Prevention of esophageal lesions during atrial fibrillation catheter ablation using esophageal temperature monitoring: A systematic review and meta-analysis.

INTRODUCTION: The use of esophageal temperature monitoring (ETM) for the prevention of esophageal injury during atrial fibrillation (AF) ablation is often advocated. However, evidence supporting its use is scarce and controversial. We therefore aimed to review the evidence assessing the efficacy of ETM for the prevention of esophageal injury. METHODS: We performed a meta-analysis and systematic review of the available literature from inception to December 31, 2022. All studies comparing the use of ETM, versus no ETM, during radiofrequency (RF) AF ablation and which reported the incidence of endoscopically detected esophageal lesions (EDELs) were included. RESULTS: Eleven studies with a total of 1112 patients undergoing RF AF ablation were identified. Of those patients, 627 were assigned to ETM (56%). The overall incidence of EDELs was 9.8%. The use of ETM during AF ablation was associated with a non significant increase in the incidence of EDELs (12.3% with ETM, vs. 6.6 % without ETM, odds ratio, 1.44, 95%CI, 0.49, 4.22, p = .51, I2 = 72%). The use of ETM was associated with a significant increase in the energy delivered specifically on the posterior wall compared to patients without ETM (mean power difference: 5.13 Watts, 95% CI, 1.52, 8.74, p = .005). CONCLUSIONS: The use of ETM does not reduce the incidence of EDELs during RF AF ablation. The higher energy delivered on the posterior wall is likely attributable to a false sense of safety that may explain the lack of benefit of ETM. Further randomized controlled trials are needed to provide conclusive results.

Additional value of cardiac magnetic resonance feature tracking parameters for the evaluation of the arrhythmic risk in patients with mitral valve prolapse.

OBJECTIVES: The identification of patients with mitral valve prolapse (MVP) presenting high arrhythmic risk remains challenging. Cardiovascular Magnetic Resonance (CMR) feature tracking (FT) may improve risk stratification. We analyzed the role of CMR-FT parameters in relation to the incidence of complex ventricular arrhythmias (cVA) in patients with MVP and mitral annular disjunction (MAD). METHODS: 42 patients with MVP and MAD who underwent 1.5 T CMR were classified as MAD-cVA (n = 23, 55%) in case of cVA diagnosed on a 24-h Holter monitoring and as MAD-noVA in the absence of cVA (n = 19, 45%). MAD length, late gadolinium enhancement (LGE), basal segments myocardial extracellular volume (ECV) and CMR-FT were assessed. RESULTS: LGE was more frequent in the MAD-cVA group in comparison with the MAD-noVA group (78% vs 42%, p = 0.002) while no difference was observed in terms of basal ECV. Global longitudinal strain (GLS) was reduced in MAD-cVA compared to MAD-noVA (- 18.2% ± 4.6% vs - 25.1% ± 3.1%, p = 0.004) as well as global circumferential strain (GCS) at the mid-ventricular level (- 17.5% ± 4.7% vs - 21.6% ± 3.1%, p = 0.041). Univariate analysis identified as predictors of the incidence of cVA: GCS, circumferential strain (CS) in the basal and mid infero-lateral wall, GLS, regional longitudinal strain (LS) in the basal and mid-ventricular inferolateral wall. Reduced GLS [Odd ratio (OR):1.56 (confidence interval (CI) 95%: 1.45-2.47; p < 0.001)] and regional LS in the basal inferolateral wall [OR: 1.62 (CI 95%: 1.22-2.13; p < 0.001)] remained independent prognostic factors in multivariate analysis. CONCLUSION: In patients with MVP and MAD, CMR-FT parameters are correlated with the incidence of cVA and may be of interest in arrhythmic risk stratification.

Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort.

AIMS: Stereotactic arrhythmia radioablation (STAR) has been recently introduced for the management of therapy-refractory ventricular tachycardia (VT). VT recurrences have been reported after STAR but the mechanisms remain largely unknown. We analysed recurrences in our patients after STAR. METHODS AND RESULTS: From 09.2017 to 01.2020, 20 patients (68 ± 8 y, LVEF 37 ± 15%) suffering from refractory VT were enrolled, 16/20 with a history of at least one electrical storm. Before STAR, an invasive electroanatomical mapping (Carto3) of the VT substrate was performed. A mean dose of 23 ± 2 Gy was delivered to the planning target volume (PTV). The median ablation volume was 26 mL (range 14-115) and involved the interventricular septum in 75% of patients. During the first 6 months after STAR, VT burden decreased by 92% (median value, from 108 to 10 VT/semester). After a median follow-up of 25 months, 12/20 (60%) developed a recurrence and underwent a redo ablation. VT recurrence was located in the proximity of the treated substrate in nine cases, remote from the PTV in three cases and involved a larger substrate over ≥3 LV segments in two cases. No recurrences occurred inside the PTV. Voltage measurements showed a significant decrease in both bipolar and unipolar signal amplitude after STAR. CONCLUSION: STAR is a new tool available for the treatment of VT, allowing for a significant reduction of VT burden. VT recurrences are common during follow-up, but no recurrences were observed inside the PTV. Local efficacy was supported by a significant decrease in both bipolar and unipolar signal amplitude.

[Cardiology: what's new in 2022]. / Cardiologie : ce qui a changé en 2022.

The year of 2022 was marked by many novelties in the fields of interventional cardiology, heart failure, electrophysiology, cardiac imaging, and congenital heart disease. These advances will certainly change our daily practice, on top of improving the diagnosis and treatment of many heart conditions. In addition, the European Society of Cardiology has updated its guidelines on pulmonary hypertension, ventricular arrhythmias and sudden death, cardiovascular assessment of patients undergoing non-cardiac surgery. The members of the Cardiology division of Lausanne University Hospital (CHUV) here present the publications which they considered to be the most important of the past year.

L'année 2022 a été marquée par de nombreuses nouveautés dans les domaines de la cardiologie interventionnelle, de l'insuffisance cardiaque, de l'électrophysiologie, de l'imagerie cardiaque et des cardiopathies congénitales. Ces progrès vont certainement faire évoluer notre pratique quotidienne, en plus d'améliorer le diagnostic et le traitement de nombreuses cardiopathies. Par ailleurs, la Société européenne de cardiologie a mis à jour ses recommandations portant sur l'hypertension pulmonaire, les arythmies ventriculaires et la mort subite ainsi que le bilan cardiologique avant une chirurgie non cardiaque. Les membres du Service de cardiologie du CHUV vous présentent ici les travaux qui leur ont semblé être les plus importants de l'année écoulée.

Feasibility of adenosine stress cardiovascular magnetic resonance perfusion imaging in patients with MR-conditional transvenous permanent pacemakers and defibrillators.

BACKGROUND: The use of stress perfusion-cardiovascular magnetic resonance (CMR) imaging remains limited in patients with implantable devices. The primary goal of the study was to assess the safety, image quality, and the diagnostic value of stress perfusion-CMR in patients with MR-conditional transvenous permanent pacemakers (PPM) or implantable cardioverter-defibrillators (ICD). METHODS: Consecutive patients with a transvenous PPM or ICD referred for adenosine stress-CMR were enrolled in this single-center longitudinal study. The CMR protocol was performed using a 1.5 T system according to current guidelines while all devices were put in MR-mode. Quality of cine, late-gadolinium-enhancement (LGE), and stress perfusion sequences were assessed. An ischemia burden of ≥ 1.5 segments was considered significant. We assessed the safety, image quality and the occurrence of interference of the magnetic field with the implantable device. In case of ischemia, we also assessed the correlation with the presence of significant coronary lesions on coronary angiography. RESULTS: Among 3743 perfusion-CMR examinations, 66 patients had implantable devices (1.7%). Image quality proved diagnostic in 98% of cases. No device damage or malfunction was reported immediately and at 1 year. Fifty patients were continuously paced during CMR. Heart rate and systolic blood pressure remained unchanged during adenosine stress, while diastolic blood pressure decreased (p = 0.007). Six patients (9%) had an ischemia-positive stress CMR and significant coronary stenoses were confirmed by coronary angiography in all cases. CONCLUSION: Stress perfusion-CMR is safe, allows reliable ischemia detection, and provides good diagnostic value.

Narrow complex tachycardia with discordant 12-lead RP intervals.

We present a case of supraventricular tachycardia (SVT) with discordant RP intervals on 12­lead ECG, rendering the diagnosis initially challenging. However, clues present on the ECG during SVT along with an ECG in sinus rhythm helped to elucidate the mechanism and the underlying diagnosis.

Evaluation and optimization of novel extraction algorithms for the automatic detection of atrial activations recorded within the pulmonary veins during atrial fibrillation.

BACKGROUND AND OBJECTIVE: The automated detection of atrial activations (AAs) recorded from intracardiac electrograms (IEGMs) during atrial fibrillation (AF) is challenging considering their various amplitudes, morphologies and cycle length. Activation time estimation is further complicated by the constant changes in the IEGM active zones in complex and/or fractionated signals. We propose a new method which provides reliable automatic extraction of intracardiac AAs recorded within the pulmonary veins during AF and an accurate estimation of their local activation times. METHODS: First, two recently developed algorithms were evaluated and optimized on 118 recordings of pulmonary vein IEGM taken from 35 patients undergoing ablation of persistent AF. The adaptive mathematical morphology algorithm (AMM) uses an adaptive structuring element to extract AAs based on their morphological features. The relative-energy algorithm (Rel-En) uses short- and long-term energies to enhance and detect the AAs in the IEGM signals. Second, following the AA extraction, the signal amplitude was weighted using statistics of the AA sequences in order to reduce over- and undersensing of the algorithms. The detection capacity of our algorithms was compared with manually annotated activations and with two previously developed algorithms based on the Teager-Kaiser energy operator and the AF cycle length iteration, respectively. Finally, a method based on the barycenter was developed to reduce artificial variations in the activation annotations of complex IEGM signals. RESULTS: The best detection was achieved using Rel-En, yielding a false negative rate of 0.76% and a false positive rate of only 0.12% (total error rate 0.88%) against expert annotation. The post-processing further reduced the total error rate of the Rel-En algorithm by 70% (yielding to a final total error rate of 0.28%). CONCLUSION: The proposed method shows reliable detection and robust temporal annotation of AAs recorded within pulmonary veins in AF. The method has low computational cost and high robustness for automatic detection of AAs, which makes it a suitable approach for online use in a procedural context.

[Epicardial adipose tissue and atrial fibrillation]. / Tissu adipeux épicardique et fibrillation auriculaire.

Atrial fibrillation (AF) is the most common arrhythmia encountered in adults; it is associated with a significant morbidity and mortality. Obesity is a risk factor contributing to AF occurrence. Recently, interest has focused on epicardial adipose tissue (EAT), defined as a fatty deposit located between the epicardium and the visceral pericardium. Its characteristics are distinct from classic adipose deposits: it infiltrates the epicardial myocardium and secretes cytokines, which modulate cardiomyocyte electrophysiology and cardiac remodeling. Different studies show that EAT can be an independent risk factor for AF and that EAT thickness, as measured by CT or MRI, could predict the presence, severity and recurrence of AF.

La fibrillation auriculaire (FA) est l'arythmie la plus fréquemment rencontrée chez l'adulte ; elle est associée à une morbi-mortalité importante. L'obésité est un facteur de risque contribuant à sa survenue. Récemment, l'intérêt s'est porté sur le tissu adipeux épicardique (TAE), défini comme un dépôt adipeux situé entre l'épicarde et le péricarde viscéral. Ses caractéristiques sont distinctes des dépôts adipeux classiques : il infiltre le myocarde épicardique et sécrète des cytokines modulant l'électrophysiologie des cardiomyocytes et provoquant un remodelage fibro-adipeux cardiaque. Différentes études montrent que le TAE peut être un facteur de risque indépendant de survenue de FA. L'épaisseur du TAE mesurée par CT-scan ou par IRM pourrait être utilisée comme facteur prédictif de la présence, de la gravité et de la récidive de FA.

[Cardiology]. / Cardiologie.

Significant advances have been made in 2021 in the areas of interventional cardiology, heart failure, cardiac imaging, electrophysiology and congenital heart disease. In addition to improving the screening, diagnosis and management of many heart diseases, these advances will change our daily practice. Moreover, the European Society of Cardiology has updated its guidelines on heart failure, valve disease, cardiac pacing and cardiovascular disease prevention. As in previous years, members of the Cardiology division of Lausanne University Hospital (CHUV) came together to select and present to you the papers that they considered to be the most important of the past year.

De nombreux progrès ont été réalisés en 2021 dans les domaines de la cardiologie interventionnelle, de l'insuffisance cardiaque, de l'imagerie cardiaque, de l'électrophysiologie et des cardiopathies congénitales. En plus d'améliorer le dépistage, le diagnostic et la prise en charge de nombreuses cardiopathies, ces avancées vont faire évoluer notre pratique quotidienne. Par ailleurs, la Société européenne de cardiologie a mis à jour ses recommandations portant sur l'insuffisance cardiaque, les valvulopathies, la stimulation cardiaque et la prévention des maladies cardiovasculaires. Comme les années précédentes, les membres du Service de cardiologie du CHUV se sont réunis pour sélectionner et vous présenter les travaux qui leur ont semblé être les plus importants de l'année écoulée.

Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse.

OBJECTIVES: We aimed to evaluate the relationship between mitral annular disjunction (MAD) severity and myocardial interstitial fibrosis at the left ventricular (LV) base in patients with mitral valve prolapse (MVP), and to assess the association between severity of interstitial fibrosis and the occurrence of ventricular arrhythmic events. BACKGROUND: In MVP, MAD has been associated with myocardial replacement fibrosis and arrhythmia, but the importance of interstitial fibrosis remains unknown. METHODS: In this retrospective study, 30 patients with MVP and MAD (MVP-MAD) underwent cardiovascular magnetic resonance (CMR) with assessment of MAD length, late gadolinium enhancement (LGE), and basal segments myocardial extracellular volume (ECVsyn). The control group included 14 patients with mitral regurgitation (MR) but no MAD (MR-NoMAD) and 10 patients with normal CMR (NoMR-NoMAD). Fifteen MVP-MAD patients underwent 24 h-Holter monitoring. RESULTS: LGE was observed in 47% of MVP-MAD patients and was absent in all controls. ECVsyn was higher in MVP-MAD (30 ± 3% vs 24 ± 3% MR-NoMAD, p < 0.001 and vs 24 ± 2% NoMR-NoMAD, p < 0.001), even in MVP-MAD patients without LGE (29 ± 3% vs 24 ± 3%, p < 0.001 and vs 24 ± 2%, p < 0.001, respectively). MAD length correlated with ECVsyn (rho = 0.61, p < 0.001), but not with LGE extent. Four patients had history of out-of-hospital cardiac arrest; LGE and ECVsyn were equally performant to identify those high-risk patients, area under the receiver operating characteristic (ROC) curve 0.81 vs 0.83, p = 0.84). Among patients with Holter, 87% had complex ventricular arrhythmia. ECVsyn was above the cut-off value in all while only 53% had LGE. CONCLUSION: Increase in ECVsyn, a marker of interstitial fibrosis, occurs in MVP-MAD even in the absence of LGE, and was correlated with MAD length and increased risk of out-of-hospital cardiac arrest. ECV should be includedin the CMR examination of MVP patients in an effort to better assess fibrous remodelling as it may provide additional value beyond the assessment of LGE in the arrhythmic risk stratification.

[Mitral valve prolapse: beyond mitral regurgitation, the arrhythmic risk]. / Prolapsus mitral : une étiologie méconnue d'arythmie ventriculaire et de mort subite.

Mitral prolapse is a common condition, defined by the systolic bulging of at least one mitral leaflet into the left atrium, which is often accompanied by various degree of mitral insufficiency. While for most of the patients the prognosis is linked to the severity of the valve regurgitation and its repercussions on the left ventricle (dilation and/or dysfunction), a minority of patients present with severe ventricular arrhythmia and an increased risk of sudden cardiac death, irrespective of the severity of the mitral regurgitation. To describe this particular condition, the terms arrhythmic or malignant mitral valve prolapse have been coined. The aim of this article is to describe the clinical, electrocardiographic and morphologic characteristics, which have been associated with an increased risk of arrhythmia in patients with mitral prolapse.

Le prolapsus mitral est une pathologie fréquente, définie par le bombement en systole d'au moins un feuillet mitral dans l'oreillette gauche, qui s'accompagne fréquemment d'un degré variable d'insuffisance mitrale. Dans la majorité des cas, le pronostic est lié à la sévérité de l'insuffisance valvulaire et ses répercussions sur le ventricule gauche (dilatation et/ou dysfonction). Toutefois, dans certaines formes, le prolapsus mitral se manifeste par une susceptibilité aux arythmies ventriculaires et s'associe à un risque accru de mort subite, indépendamment de la présence ou de la sévérité de l'insuffisance valvulaire. On parle alors de syndrome du prolapsus mitral arythmique ou prolapsus mitral malin. Cet article décrit les caractéristiques cliniques, électrocardiographiques et morphologiques associées au risque arythmique chez les patients atteints d'un prolapsus mitral.

[Cardiology]. / Cardiologie.

In 2020, new guidelines have been published by the European Society of Cardiology including those on non-ST-segment elevation acute coronary syndromes, atrial fibrillation and adult congenital heart disease. Regarding interventional cardiology, POPular TAVI opens the possibility of anti-platelet monotherapy after transcutaneous aortic valve replacement. EMPEROR-Reduced confirms the importance of SGLT2 inhibitors in the treatment of heart failure with reduced ejection fraction. Within the field of imaging, stress MRI has now become the first-line technique for the screening of coronary artery disease, demonstrating an excellent cost-benefit ratio. Finally, renin-angiotensin-aldosterone inhibitors do not appear to increase the risk of an infection by COVID-19.

L'année 2020 a été marquée par la publication de nouvelles guidelines de la Société européenne de cardiologie dont le syndrome coronarien aigu sans élévation du segment ST, la fibrillation auriculaire et les cardiopathies congénitales à l'âge adulte. En interventionnel, POPular TAVI permet d'envisager la monothérapie antithrombotique après remplacement de la valve aortique par voie transcutanée. EMPEROR-Reduced confirme l'importance des inhibiteurs du cotransporteur sodium-glucose de type 2 dans le traitement de l'insuffisance cardiaque à fraction d'éjection réduite. En imagerie, l'IRM de stress s'impose comme examen de choix pour le dépistage de la maladie coronarienne avec un rapport coût-bénéfice favorable. Enfin, les inhibiteurs du système rénine-angiotensine-aldostérone ne semblent pas augmenter le risque d'une infection au Covid-19.

Interatrial septum dissection and atrial wall hematoma following transseptal puncture: A systematic review of the literature.

BACKGROUND: Interatrial septum (IAS) dissection due to transseptal puncture (TSP) is a rare, underreported complication of the procedure. Data on the mechanism, diagnosis, and management of this complication are lacking. METHODS: We conducted a systematic review of all reported cases of IAS dissection with or without associated LA hematoma due to TSP, by thoroughly searching MEDLINE and EMBASE through May 2019. RESULTS: After screening of n = 882 studies, eight studies with a total of 19 patients addressed the complication of IAS dissection and/or LA hematoma secondary to TSP. Median age was 63 years with a 1:1 male to female ratio. Ablation of atrial fibrillation was the most frequently reported procedure (84%). Diagnosis was established using fluoroscopy with contrast injection (58%), TEE (32%) or intracardiac echocardiography (5%). The mechanism identified involved puncture of the septum secundum portion of the IAS, leading to transient needle passage into the extracardiac space. In the majority of patients, the hematoma remained localized in the IAS and management was conservative with progressive resolution of the hematoma during follow-up (95%). Two patients (11%) required further intervention by either pericardiocentesis or surgical drainage due to hemodynamic instability. CONCLUSIONS: IAS dissection with or without hematoma after TSP remains an underdiagnosed entity. The main mechanism involves lesion to the septum secundum portion of the IAS, resulting in needle passage into the extracardiac space and local bleeding. Although conservative management may be sufficient in the majority of cases, interventional cardiologists should be familiar with this complication and its diagnosis.

The 'double transition': a novel electrocardiogram sign to discriminate posteroseptal accessory pathways ablated from the right endocardium from those requiring a left-sided or epicardial coronary venous approach.

AIMS: The precise localization of manifest posteroseptal accessory pathways (APs) often poses diagnostic challenges considering that a small area may encompass AP that may be ablated from the right or left endocardium, or epicardially within the coronary sinus (CS). We sought to explore whether the QRS transition pattern in the precordial lead may help to discriminate the necessary ablation approach. METHODS AND RESULTS: Consecutive patients who underwent a successful ablation of a single manifest AP over a 5-year period were included. Standard 12-lead electrocardiograms were reviewed. A total of 273 patients were identified. Mean age was 31 ± 15 years and 62% were male. Of the 110 identified posteroseptal AP, 64 were ablated from the right endocardium, 33 from the left endocardium, and 13 inside the CS. While a normal precordial QRS transition was most often observed, a subset of 33 patients presented an atypical 'double transition' pattern which specifically identified right endocardial AP. The combination of a q wave in V1 with a proportion of the positive QRS component in V1 < V2 > V3, predicted a right endocardial AP with a 100% specificity. In case of a positive QRS sum in V2, this 'double transition' pattern predicted a posteroseptal right endocardial AP with 99.5% specificity and 44% sensitivity. The positive predictive value was 97%. The only false positive was a midseptal AP. In the case of a negative or isoelectric QRS sum in V2, APs were located more laterally on the tricuspid annulus. CONCLUSION: The combination of a q wave in V1 with a double QRS transition pattern in the precordial leads is highly specific of a right endocardial AP and rules out the need for CS or left-sided mapping.

[Sinus node dysfunction, Brugada syndrome and long QT syndrome affecting the same patient†: when genetics can't make head or tail of it]. / Dysfonction sinusale, syndrome de Brugada et syndrome du QT long chez un même patient - Quand la génétique y perd son latin.

The gene SCN5A encodes the cardiac sodium channel which, through the conduction of Na+ current into the cell, generates the fast upstroke of the action potential of cardiomyocytes. Pathogenic variants of SCN5A have been causally associated to several hereditary cardiac diseases including, among others, Brugada syndrome, congenital long QT syndrome and sinus node dysfunction. Recently, overlap syndromes have been described that are characterized by the simultaneous expression of mixed clinical phenotypes among two or more hereditary cardiac diseases associated to the gene SCN5A (HCD-SCN5A). For this reason, it is time to rethink about HCD-SCN5A as different expressions of the same complex spectrum encompassing multiple clinical phenotypes with pronounced overlaps instead of as distinct clinical entities.

Le gène SCN5A code pour le canal sodique cardiaque qui est responsable de la pente de dépolarisation rapide du potentiel d'action. Plusieurs cardiopathies héréditaires (CH) ont été associées à des variants pathogènes du gène SCN5A incluant, entre autres, le syndrome de Brugada, le syndrome du QT long congénital et la dysfonction sinusale. Récemment, des syndromes de chevauchement ont été également décrits, s'exprimant, chez un même patient, par un phénotype clinique mixte comprenant une combinaison des manifestations rapportées ci-dessus. Dans ce contexte, nous devrions donc reconsidérer cliniquement les CH impliquant le gène SCN5A comme des expressions différentes d'un même éventail de phénotypes cliniques avec chevauchements marqués plutôt que comme des entités cliniques distinctes et isolées.

[Cardiology]. / Cardiologie.

In 2019, the guidelines on the new entity « chronic coronary syndrome ¼ have been published. They influence importantly the work-up and treatment of patients with stable coronary artery disease. We will also report on publications showing the benefit of percutaneous aortic valve implantation (TAVI) in patients with aortic stenosis and low risk surgical risk. With regard to infectious endocarditis, we elucidate the importance of the vegetation's size for predicting mortality and the prognostic value of the positron emission tomography in predicting septic embolism. We highlight the spectacular results of the DAPA-HF study in patients with heart failure and review publications showing the important role of the detection of myocardial fibrosis and scar by cardiac MRI for risk stratification of sudden cardiac death.

L'année 2019 a été marquée par la publication de recommandations sur une nouvelle entité, appelée « syndrome coronarien chronique ¼, qui modifient de manière importante la prise en charge et le traitement des patients avec une maladie coronarienne stable. On relève plusieurs publications démontrant, chez les patients ayant une sténose aortique, et étant à bas risque chirurgical, le bénéfice d'un traitement percutané par rapport à un traitement chirurgical. La prise en charge de l'endocardite a été challengée par deux publications montrant que la taille de la végétation est un facteur de risque de mortalité et la valeur pronostique de la tomographie par émission de positons dans la survenue d'emboles septiques. Nous discutons les résultats spectaculaires de l'étude DAPA-HF dans le domaine d'insuffisance cardiaque et plusieurs études montrant l'intérêt de la recherche de cicatrice myocardique à l'IRM cardiaque dans la stratification du risque de mort subite.

[Management of refractory ventricular tachycardia using stereotactic body radiotherapy]. / Prise en charge des tachycardies ventriculaires réfractaires par radiothérapie stéréotaxique.

Stereotactic body radiotherapy (SBRT) is routinely used in oncology to treat non-invasively solid tumors with high precision and efficacy. Recently, this technology has been evaluated in the treatment of ventricular tachycardia (VT). This article presents the basic underlying principles, proofs of concept and main results of clinical studies that used SBRT for the treatment of VT.

La radiothérapie stéréotaxique (SBRT) est une technologie couramment utilisée en oncologie pour traiter de façon non invasive les tumeurs solides avec précision et efficacité. Récemment, cette technologie a été évaluée dans le traitement des tachycardies ventriculaires (TV). Cet article présente les principes de base sous-jacents, le concept ainsi que les résultats des premières études cliniques ayant traité avec succès des patients souffrant de TV avec la SBRT.

[The year in cardiology : 2018]. / Cardiologie.

This review article provides a broad overview of the novelties in cardiology in 2018. Advances in interventional cardiology and cardiovascular prevention, heart failure, electrophysiology and non-invasive cardiovascular imaging have provided important new insights in the pathophysiology, diagnosis and treatment of ischemic and valvular heart disease, heart failure, rhythm disorders and cardiomyopathies. This article provides an overview of the most relevant articles published in 2018.

L'année 2018 a été riche en nouveautés dans les domaines de la cardiologie interventionnelle, de l'insuffisance cardiaque, de l'électrophysiologie et de l'imagerie cardiaque. Les progrès dans ces domaines respectifs ont fourni de nouveaux outils pour le diagnostic et le traitement des cardiopathies ischémiques et valvulaires, de l'insuffisance cardiaque à fraction d'éjection réduite ou préservée, des troubles du rythme et des cardiomyopathies. Cet article fournit un aperçu des articles les plus pertinents publiés en 2018.