Publications by authors named "Hugues Blangy"
Background And Aims: Prophylactic implantable cardioverter-defibrillators (ICDs) are not recommended until left ventricular ejection fraction (LVEF) has been reassessed 40 to 90 days after an acute myocardial infarction. In the current therapeutic era, the prognosis of sustained ventricular arrhythmias (VAs) occurring during this early post-infarction phase (i.e.
View Article and Find Full Text PDFBackground: An implantable loop recorder is an effective tool for diagnosing unexplained syncope. However, after a first episode in non-high-risk patients, the usefulness of implantable loop recorder implantation remains unclear.
Aims: To analyse relevant risk factors for significant bradycardia in order to identify patients who do or do not benefit from implantable loop recorder implantation.
Article Synopsis
- Very few studies have explored the effectiveness of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in patients with congenital heart disease (CHD), which this research aims to address.
- In a French cohort study of 4,924 patients implanted with an S-ICD, only 101 were found to have CHD, often presenting at a younger age and more often for secondary prevention compared to non-CHD patients.
- The study found that while patients with CHD had a higher crude risk of receiving appropriate shocks from their S-ICD, this risk was not significant after adjusting for other factors, indicating that complications and inappropriate shocks were similar across both patient groups.
Aims: While elevated resting heart rate measured at a single point of time has been associated with cardiovascular outcomes, utility of continuous monitoring of nocturnal heart rate (NHR) has never been evaluated. We hypothesized that dynamic NHR changes may predict, at short term, impending cardiovascular events in patients equipped with a wearable cardioverter-defibrillator (WCD).
Methods And Results: The WEARIT-France prospective cohort study enrolled heart failure patients with WCD between 2014 and 2018.
CRT-D replacement strategy: results of the BioCONTINUE study.
J Interv Card Electrophysiol
August 2023
Background: In patients with cardiac resynchronization therapy defibrillators (CRT-Ds), the need for implantable cardioverter-defibrillator (ICD) back-up may be questionable at time of CRT-D replacement (REP) if ICD implant criteria are no longer met due to an improved left ventricular ejection fraction (LVEF) and if no major ventricular arrhythmic event (VAE) occurred during the CRT-D lifetime. The aim of our study was to assess the relevance of ICD back-up and predictors of VAE after REP in primary prevention CRT-D patients.
Methods: The prospective, observational, international BioCONTINUE study investigated the rate of patients with at least 1 sustained VAE (sVAE) post-REP and searched for predictive factors of sVAE.
Article Synopsis
- The study investigates the outcomes of cardiogenic shock patients receiving temporary circulatory support (TCS) as a bridge to left ventricular assist device (LVAD) implantation, comparing them to patients without TCS.
- Out of 329 patients analyzed, those under TCS had similar 30-day survival rates to those who had TCS removed or did not use a bridging strategy but experienced longer ICU stays and increased mechanical ventilation time.
- Key predictors of mortality in the TCS group include combined surgery with LVAD, body mass index (BMI), and duration of heart failure, while the use of TCS itself did not significantly impact survival rates.
Background: Despite guidelines describing the optimal diagnostic and therapeutic procedures for patients with suspected cardiac implantable electronic device (CIED) infections, their management is often challenging.
Aims: To describe our diagnostic and therapeutic practices for suspected CIED infection, and to compare them with European Heart Rhythm Association (EHRA) guidelines.
Methods: Patients hospitalized in the tertiary care Nancy University Hospital for suspected CIED infection from 2014 to 2019 were included retrospectively.
Article Synopsis
- Advanced heart failure patients often experience delays in being referred for mechanical circulatory support, specifically left ventricular assist devices (LVAD), which raises concerns about their survival rates post-implantation.
- The study analyzed data from the ASSIST-ICD registry involving 303 non-inotrope-dependent patients, discovering that factors like older age and certain surgical procedures significantly increase mortality risk after receiving an LVAD.
- Despite LVAD support, survival rates over five years remain low, highlighting the need for improved patient selection to enhance outcomes in such high-risk individuals.
Article Synopsis
- LVAD implantation in patients with recently diagnosed cardiomyopathy is under-researched, and this study aims to explore characteristics and outcomes of such patients within 30 days of their diagnosis.
- Out of 652 patients studied, 117 had recently diagnosed cardiomyopathy and experienced LVAD implantation after an average of 15 days, showing they were generally younger and had more severe symptoms compared to those with remote diagnoses.
- Although immediate postoperative survival rates were similar between groups, patients with recently diagnosed cardiomyopathy had improved long-term survival, with certain factors like sudden cardiac arrest identified as risk indicators for higher mortality.
Aims: We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability.
Methods And Results: Across 88 French centres, the WEARIT-France study enrolled retrospectively patients who used the WCD between May 2014 and December 2016, and prospectively all patients equipped for WCD therapy between January 2017 and March 2018. All patients received systematic education session through a standardized programme across France at the time of initiation of WCD therapy and were systematically enrolled in the LifeVest Network remote services.
Article Synopsis
- LVAD implantation can be a viable treatment option for elderly patients (70+) with heart failure who aren't suitable for heart transplants.
- An observational study analyzed 652 patients from 2006 to 2016, with 74 (11.3%) being elderly, showing similar hospitalization patterns and complication rates between elderly and younger patients.
- The findings indicate that elderly patients receiving LVADs have comparable mid-term survival rates to younger patients, supporting the use of LVADs in this age group.
Objectives: The aim of this multicenter study was to characterize the efficacy and safety of subcutaneous implantable cardioverter-defibrillators (S-ICDs) lead extraction procedures.
Background: S-ICDs have been developed to limit lead-related complications inherent to transvenous ICD devices. To date, no study has specifically investigated the safety and feasibility of S-ICD lead extraction procedures.
Implantable cardiac defibrillator leads dysfunction after LVAD implantation.
Pacing Clin Electrophysiol
November 2020
Article Synopsis
- * Out of 401 patients with an ICD before LVAD, 122 had their ICD checked before and after implantation, with 55% showing significant lead dysfunction, including issues with sensing and pacing.
- * Despite the lead dysfunction observed, it did not result in severe clinical problems, indicating that management of these issues was effective and conservative.
Background: In this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, and associated prognoses.
Methods: In this multicenter registry‒based study, we retrospectively included all patients who underwent S-ICD implantation at 3 tertiary centers. The prognostic impact of S-ICD shock was assessed with a composite outcome that included all-cause death and hospitalisation for heart failure.
Article Synopsis
- The study aimed to assess the usage and outcomes of left ventricular assist devices (LVADs) in France from 2007 to 2016 using data from the ASSIST-ICD registry, involving 671 patients across 20 hospitals.
- The overall survival rates for LVAD support or transplantation were 65.2% at 1 year, steadily decreasing to 47.7% by 5 years, with significant complications such as infections and strokes noted.
- The findings highlight improved survival outcomes compared to earlier registries, despite patients being older and having more severe conditions, indicating differences in national treatment approaches and patient profiles.
Article Synopsis
- The study aimed to assess how uncommon etiologies of cardiomyopathy affect patient outcomes in those receiving Left-ventricular assist devices (LVADs) compared to more common ischemic or idiopathic dilated cardiomyopathies.
- Conducted over 19 centers from 2006 to 2016, the research found that out of 652 LVAD recipients, 90.5% had ischemic/idiopathic causes, while 9.5% had uncommon causes like hypertrophic cardiomyopathy, cancer-related cardiac dysfunction, and myocarditis.
- Although both groups had similar survival rates during a 9.1-month follow-up, those with hypertrophic cardiomyopathy,
Article Synopsis
- The study investigates the occurrence and impact of early ventricular arrhythmias (VAs) in patients who received left ventricular assist devices (LVAD) post-surgery, focusing on the first 30 days after implantation.
- Significant predictors of early VAs include a prior history of VAs and undergoing additional surgeries alongside the LVAD procedure, with early VAs notably increasing the risk of death within the first month.
- Despite early VAs raising the risk of 30-day mortality, they do not affect long-term survival rates in patients who are discharged alive from the hospital.*
Background: Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections.
Methods: Patients included in the ASSIST-ICD study (19 centers) were enrolled.
Article Synopsis
- * Conducted at 19 centers over a decade, the study tracked 659 LVAD recipients, finding that 26.9% experienced late VAs, defined as sustained arrhythmias requiring treatment more than 30 days post-implant.
- * Researchers identified six key risk factors for late VAs, leading to the development of a "VT-LVAD score" that categorizes patients into risk groups, potentially aiding in decision-making for ICD implantation.
Article Synopsis
- This study looked at patients who had a special heart valve surgery called TAVI to see what might lead them to need a pacemaker afterward.
- They found that having certain heart conditions, using a specific type of valve called the Medtronic CoreValve, and larger heart devices increased the chance of needing a pacemaker.
- By checking some heart measurements before surgery, doctors could predict which patients might need a pacemaker during or after their TAVI procedure.
Despite the increasingly high rate of implantation of pacemakers (PM) and cardioverter-defibrillators (ICD) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety, and effectiveness of the conventional pacing, ICD and cardiac resynchronization therapy (CRT) in elderly patients. Although peri-procedural risk may be slightly higher in the elderly, the procedure of implantation of PMs and ICDs is still relatively safe in this age group.
View Article and Find Full Text PDFDespite the increasingly high rate of implantation of pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety and effectiveness of conventional pacing, ICDs and cardiac resynchronization therapy (CRT) in elderly patients. Although periprocedural risk may be slightly higher in the elderly, the implantation procedure for PMs and ICDs is still relatively safe in this age group.
View Article and Find Full Text PDFBackground: Programmed ventricular stimulation (PVS) is a technique for screening patients at risk for ventricular tachycardia (VT) after myocardial infarction (MI), but the results might be difficult to interpret.
Objectives: To investigate the results of PVS after MI, according to date of completion.
Methods: PVS results were interpreted according to the mode of MI management in 801 asymptomatic patients: 301 (group I) during the period 1982-1989, 315 (group II) during 1990-1999, and 185 (group III) during 2000-2010.