68 results match your criteria: "University Hospital "Ospedali Riuniti Umberto I - Lancisi - Salesi"[Affiliation]"

Background: The surgical pathway represents a fundamental process in hospital productivity, and its digitalization is a major focus for hospital management. ASL Roma 1 health authority has taken up this digitalization challenge by introducing an Operation Room Management (ORM) system within the operating block of one of its hospital facilities in 2022.

Study Design: Interrupted Time Series analysis.

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Background: Among inherited cardiomyopathies involving the left ventricle, whether dilated or not, certain genotypes carry a well-established arrhythmic risk, notably manifested as sustained monomorphic ventricular tachycardia (SMVT). Nonetheless, the precise localization and electrophysiological profile of this substrate remain undisclosed across different genotypes.

Methods: Patients diagnosed with cardiomyopathy and left ventricle involvement due to high-risk genetic variants and SMVT treated by electrophysiological study were recruited from 18 European/US centers.

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Tissue oedema following pulsed field ablation recognized during a concomitant left atrial appendage closure procedure: a case report.

Eur Heart J Case Rep

September 2024

Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Straße 4, 60431, Frankfurt am Main, Germany.

Article Synopsis
  • In patients with non-valvular atrial fibrillation at high stroke risk who can't take long-term anticoagulants, left atrial appendage closure (LAAC) serves as an alternative treatment.
  • A case study of a 74-year-old female highlighted the successful use of pulsed field ablation (PFA) for pulmonary vein isolation (PVI) along with LAAC using the WATCHMAN FLX™ device.
  • Follow-up showed no stroke or bleeding incidents over 6 months, with an initial swelling around the LAAC device resolving and a stable, albeit slightly tilted, device position without leakage.
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  • The study looks at how the location where doctors put tubes in the arteries for heart support affects brain health after surgery.
  • They compared three methods: using the aorta, subclavian/axillary arteries, and femoral artery to see which had the least brain problems.
  • Results showed that patients using the subclavian/axillary method had more major brain issues compared to the others, and also had more seizures after the surgery.
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  • ECLS cannulation in post-cardiotomy patients is uncommon in general wards, with only 39 out of 2058 patients studied undergoing the procedure while at the hospital.
  • The majority of these patients faced complications like acute kidney injury and arrhythmias, with a high in-hospital mortality rate of 84.6%, predominantly due to persistent heart failure.
  • Findings suggest that ECLS cannulation mainly affects low-risk patients who experience cardiac arrest post-surgery, indicating a need for further research into improving outcomes.
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Article Synopsis
  • * Conducted across 34 centers globally from 2000 to 2020, the study included over 2,000 adult patients split into different ECMO duration groups, revealing higher complications and mortality rates associated with longer ECMO durations.
  • * The findings suggest that while most in-hospital complications increase with ECMO duration, post-discharge survival rates remain similar across groups, with specific risk factors like age and pre-existing conditions affecting long-term survival for those on ECMO longer than 7 days.
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  • Recent data indicates that pulsed field ablation (PFA) technology for treating atrial fibrillation (AF) shows shorter procedural times as operators gain experience.
  • A study involving 752 patients found significant reductions in procedure time and fluoroscopy time as the number of PFA procedures increased among operators, with most procedures performed by those who had completed over 20 PFA cases.
  • The findings suggest that the PFA system is both efficient and safe for AF treatment, with a quick learning curve, enabling improved outcomes after just a small number of procedures.
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  • Limited research exists on pulsed-field ablation (PFA) for patients with persistent atrial fibrillation (PeAF) undergoing left atrial posterior wall isolation (LAPWI), as highlighted in a study involving 249 patients across 9 Italian centers.
  • The study found that LAPWI was successfully performed in 57.6% of cases without any major complications, and only 2.4% experienced minor issues.
  • Results indicated that PFA is a feasible and rapid method for LAPWI, providing effective outcomes without significantly increasing procedural times, making it a promising option for PeAF treatments.
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Background: Intracardiac echocardiography (ICE) is increasingly employed in atrial fibrillation (AF) ablation procedures, with the potential to enhance procedural efficacy. Nevertheless, there is currently a lack of evidence assessing the impact of ICE on the efficiency, effectiveness, and safety outcomes in the context of novel pulsed-field ablation (PFA) for AF.

Purpose: We aimed to assess whether the use of ICE could improve procedural parameters in a large population undergoing AF ablation with FARAPULSE™ catheter.

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Background: A novel method to measure atrial fibrillation cycle length (AF-CL) was recently described, based on the average of 10 consecutive signals (FARS10). FARS10 accurately identified pulmonary vein isolation (PVI)-responders among patients with persistent AF. Whether this method is applicable to patients with paroxysmal AF is unknown.

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Article Synopsis
  • The study examines the use of extracorporeal membrane oxygenation (ECMO) in adults experiencing cardiogenic shock after heart surgery, noting significant in-hospital mortality rates (60.5%).
  • Conducted across 34 centers from 2000 to 2020, the research analyzes patient characteristics and factors affecting both in-hospital and long-term survival.
  • Despite high initial mortality, approximately 66% of hospital survivors can expect to live for a decade post-discharge, with age and certain postoperative complications influencing long-term outcomes.
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On-Support and Postweaning Mortality in Postcardiotomy Extracorporeal Membrane Oxygenation.

Ann Thorac Surg

November 2023

Department of Cardio-Thoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.

Article Synopsis
  • Postcardiotomy venoarterial extracorporeal membrane oxygenation (VA ECMO) shows a gap between the rates of successful weaning from the device and actual survival after discharge, prompting an analysis of patient outcomes.
  • A study of 2058 adult patients revealed that 62.7% could be weaned off VA ECMO, but only 39.6% survived to be discharged; major causes of death included multiorgan failure and persistent heart failure, with significant differences in mortality rates during and after ECMO support.
  • Key risk factors for on-ECMO mortality included emergency surgery and preoperative cardiac issues, while postweaning mortality was linked to complications like diabetes and septic shock.
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Aims: Management of patients with atrial fibrillation (AF) and concomitant heart failure (HF) remains complex. The Antwerp score, based on four parameters [QRS >120 ms (2 points), known aetiology (2 points), paroxysmal AF (1 point), severe atrial dilation (1 point)] adequately estimated the probability of left ventricular ejection fraction (LVEF) recovery after AF ablation in a single-centre cohort. The present study aims to externally validate this prediction model in a large European multi-centre cohort.

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Article Synopsis
  • * Out of 32 responding centers, half had dedicated ECLS specialists, and 81.3% utilized additional mechanical circulatory support, but anticoagulation protocols varied widely without consistent guidelines.
  • * Findings indicate a significant diversity in clinical practices for PC-ECLS management, highlighting the need for standardized protocols and better use of existing evidence to improve care.
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Objectives: Postcardiotomy extracorporeal membrane oxygenation (ECMO) can be initiated intraoperatively or postoperatively based on indications, settings, patient profile, and conditions. The topic of implantation timing only recently gained attention from the clinical community. We compare patient characteristics as well as in-hospital and long-term survival between intraoperative and postoperative ECMO.

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Introduction: Brugada syndrome (BrS) has a dynamic ECG pattern that might be revealed by certain conditions such as fever. We evaluated the incidence and management of ventricular arrhythmias (VAs) related to COVID-19 infection and vaccination among BrS patients carriers of an implantable loop recorder (ILR) or implantable cardioverter-defibrillator (ICD) and followed by remote monitoring.

Methods: This was a multicenter retrospective study.

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Article Synopsis
  • * Cardioversion can stop VT but may increase mortality, while antiarrhythmic drugs have side effects and low success rates. Catheter ablation, though effective, is invasive and can be risky for unstable patients.
  • * Stereotactic arrhythmia radioablation is a new, non-invasive treatment option for VT, developed for patients who don't respond to traditional therapies. Early studies show promise in improving outcomes, making it an exciting area
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Article Synopsis
  • Obesity is a significant concern in cardiac surgery, particularly for patients needing postcardiotomy V-A ECMO, but its impact on their outcomes is uncertain.
  • The PELS-1 study analyzed data from 2046 patients across 36 centers over 20 years, categorizing them by BMI and measuring in-hospital mortality and other major adverse events.
  • Findings revealed no significant difference in in-hospital mortality rates among different BMI categories, suggesting BMI should not be used to assess risk in these patients undergoing V-A ECMO.
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The role of subclinical atrial fibrillation as a cause of cryptogenic stroke is unambiguously established. Long-term electrocardiogram (ECG) monitoring remains the sole method for determining its presence following a negative initial workup. This position paper of the European Society of Cardiology Working Group on e-Cardiology first presents the definition, epidemiology, and clinical impact of cryptogenic ischaemic stroke, as well as its aetiopathogenic association with occult atrial fibrillation.

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Atypical Cases of Typical Atrial Flutter? A Case Study.

Card Electrophysiol Clin

September 2022

Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy.

Ablation of typical atrial flutter has a high safety and efficacy profile, but hidden pitfalls may be encountered. In some cases, a longer cycle length with isoelectric lines is associated with a different or more complex arrhythmogenic substrate, which may be missed if conduction block of the cavotricuspid isthmus is performed in the absence of the clinical arrhythmia. Prior surgery may have consistently modified the atrial substrate and complex or multiple arrhythmias associated with an isthmus-dependent circuit can be encountered.

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Mapping and Ablation of Atypical Atrial Flutters.

Card Electrophysiol Clin

September 2022

Department of Heart and Vessels, Ospedale di Circolo - University of Insubria, Viale Borri, 57, Varese 21100, Italy; Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy. Electronic address:

Atypical atrial flutters are complex, hard-to-manage atrial arrhythmias. Catheter ablation has progressively emerged as a successful treatment option with a remarkable role played by irrigated-tip catheters and 3D electroanatomic mapping systems. However, despite the improvement of these technologies, the ablation results may be still suboptimal due to the progressive atrial substrate modification occurring in diseased hearts.

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Pathophysiology of Atypical Atrial Flutters.

Card Electrophysiol Clin

September 2022

Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy; Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy. Electronic address:

Atypical atrial flutters are complex supraventricular arrhythmias that share different pathophysiological aspects in common. In most cases, the arrhythmogenic substrate is essentially embodied by slow-conducting areas eliciting re-entrant circuits. Although atrial scarring seems to promote slow conduction, these arrhythmias may occur even in the absence of structural heart disease.

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