The awareness and acceptance of anti-COVID 19 vaccination in adolescence.

Background: COVID-19 had devastating effects on children's and adolescents' life, including neuropsychological impairment, discontinuation of social life and education. Since June 2021, antiCOVID19 vaccination has become available to adolescents in Italy up to 12 years and since December 2021 to children aged more than 5 years. The pediatric population represents a challenging target for vaccination.

Two-Dimensional Transesophageal Echocardiography Assessment of the Major Aortic Annulus Diameter in Patients Undergoing Transcatheter Aortic Valve Replacement.

Background: Multidetector computed tomography (MDCT) is the gold standard in annulus sizing before transcatheter aortic valve replacement (TAVR). However, MDCT has limited applicability in specific subgroups of patients, such as those with atrial fibrillation and chronic kidney disease. Two-dimensional transesophageal echocardiography (2DTEE) has traditionally been limited to the long-axis measurement of the anteroposterior diameter of the aortic annulus.

Stepwise endo-/epicardial catheter ablation for atrial fibrillation: The Mediterranea approach.

Background: Outcomes of catheter ablation (CA) among patients with nonparoxysmal atrial fibrillation (AF) are largely disappointing.

Objective: We sought to evaluate the feasibility, effectiveness, and safety of a single-stage stepwise endo-/epicardial approach in patients with persistent/longstanding-persistent AF.

Methods: We enrolled 25 consecutive patients with symptomatic persistent (n = 4) or longstanding-persistent (n = 21) AF and at least one prior endocardial procedure, who underwent CA using an endo-/epicardial approach.

Catheter, surgical, or hybrid procedure: what future for atrial fibrillation ablation?

Background: The debate on the best treatment strategy for atrial fibrillation (AF) has expanded following the introduction of the so-called "hybrid procedure" that combines minimally invasive epicardial ablation with endocardial catheter ablation. However, the advantage of the hybrid approach over conventional epicardial ablation remains to be established.

Methods: From June 2008 to December 2020, 609 surgical AF ablation procedures through a right minithoracotomy were performed at our institution.

Targeting Bachmann's bundle in hybrid ablation for long-standing persistent atrial fibrillation: a proof of concept study.

Background: Catheter-based or surgical procedures in patients with long-standing persistent atrial fibrillation (LSPAF) remain a challenge. As a result, different approaches including hybrid (surgical and endocardial) ablation have been developed. Bachmann's bundle (BB) is a mainly epicardial structure capable of sustaining arrhythmic reentry that could be involved in the development and perpetuation of atrial fibrillation.

Stand-Alone Thoracoscopic Left Atrial Appendage Closure in Nonvalvular Atrial Fibrillation Patients at High Bleeding Risk.

Objective: In nonvalvular atrial fibrillation (AF) patients at high bleeding risk, oral anticoagulants (OAC) may be contraindicated, and percutaneous left atrial appendage (LAA) closure has been advocated. However, following percutaneous procedure, either OAC or dual antiplatelet treatment is required. In this study, we present our experience in treating nonvalvular AF patients at high bleeding risk with thoracoscopic LAA closure with no subsequent antithrombotic therapy.

A modified surgical ablation line for atrial fibrillation. The Bachmann line.

Surgical treatment of atrial fibrillation generally consists in the isolation of the pulmonary veins ("box-lesion"). Bachmann's bundle is a cardiac structure that may play an important role in the genesis of the atrial fibrillation. Surgical isolation of such bundle has not been reported before.

Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system: results from a randomized study.

Purpose: Contact with cardiac tissue is an important determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei X™ robotic navigation system (RNS) (Hansen Medical, Mountain View, CA, USA) has been validated for contact force (CF) sensing expressed in grams (g). The Thermocool® SmartTouch™ catheter enables the measurement of catheter tip CF and direction inside the heart.

Usefulness of intracardiac echocardiography during pulmonary vein isolation with the novel multipolar irrigated ablation catheter (nMARQ™).

Background: Previous studies reported the usefulness of an irrigated circular radiofrequency ablation catheter (nMARQ(TM), Biosense Webster) for pulmonary vein isolation (PVI). We evaluated the role of intracardiac echocardiography (ICE) to optimize the manipulation of nMARQ(TM) catheter.

Methods: Thirty-seven patients (pts), (mean age 55 ± 12 years; 28 males) were enrolled to perform PVI.

Continuous spikes and waves during slow sleep in a child with karyotype 47, XYY.

The XYY syndrome is a sex chromosome aneuploidy occurring in one of 1,000 live male births. Only few data exist regarding the correlation between this syndrome and epilepsy. An EEG pattern suggestive of benign focal epilepsy with centro-temporal spikes has recently been described in four XYY patients.

Relationship of quality of life with procedural success of atrial fibrillation (AF) ablation and postablation AF burden: substudy of the STAR AF randomized trial.

Background: The Substrate and Trigger Ablation for Reduction of Atrial Fibrillation (STAR AF) trial compared 3 strategies for ablation of high-burden paroxysmal/persistent atrial fibrillation (AF): complex fractionated electrogram ablation (CFE), pulmonary vein isolation (PVI), or a combined approach (PVI with CFE). This subanalysis aimed to identify the effect on quality of life (QOL) conferred by ablation strategy, AF recurrence, and type of AF.

Methods: The STAR AF study (n = 100) found 88%, 68%, and 38% freedom from AF > 30 seconds at 12 months for PVI with CFE, PVI, and CFE approaches, respectively (P = 0.

Clinical impact of catheter ablation in patients with asymptomatic atrial fibrillation: the IRON-AF (Italian registry on NavX atrial fibrillation ablation procedures) study.

Whether and to what extent patients with asymptomatic atrial fibrillation (AF) would benefit from catheter ablation has not been investigated. This is the first multicenter prospective study reporting on the outcome of catheter ablation in patients with asymptomatic AF. Consecutive patients (n = 545) referred for AF ablation were prospectively enrolled in a multicenter Italian registry.

Ablation of paroxysmal and persistent atrial fibrillation with multielectrode phased radiofrequency duty-cycled catheters: long-term results from a large cohort of patients.

Background: Catheter ablation is a widely used approach to treat patients with drug refractory paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (CAF). The aim of this analysis was to evaluate the long-term safety and efficacy of the multielectrode/phased radiofrequency (RF)/duty-cycled ablation catheters in the treatment of both PAF and CAF in a large cohort of patients.

Methods And Results: From July 2008 to February 2010, 429 consecutive drug refractory symptomatic patients (mean age 60 ± 12 years old, 58% men, 68% PAF, 32% CAF) were treated.

Catheter ablation of atrial fibrillation guided by a 3D electroanatomical mapping system: a 2-year follow-up study from the Italian Registry On NavX Atrial Fibrillation ablation procedures (IRON-AF).

Aims: Clinical trials have established that atrial fibrillation (AF) catheter ablation improves symptoms in appropriately selected patients. Confirmation of these results by long-term prospective observational studies is needed. This registry was created to describe the experience of 16 Italian centers with a large cohort of AF patients treated with catheter ablation guided by the NavX 3D mapping system.

Incidence and significance of early recurrences associated with different ablation strategies for AF: a STAR-AF substudy.

Background: Early recurrences of atrial tachyarrhythmias (ERAT) are common after atrial fibrillation (AF) ablation, and predict late recurrences (LR). We sought to determine the impact of different ablation strategies on ERAT and LR.

Methods And Results: The STAR-AF trial randomized 100 patients with paroxysmal or persistent AF to ablation of complex fractionated electrograms (CFAE) alone, pulmonary vein isolation (PVI) alone, or combined PVI + CFAE.

Experimental assessment of level pool routing in preliminary design of floodplain storage.

Among control structures in flood management, floodplain storage represents one of the most effective measures, since it holds part of flood volume in a delimited area thus reducing the peak discharge. Sizing of floodplain storage, both on-stream and off-stream, is complex and several methodologies for preliminary design are available in literature, almost all assuming level pool reservoir routing, i.e.

Defibrillation testing at the time of implantation of cardioverter defibrillator in the clinical practice: a nation-wide survey.

Aims: Despite an effective defibrillation testing (DT) is considered mandatory to be consistent with the rules of good clinical practice, some physicians are concerned about the risk of complications related to the induction test, and in real world clinical practice, several implant procedures are performed without any induction test. We conducted a systematic nation-wide retrospective survey in order to determine the DT rate and its complications.

Methods And Results: An ad hoc questionnaire was sent to all 343 Italian implanting centres and the data from the 229 (67%) centres that answered were analysed.

Widespread electroanatomic alterations of right cardiac chambers in patients with myotonic dystrophy type 1.

Introduction: Conduction disturbances and arrhythmias characterize the cardiac feature of myotonic dystrophy type 1 (MD1); a myocardial involvement has been suggested as part of the cardiac disease. The aim of our study was to investigate the underlying myocardial alterations using electroanatomic mapping (CARTO) and their possible correlation with genetic and neurological findings.

Methods And Results: Right atrial and ventricular CARTO maps were obtained in 13 MD1 patients.

Safety and feasibility of coronary sinus left ventricular leads extraction: a preliminary report.

Background: transvenous positioning of the left ventricular (LV) lead in a branch of the coronary sinus (CS) is generally the preferred implantation technique in biventricular pacing. Very few data are reported about removal of LV pacing leads positioned in a CS branch. Aim of the study was to describe our experience with percutaneous extraction of LV pacing leads in order to evaluate feasibility and safety of this procedure.

A randomized evaluation of different approaches to coronary sinus venography during biventricular pacemaker implants.

Aim: Biventricular implantation procedures require contrast venography of the coronary sinus. The aim of our study was to evaluate the efficacy and safety of contrast venography obtained by direct manual contrast injection into the guiding catheter, compared with venography obtained after occlusion of the coronary sinus by a Swan-Ganz catheter.

Methods: Eighty-three patients were randomly assigned to direct or occlusive venography technique.

A randomized comparison of alternative techniques to achieve coronary sinus cannulation during biventricular implantation procedures.

Introduction: Biventricular pacing system implantation is a time-consuming and challenging procedure. A critical step in biventricular pacemaker implantation is coronary sinus (CS) cannulation. CS cannulation can be achieved either using dedicated guiding catheters (guiding catheter alone positioning strategy, GCA) or with the aid of an electrophysiology catheter advanced inside the guiding catheter (electrophysiology catheter aided positioning strategy, EPA).

Cardiac features of Emery-Dreifuss muscular dystrophy caused by lamin A/C gene mutations.

Aims: Retrospective studies have identified a mutation in the lamin A/C (LMNA) gene in patients selected on the basis of a phenotype characterized by dilated cardiomyopathy, atrioventricular conduction disturbances and sudden death. However, the features of cardiac abnormalities in patients with an initial diagnosis of Emery-Dreifuss muscular dystrophy (EDMD) are poorly known. Aim of the present study was to investigate the spectrum of cardiac disease in patients with an initial diagnosis of EDMD caused by a mutation in the LMNA gene.