Publications by authors named "Victor Waldmann"

Background And Aims: The natural history of congenital or childhood non-immune, isolated atrioventricular block (AVB) is poorly defined. We aimed at clarifying its long-term outcomes.

Methods: We retrospectively studied 385 children with isolated, non-immune AVB diagnosed from in utero or up to 18 years of age, at 29 French medical centers, between 1980 and 2022.

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Background: Sudden cardiac death is the most common cause of death in childhood hypertrophic cardiomyopathy (HCM). Recently, 2 risk scores have been developed to estimate the 5-year risk of sudden cardiac death. We aimed to assess their respective performances in an independent cohort.

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Background: Ventricular tachycardia (VT) substrate characteristics before transcatheter pulmonary valve replacement (TPVR) in repaired tetralogy of Fallot (rTOF) are unknown.

Objectives: In this study, the authors sought to evaluate substrates for sustained monomorphic VT before TPVR in rTOF.

Methods: Retrospective (2017 to 2021) and prospective (commencing 2021) rTOF patients with native right ventricular outflow tract referred for electrophysiology study (EPS) before TPVR were included.

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  • SCN5A gene variants are linked to various cardiac electrical disorders, but they can also result in complex phenotypes like overlap syndromes, which haven't been thoroughly studied.
  • The study analyzed DNA from over 13,500 patients with a focus on those carrying pathogenic SCN5A variants, finding that most were tied to well-defined conditions like Brugada syndrome and long QT syndrome.
  • About 19% of the variants were associated with complex phenotypes, and only a small number (8 out of 9,960 patients) showed a potential link to dilated cardiomyopathies (DCM), suggesting it's a rare association.
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Background: A risk model has been proposed to provide a patient individualized estimation of risk for major clinical events (heart failure events, ventricular arrhythmia, all-cause mortality) in patients with transposition of the great arteries and atrial switch surgery. We aimed to externally validate the model.

Methods And Results: A retrospective, multicentric, longitudinal cohort of 417 patients with transposition of the great arteries (median age, 24 years at baseline [interquartile range, 18-30]; 63% men) independent of the model development and internal validation cohort was studied.

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  • Permanent pacing is often necessary after tricuspid valve interventions, and leadless pacemakers (LPs) are emerging as a preferred solution due to specific challenges these procedures pose.
  • A study involving 40 patients showed successful LP implantation, with the procedure taking an average of about 58 minutes and no acute complications.
  • Long-term follow-up indicated stable electrical parameters after the procedure, with four deaths occurring during the mean follow-up period of 10 months, unrelated to the LP implantation.
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Introduction: Pacemaker implantation can be challenging in patients with congenital heart disease.

Methods And Results: In a patient with Ebstein disease and symptomatic sinus node dysfunction, despite multiple attempts, the Micra® pacemaker could not be implanted in the severely dilated right ventricle. In that context, and after iodine injection to confirm the appropriate location, the Micra® pacemaker was successfully implanted in the right appendage at the first attempt.

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International guidelines on the use of anti-thrombotic therapies in left-sided ablations other than atrial fibrillation (AF) are lacking. The data regarding antiplatelet or anticoagulation strategies after catheter ablation (CA) procedures mainly derive from AF, whereas for the other arrhythmic substrates, the anti-thrombotic approach remains unclear. This survey aims to explore the current practices regarding antithrombotic management before, during, and after left-sided endocardial ablation, not including atrial fibrillation (AF), in patients without other indications for anti-thrombotic therapy.

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Aims: The incidence of atrial tachyarrhythmias is high in patients with atrioventricular septal defect (AVSD). No specific data on catheter ablation have been reported so far in this population. We aimed to describe the main mechanisms of atrial tachyarrhythmias in patients with AVSD and to analyse outcomes after catheter ablation.

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  • There are significant differences in sudden cardiac death (SCD) rates and the types of ventricular arrhythmias (VAs) in patients with congenital heart defects (CHD), categorized into two groups: Group A (with distinct anatomical structures) and Group B (with diffuse or less-defined issues).
  • Group A includes patients with clear pathways for ventricular tachycardia (VT), while Group B involves complex conditions like Ebstein anomaly and transposition of great arteries, which tend to have more severe arrhythmias like polymorphic VT and ventricular fibrillation.
  • For Group B patients, the effectiveness of tests like programmed ventricular stimulation is uncertain, and catheter ablation is less commonly used;
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Patients with congenital heart disease associated with a higher risk for ventricular arrhythmias (VA) and sudden cardiac death (SCD) can be divided conceptually into those with discrete mechanisms for reentrant monomorphic ventricular tachycardia (VT) (Group A) and those with more diffuse substrates (Group B). Part I of this review addresses Group A lesions, which predominantly consist of tetralogy of Fallot and related variants. Well-defined anatomic isthmuses for reentrant monomorphic VT are interposed between surgical scars and the pulmonary or tricuspid annulus.

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Background: Patients with repaired tetralogy of Fallot (TOF) are at risk for ventricular tachycardia (VT) related to well-described anatomical isthmuses.

Objective: The purpose of this study was to explore QRS morphology as an indicator of anatomical isthmus conduction.

Methods: Patients with repaired TOF and complete right bundle branch block referred for transcatheter pulmonary valve replacement (PVR) or presenting with sustained VT underwent comprehensive 3-dimensional mapping in sinus rhythm.

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  • 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.
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Patients with repaired tetralogy of Fallot are at elevated risk for ventricular arrhythmia and sudden cardiac death. Over the past decade, the pathogenesis and natural history of ventricular tachycardia has become increasingly understood, and catheter ablation has emerged as an effective treatment modality. Concurrently, there has been great progress in the development of a versatile array of transcatheter valves that can be placed in the native right ventricular outflow tract for the treatment of long-standing pulmonary regurgitation.

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  • The study explores young electrophysiology (EP) professionals’ concerns about radiation exposure and its effects on reproduction and pregnancy, showing a significant level of apprehension among participants.
  • A survey conducted with 252 EP personnel revealed that a large percentage were worried about radiation's impact on reproductive health and were mostly unaware of existing safety guidelines.
  • The findings indicate a need for better communication and adherence to safety measures, as many women in EP labs face restrictions during pregnancy, with zero-fluoroscopy being favored for safety.
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Congenital heart disease (CHD) often involves the systemic right ventricle (SRV), which is the morphological right ventricle that supports systemic circulation. SRV patients are at a higher risk of sudden cardiac death (SCD) than other adult CHD patients and continues to be a significant cause of death in this aging population. However, the pathophysiology of ventricular arrhythmias in SRV is still not fully understood, and there may be differences between subtypes of CHD.

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Introduction: The prevalence of congenital heart disease (CHD) is steadily increasing among adults. Atrial arrhythmias are frequent late complications and are associated with substantial morbidity.

Areas Covered: We discuss key considerations regarding management strategies for atrial arrhythmias in common forms of CHD and offer future perspectives.

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Aims: The epidemiology of sudden cardiac death (SCD) after heart transplantation (HTx) remains imprecisely described. We aimed to assess the incidence and determinants of SCD in a large cohort of HTx recipients, compared with the general population.

Methods And Results: Consecutive HTx recipients (n = 1246, 2 centres) transplanted between 2004 and 2016 were included.

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Background: Ventricular arrhythmias and sudden death are recognized complications in tetralogy of Fallot. Electrophysiological studies (EPS) before pulmonary valve replacement (PVR), the most common reintervention in tetralogy of Fallot, could potentially inform therapy to improve arrhythmic outcomes.

Methods: A prospective multicenter study was conducted to systematically assess EPS with programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR from January 2020 to December 2021.

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Article Synopsis
  • The study examines the role of platelet activation in influencing mortality rates in COVID-19 patients by analyzing two patient cohorts for blood biomarkers related to platelet activity.
  • In cohort A of 208 patients, higher levels of soluble platelet biomarkers were noted in critical patients, linking them to increased in-hospital mortality; however, this association was not significant when adjusting for coagulopathy indicators.
  • Results from cohort B, which included nearly 2900 patients, indicated that prior use of antiplatelet medications did not significantly affect mortality outcomes, suggesting that coagulopathy may be a more critical factor in the progression of COVID-19.
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