Biomedical subjects

G Derumeaux

Publications and source records attributed to G Derumeaux.

57 records · Page 4Linked to original sources

PubMed1991

The role of catheter ablation techniques in the treatment of classic (type 1) atrial flutter.

Several attempts at circuit interruption of type 1 atrial flutter by means of surgical or catheter techniques have been published. We recently reported the results of a series of patients who underwent catheter fulguration of the low septal right atrium, with a mean follow-up of almost 3 years. True electrophysiological success was observed in 7/14 patients (50%). Clinical success, defined as absence of symptoms, was observed in 8 was observed in 8/14 (57%) in this patient population. No serious complications were encountered, but the potential risks of DC shock, and the experience that we gained in right atrial mapping using this approach, led us to reconsider the role of atrial DC ablation in these patients. Additional studies assessing the meaning of fragmented electrograms, and identification of one (or of several) slow conduction areas of the reentrant circuit are ongoing.

Atrial Flutter↗

PubMed1991

[Contribution of the continuity equation for the assessment of mitral valve area in mitral stenosis].

The aim of this study was to evaluate the continuity equation in the quantification of mitral valve area in mitral stenosis, the area being considered as the product of the area of the left ventricular outflow tract multiplied by the ratio of the velocity time integrals of the aortic or pulmonary flow to that mitral flow. The continuity equation was compared to two other echocardiographic methods, planimetry and Hatle's method, and to the results obtained at catheterization using the Gorlin formula in a population of 44 patients with mitral stenosis. All were in sinus rhythm; twelve had Grade I mitral regurgitation and 9 patients had Grade I aortic regurgitation. Excellent correlation were observed between the values obtained by the continuity equation and planimetry (r = 0.91; SEE = 0.19 cm2; p less than 0.001) and Hatle's method (r = 0.87; SEE = 0.20 cm2, p less than 0.001). The correlation with the catheter values were also excellent (r = 0.83; SD = 0.22 cm2, p less than 0.001), better than those observed with Hatle's method (r = 0.73; SEE = 0.27 cm2, p less than 0.001) and very similar to those obtained with planimetry (r = 0.87; SEE = 0.23 cm2, p less than 0.001). The sensibility and specificity of the continuity equation for the diagnosis of severe mitral stenosis (surface less than 1.5 cm2) were 90% and 100% respectively, when those of Hatle's method were 88% and 91% respectively. The continuity equation in the evaluation of mitral valve area in mitral stenosis seems to be reliable and accurate compared with catheter data, and superior to Hatle's method.

Echocardiography, Doppler↗

PubMedDate not supplied

[Study of combined anticoagulant (fluindione)-aspirin therapy in patients with atrial fibrillation at high risk for thromboembolic complications. A randomized trial (FFAACS)].

BACKGROUND: A combination of low-dose aspirin (A) and anticoagulation (AC) may provide better protection against thromboembolic events compared with AC alone in high-risk patients with atrial fibrillation (AF). METHODS: We performed a multicentric placebo-controlled double blind-trial to test the preventive efficacy against thromboembolic events of the addition of aspirin (A) (100 mg) or placebo (P) to anticoagulant treatment in patients with high-risk atrial fibrillation. A total of 157 patients were included, with atrial fibrillation and previous thromboembolic event or older than 65 years with either a history of hypertension, a recent episode of heart failure or a left ventricular dysfunction. All patients received fluindione (F) and P or F and A, with an INR target between 2 and 2.6. The primary endpoint was a combined endpoint of stroke (ischaemic or haemorrhagic), myocardial infarction, systemic arterial emboli or vascular death. RESULTS: The study had to be stopped prematurely owing to a too low recruitment rate. During follow-up (0.84 years) 3 non-fatal thromboembolic events were recorded (1P, 2A) and 6 patients died (3P, 3A), none of them from a thromboembolic complication. However, 3 deaths were secondary to severe haemorrhagic complications (1P, 2A). Non-fatal haemorrhagic complications occurred more often in group A (n = 10, 13.1 pour cent) compared with group P (n = 1, 1.2 pour cent), p = 0.003. CONCLUSION: The FFAACS study was not able to show any therapeutic benefit from the addition of aspirin to anticoagulant in patients with high-risk AF. Such a combination increased the incidence rate of bleeding complications, which therefore greatly reduces its potential overall benefit.

Aged↗