged as a possible solution in non-responders.

Relation of QRS duration to response to cardiac resynchronization therapy.

Left bundle branch block (LBBB) is the most reliable electrocardiographic predictor of responsiveness to cardiac resynchronization therapy (CRT). However, not all patients with LBBB will respond to CRT. Our aim was to investigate the interaction between QRS duration, LBBB-type morphology, and the responsiveness to CRT.