{"id":3398,"date":"2023-06-19T11:45:52","date_gmt":"2023-06-19T09:45:52","guid":{"rendered":"https:\/\/rythmologie.fr\/index\/?p=3398"},"modified":"2023-06-19T11:49:05","modified_gmt":"2023-06-19T09:49:05","slug":"newsletter-juin-2023-magnetic-resonance-imaging-based-dual-cardiac-resynchronization-therapy-a-prospective-left-bundle-branch-pacing-study-madurai-lbbp-study-s-s-ponnusamy-v-ganesan-v-ramali","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/newsletter-juin-2023-magnetic-resonance-imaging-based-dual-cardiac-resynchronization-therapy-a-prospective-left-bundle-branch-pacing-study-madurai-lbbp-study-s-s-ponnusamy-v-ganesan-v-ramali\/","title":{"rendered":" Newsletter Juin 2023 – Magnetic resonance ..."},"content":{"rendered":"

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Newsletter Groupe Rythmologie \u2013 Stimulation cardiaque de la SFC<\/h2><\/div>
Juin 2023<\/div><\/div>[vc_empty_space height=”24px”][vc_separator color=”custom” accent_color=”#e42925″][\/vc_column][\/vc_row][vc_row][vc_column]
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Magnetic resonance imaging based Dual cardiac Resynchronization therapy: A prospectIve Left Bundle Branch Pacing study (MADURAI LBBP study) S.S. PONNUSAMY, V. GANESAN, V. RAMALINGAM et al.<\/h3><\/div>
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Rapport\u00e9 par <\/em>Michel Chauvin Strasbourg<\/em><\/p>\n

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Il s\u2019agit d\u2019une \u00e9tude prospective destin\u00e9e \u00e0 \u00e9valuer la faisabilit\u00e9 et l\u2019efficacit\u00e9 de la stimulation de la branche gauche (LBBP) avec ou sans implantation d\u2019un DAI, chez des patients avec cardiopathie non isch\u00e9mique, FEVG \u2264\u00a035%, relevant d\u2019une indication de resynchronisation, et apr\u00e8s stratification selon le degr\u00e9 de fibrose \u00e0 l\u2019IRM.<\/p>\n

M\u00e9thode\u00a0: <\/u><\/strong><\/h3>\n

L\u2019\u00e9tude est prospective, non randomis\u00e9e, et les patients recrut\u00e9s dans un centre unique. Le recrutement s\u2019est fait de janvier 2019 \u00e0 d\u00e9cembre 2022.<\/p>\n

Les patients enr\u00f4l\u00e9s sont class\u00e9s apr\u00e8s IRM dans l\u2019une des populations suivantes\u00a0selon que le pourcentage de fibrose a \u00e9t\u00e9 constat\u00e9 < ou > \u00e0 10% :<\/p>\n

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  • Groupe I <\/u>: <10% de fibrose: implantation LBBP + PM (soi en mode resynchronization ou CRT d\u00e9nomm\u00e9s LOT-CRT-P dans l\u2019\u00e9tude, soit en mode DDD encore d\u00e9nomm\u00e9s LOT-DDD dans l\u2019\u00e9tude)<\/li>\n
  • \u00a0Groupe II<\/u> : \u226510% de fibrose :\u00a0 implantation LBBP + DAI ( d\u00e9nomm\u00e9s LOT-ICD dans l\u2019\u00e9tude)<\/li>\n<\/ul>\n

    Le suivi a donn\u00e9 lieu \u00e0 des \u00e9chographies habituelles et successives, des hospitalisations pour insuffisance cardiaque, des observations de troubles rythmiques, et de constatations de d\u00e9c\u00e8s.<\/p>\n

    Objectif 1\u00b0<\/u>\u00a0:<\/strong><\/p>\n

    Les points suivants<\/p>\n

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    • Modifications de la FEVG mesur\u00e9es par \u00e9chographie \u00b315% \u00e0 6 mois<\/li>\n
    • Le d\u00e9lai jusqu\u2019au d\u00e9c\u00e8s<\/li>\n
    • Le d\u00e9lai jusqu\u2019\u00e0 la 1\u00e8r\u00e8 hospitalisation<\/li>\n
    • La survenue de TV\/FV<\/li>\n<\/ul>\n

      Objectif 2\u00b0<\/u>\u00a0:<\/strong><\/p>\n

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      • La constatation et le nombre d\u2019hyper-r\u00e9pondeurs<\/li>\n
      • La n\u00e9cessit\u00e9 d\u2019un upgrade vers un DAI<\/li>\n<\/ul>\n

        R\u00e9sultats <\/u><\/strong><\/h3>\n

        Le suivi a \u00e9t\u00e9 de 21 +\/- 12 mois<\/p>\n

        La dur\u00e9e des QRS est pass\u00e9e de 170 +\/- 20 ms \u00e0 117 +\/- 11 ms<\/p>\n

        Objectif 1\u00b0<\/u>\u00a0: Groupe I\u00a0: 68\/85 (80%)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Groupe II\u00a0: 3\/11 (27%)<\/p>\n

        FEVG\u00a0: Groupe I\u00a0: de 30 +\/- 4% \u00e0 50+\/- 12%\u00a0\u00a0\u00a0\u00a0 Groupe II\u00a0:de 27 +\/- 2 \u00e0 42 +\/- 11%<\/p>\n

        \"\"<\/p>\n

        Conclusion<\/u><\/strong><\/h3>\n

        Au vu des r\u00e9sultats de cette \u00e9tude, la resynchronisation guid\u00e9e par IRM semble une m\u00e9thode fiable et efficace.<\/p>\n

        Court commentaire<\/u>\u00a0:<\/strong> \u00e9tude int\u00e9ressante qui demande \u00e0 \u00eatre confirm\u00e9e par d\u2019autres travaux sur le sujet. Les r\u00e9sultats peuvent-ils changer notre fa\u00e7on de s\u00e9lectionner le type d\u2019implantation\u00a0?<\/p>\n

        [\/vc_column_text][vc_empty_space height=”24px”][vc_empty_space height=”24px”][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][vc_empty_space][vc_separator][vc_empty_space][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

        [vc_row][vc_column css=”.vc_custom_1663235123898{margin-top: 0px !important;border-top-width: 0px !important;background-color: rgba(255,255,255,0.1) !important;*background-color: rgb(255,255,255) !important;}”][vc_empty_space height=”24px”][vc_separator color=”custom” accent_color=”#e42925″][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space height=”24px”][vc_column_text] Il s\u2019agit d\u2019une \u00e9tude prospective destin\u00e9e \u00e0 \u00e9valuer la faisabilit\u00e9 et l\u2019efficacit\u00e9 de la stimulation de la branche gauche (LBBP) avec ou sans implantation d\u2019un DAI, chez des patients avec cardiopathie non isch\u00e9mique, FEVG \u2264\u00a035%, relevant d\u2019une indication de resynchronisation, et…<\/p>\n","protected":false},"author":2,"featured_media":3409,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[31,22],"tags":[],"class_list":["post-3398","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter","category-articles","category-31","category-22","description-off"],"_links":{"self":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3398","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/comments?post=3398"}],"version-history":[{"count":6,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3398\/revisions"}],"predecessor-version":[{"id":3408,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3398\/revisions\/3408"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/3409"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=3398"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=3398"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=3398"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}