Publications by authors named "Philippe Chevalier"

Background: Defibrillation testing (DT) remains recommended during subcutaneous implantable cardioverter defibrillator (S-ICD) implantation due to limited supporting evidence.

Objectives: The objective of this study was to evaluate the long-term impact of DT during S-ICD implantation.

Methods: The HONEST (coHOrte fraNcaise des dEfibrillateurs Sous cuTanés) study is a nationwide, ongoing observational study, including all S-ICD recipients in France (2012-2019).

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Importance: Historical restrictions on children with inherited cardiac arrhythmia or cardiomyopathy have been implemented to mitigate the potential risk of sudden death, but these limitations can be detrimental to overall health and cardiopulmonary fitness.

Objectives: To evaluate cardiopulmonary fitness and physical activity among children with inherited cardiac disease and identify the factors associated with maximum oxygen uptake (V̇o2max) in this population.

Design, Setting, And Participants: This cross-sectional, multicenter, prospective controlled study was conducted in 7 tertiary care expert centers for inherited cardiac disease in France from February 1, 2021, to June 20, 2023, with a 2-week follow-up.

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The nuclear envelope (NE), a protective membrane bordering the nucleus, is composed of highly specialized proteins that are indispensable for normal cellular activity. Lamina-associated polypeptide 1 (LAP1) is a NE protein whose functions are just beginning to be unveiled. The fact that mutations causing LAP1 deficiency are extremely rare and pathogenic is indicative of its paramount importance to preserving human health, anticipating that LAP1 might have a multifaceted role in the cell.

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The placement of cardiovascular implantable electronic devices (CIED) comes with a risk of adverse events (AE). AE comprise complications associated with the procedure and the device. CIED infection is a severe AE.

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Introduction: Infection is a significant complication of cardiac implantable electronic device (CIED) therapy. The European TauroPace™ Registry investigates the safety and efficacy of TauroPace™ (TP), an antimicrobial solution containing taurolidine, designed to prevent CIED infections.

Methods: This multicenter study included patients undergoing CIED procedures at participating centers where TP was used as a disinfectant for external hardware surfaces and an antiseptic for irrigating surgical sites.

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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.

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Article Synopsis
  • - LAP1 is a nuclear envelope protein crucial for cell homeostasis, with mutations in its gene linked to severe diseases and early mortality, yet its specific functions in humans remain underexplored.
  • - This study analyzed the proteome of fibroblasts with a pathogenic LAP1 mutation (LAP1 E482A) to identify global changes in protein levels compared to normal fibroblasts, and conducted functional assays to determine disrupted biological processes.
  • - The findings indicate that LAP1 deficiency affects various cellular functions, including DNA repair and protein metabolism, potentially illuminating new roles for LAP1 and suggesting targets for future therapies for related diseases.
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Background: Idiopathic ventricular fibrillation (IVF) can be associated with undetected distinct conditions such as microstructural cardiomyopathic alterations (MiCM) or Purkinje (Purk) activities with structurally normal hearts.

Objectives: This study sought to evaluate the characteristics of recurrent VF recorded on implantable defibrillator electrograms, associated with these substrates.

Methods: This was a multicenter collaboration study.

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Article Synopsis
  • There is limited understanding of how idiopathic ventricular fibrillation (IVF) starts, but previous research suggests that it usually doesn't depend on pauses in heart rhythm.
  • The study aimed to investigate the initiation patterns of polymorphic ventricular tachycardia (PVT) in IVF patients, analyzing a total of 410 arrhythmia episodes among 180 patients.
  • Results showed that about 27.2% of PVT episodes were pause-dependent, with the majority occurring during normal heart rhythms and initiating PVCs mostly having short coupling intervals (under 350 ms).
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Sudden cardiac death (SCD) is a major public health issue worldwide. In the young (< 40 years of age), genetic cardiomyopathies and viral myocarditis, sometimes in combination, are the most frequent, but underestimated, causes of SCD. Molecular autopsy is essential for prevention.

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Background: Electrocardiographic screening before subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is unsuccessful in around 10% of cases. A personalized screening method, by slightly moving the electrodes, to obtain a better R/T ratio has been described to overcome traditional screening failure.

Objective: The objectives of the SIS study were to assess to what extent a personalized screening method improves eligibility for S-ICD implantation and to evaluate the inappropriate shock rate after such screening success.

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  • A study was conducted to assess how well two wearable ECG devices, the Apple Watch and KardiaMobile 6L, can accurately measure important heart metrics in patients with congenital long QT syndrome (LQTS).* -
  • Researchers compared these wearable devices' readings to a standard 12-lead ECG in 98 patients and found that both devices offered moderate to strong correlations, especially in measuring the corrected QT interval and analyzing ST-T wave patterns.* -
  • While the wearable devices showed promise as additional monitoring tools, they are not a substitute for traditional 12-lead ECG tests in managing patients with LQTS.*
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  • The study identifies a novel homozygous missense variant (p.Gly603Ser) in the KCNH2 gene linked to severe long-QT syndrome (LQTS) in a family context.
  • The research employs functional analysis using Xenopus oocytes to compare the effects of this variant with the wild-type version of the gene, revealing significant differences in electrical properties.
  • The findings suggest that while this variant leads to severe yet survivable LQTS in homozygous individuals, it causes a milder Type 2 LQTS in heterozygous carriers, marking a unique discovery in the genetic understanding of heart rhythm disorders.
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  • The study investigates the prevalence and effects of pathogenic variants in a specific gene related to cardiomyopathy and sudden cardiac death among patients.
  • Out of 9,516 tested individuals, 31 were found to carry pathogenic variants, mostly presenting with dilated cardiomyopathy, with some also experiencing severe cardiac issues.
  • Although the overall prognosis for dilated cardiomyopathy in variant carriers seems favorable, severe conditions and early onset were noted, especially in those with double variants.
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  • The diagnosis of left ventricular hypertrophy (LVH) through ECG primarily relies on measuring the QRS voltage, but this method often lacks sensitivity.
  • A new approach emphasizes the understanding of electrical properties of the heart muscle and factors influencing QRS voltage beyond just size, including both spatial and non-spatial determinants.
  • This perspective reveals a wide variety of QRS patterns in LVH patients, indicating that a normal QRS complex can still exist despite underlying complications, and highlights the importance of interpreting these changes for assessing cardiovascular risk.
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Background: Cardiac implantable electronic device (CIED) placement comes with certain complications. CIED infection is a severe adverse event related to CIED placement. In randomised controlled trials, the preoperative intravenous administration of antibiotics and the adjunctive use of an antibiotic mesh envelope resulted in significant reduction in infections related to cardiac implantable electronic devices.

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Article Synopsis
  • The diagnosis of Left Ventricular Hypertrophy (LVH) using ECG mainly relies on measuring the increased amplitude of the QRS complex in specific leads.
  • The traditional understanding suggests that a larger left ventricular mass produces a stronger electrical field, leading to heightened QRS forces and amplitudes.
  • However, studies show that only a small percentage of LVH patients actually exhibit this increased QRS amplitude, indicating that the current voltage criteria have low sensitivity, prompting a discussion on potential reasons and the introduction of a new diagnostic approach.
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In the early nineties, few years before the birth of Europace, the clinical and scientific world of familial arrhythmogenic conditions was revolutionized by the identification of the first disease-causing genes. The explosion of genetic studies over a 15-year period led to the discovery of major disease-causing genes in practically all channelopathies and cardiomyopathies, bringing insight into the pathophysiological mechanisms of these conditions. The birth of next generation sequencing allowed a further step forward and other significant genes, as CALM1-3 in channelopathies and FLN C and TTN in cardiomyopathies were identified.

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A 28-year-old female patient diagnosed with Ehlers-Danlos syndrome type III (hypermobile EDS, hEDS) was admitted to the cardiology clinic due to a 3-year history of symptomatic ventricular arrhythmia in the form of multiple premature ventricular contractions (PVCs). Attempts at antiarrhythmic treatment with beta-blockers, propafenone, and verapamil were unsuccessful. Due to the diagnosis of hEDS and the high risk of vascular complications related to the ablation procedure, invasive treatment was abandoned, and it was decided to implement flecainide.

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The rhythmical nature of the cardiovascular system constantly generates dynamic mechanical forces. At the centre of this system is the heart, which must detect these changes and adjust its performance accordingly. Mechanoelectric feedback provides a rapid mechanism for detecting even subtle changes in the mechanical environment and transducing these signals into electrical responses, which can adjust a variety of cardiac parameters such as heart rate and contractility.

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