{"id":3459,"date":"2023-06-19T13:03:41","date_gmt":"2023-06-19T11:03:41","guid":{"rendered":"https:\/\/rythmologie.fr\/index\/?p=3459"},"modified":"2023-06-19T13:03:52","modified_gmt":"2023-06-19T11:03:52","slug":"newsletter-juin-2023-cardioversion","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/newsletter-juin-2023-cardioversion\/","title":{"rendered":"Newsletter Juin 2023 &#8211; CARDIOVERSION"},"content":{"rendered":"<p>[vc_row][vc_column css=&#8221;.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;}&#8221;]<div id=\"ultimate-heading-46886a14f1abe7aba\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-46886a14f1abe7aba uvc-4610  uvc-heading-default-font-sizes\" data-hspacer=\"no_spacer\"  data-halign=\"center\" style=\"text-align:center\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-46886a14f1abe7aba h2'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}' ><h2 style=\"--font-weight:theme;margin-top:20px;margin-bottom:20px;\">Newsletter Groupe Rythmologie \u2013 Stimulation cardiaque de la SFC<\/h2><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-46886a14f1abe7aba .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;margin-top:20px;margin-bottom:20px;\">Juin 2023<\/div><\/div>[vc_empty_space height=&#8221;24px&#8221;][vc_separator color=&#8221;custom&#8221; accent_color=&#8221;#e42925&#8243;][\/vc_column][\/vc_row][vc_row][vc_column]<div id=\"ultimate-heading-82336a14f1abe7b17\" class=\"uvc-heading ult-adjust-bottom-margin ultimate-heading-82336a14f1abe7b17 uvc-9355 \" data-hspacer=\"no_spacer\"  data-halign=\"left\" style=\"text-align:left\"><div class=\"uvc-heading-spacer no_spacer\" style=\"top\"><\/div><div class=\"uvc-main-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-82336a14f1abe7b17 h3'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"desktop:24px;\"}' ><h3 style=\"--font-weight:theme;color:#e42925;margin-top:24px;margin-bottom:24px;\">CARDIOVERSION Low Energy Multi-Pulse Therapy for Cardioversion of AF in Humans By: Prash Sanders<\/h3><\/div><div class=\"uvc-sub-heading ult-responsive\"  data-ultimate-target='.uvc-heading.ultimate-heading-82336a14f1abe7b17 .uvc-sub-heading '  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:normal;color:#000000;margin-top:24px;margin-bottom:24px;\"><\/p>\n<div class=\"page\" title=\"Page 2\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 4\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 4\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 7\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"font-weight: 400;\"><em>Rapport\u00e9 par <\/em><em>Frederic Sacher &#8211; Bordeaux<\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><\/div><\/div>[vc_empty_space height=&#8221;24px&#8221;][vc_column_text]<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\"><strong>But de l\u2019\u00e9tude :<\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">Evaluer la faisabilit\u00e9 et la s\u00e9curit\u00e9 d\u2019un sch\u00e9ma d\u2019impulsion multiples \u00e0 faible \u00e9nergie pour ramener le rythme sinusal chez des patients en FA.<\/p>\n<p style=\"font-weight: 400;\">Ces impulsions sont des micro chocs cens\u00e9s \u00eatre d\u00e9livr\u00e9s \u00e0 des \u00e9nergies inf\u00e9rieures au seuil douloureux.<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\"><strong>Design de l\u2019\u00e9tude\u00a0:<\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">Etude de faisabilit\u00e9 prospective multicentrique randomis\u00e9e dans laquelle chaque patient est son contr\u00f4le.<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\"><strong>Crit\u00e8res d\u2019\u00e9valuation<\/strong>\u00a0: <\/span><\/h3>\n<p style=\"font-weight: 400;\">Taux de retour en rythme sinusal.<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\"><strong>Crit\u00e8res d\u2019inclusion\u00a0: <\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">Patients adress\u00e9s pour ablation de FA paroxystique ou persistante &lt;3 mois.<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\"><strong>M\u00e9thode et R\u00e9sultats : <\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">Placement de 2 sondes\u00a0: une dans le sinus coronaire assez distale et une dans le septum \u00e0 droite pour d\u00e9livrer les chocs entre ces sondes. Une fois les sondes plac\u00e9es, une FA est induite si le patient n\u2019est pas en FA. Les th\u00e9rapies ou la p\u00e9riode \u00ab\u00a0contr\u00f4le\u00a0\u00bb sont ensuite enchain\u00e9es, si la FA dure plus de 2 minutes, en fonction de la randomisation\u00a0: 2 s\u00e9quences d\u2019impulsions multiples (IM) et 1 de contr\u00f4le (C) (IM-C-IM ou IM-IM-C ou C-IM-IM). Ces s\u00e9quences \u00e9taient r\u00e9p\u00e9t\u00e9es.<\/p>\n<p style=\"font-weight: 400;\">29 patients (77% FA paroxystique) ont \u00e9t\u00e9 inclus. Au total, 149 s\u00e9quences d\u2019impulsions multiples ont \u00e9t\u00e9 d\u00e9livr\u00e9es et ont permis un retour en rythme sinusal dans 57% des cas. Dans le bras contr\u00f4le (2 minutes de surveillance), il y a eu retour en rythme sinusal dans 38% des cas. Les complications ont \u00e9t\u00e9 un \u00e9pisode d\u2019infection apr\u00e8s la proc\u00e9dure, un \u00e9pisode d\u2019hypotension et 4 FA induites par les impulsions multiples. Il n\u2019y a pas eu d\u2019induction de fibrillation ventriculaire. Il n\u2019a pas \u00e9t\u00e9 possible d\u2019identifier une douleur \u00e9ventuelle car les proc\u00e9dures \u00e9taient des ablations de FA sous anesth\u00e9sie g\u00e9n\u00e9rale.<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"text-decoration: underline;\"><strong>Discussion :<\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">Il s\u2019agit du retour du concept de d\u00e9fibrillateur atrial. Avant qu\u2019il puisse y avoir une \u00e9ventuelle utilisation en clinique, il sera probablement n\u00e9cessaire d\u2019optimiser le sch\u00e9ma d\u2019impulsion, de s\u2019assurer de l\u2019absence de douleur et surtout de l\u2019absence de risque de d\u00e9clencher une fibrillation ventriculaire.<\/p>\n<p style=\"font-weight: 400;\">La m\u00eame technologie a \u00e9t\u00e9 \u00e9tudi\u00e9e sur le ventricule pour arr\u00eater les TV. Elle a \u00e9t\u00e9 pr\u00e9sent\u00e9e lors d\u2019une autre session (LB-456640-2) par V Tholakanahalli.<\/p>\n<p>[\/vc_column_text][vc_empty_space height=&#8221;24px&#8221;][vc_empty_space height=&#8221;24px&#8221;][\/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":"<p>[vc_row][vc_column css=&#8221;.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;}&#8221;][vc_empty_space height=&#8221;24px&#8221;][vc_separator color=&#8221;custom&#8221; accent_color=&#8221;#e42925&#8243;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space height=&#8221;24px&#8221;][vc_column_text] But de l\u2019\u00e9tude : Evaluer la faisabilit\u00e9 et la s\u00e9curit\u00e9 d\u2019un sch\u00e9ma d\u2019impulsion multiples \u00e0 faible \u00e9nergie pour ramener le rythme sinusal chez des patients en FA. Ces impulsions sont des micro chocs cens\u00e9s \u00eatre d\u00e9livr\u00e9s \u00e0 des \u00e9nergies inf\u00e9rieures au&hellip;<\/p>\n","protected":false},"author":2,"featured_media":3460,"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-3459","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\/3459","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=3459"}],"version-history":[{"count":2,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3459\/revisions"}],"predecessor-version":[{"id":3462,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/3459\/revisions\/3462"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/3460"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=3459"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=3459"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=3459"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}