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Nouvelles perspectives diagnostiques et thérapeutiques dans la prise en charge rythmologique des patients en situation d'insuffisance cardiaque

Abstract : Heart failure is a major public health issue in developed countries, with a prevalence of 1-2% of global population, rising to 10% after 70 years of age. Therapeutic progresses have succeeded in improving patients’ prognosis, particularly in case of reduced left ventricular ejection fraction. Rhythm abnormalities are frequent, and need special consideration in case of heart failure. Meanwhile, there are still some gaps in the evidence: heart failure with preserved systolic function is complex and difficult to treat, primary prevention of sudden cardiac death is effective but there is a need to better select candidates, whether elderly patients should be treated as younger individuals, and finally how to improve outcomes of atrial fibrillation catheter ablation. Firstly, we have conducted a prospective study to evaluate the Sleep Apnea Monitoring algorithm provided in a novel pacemaker in patients with diastolic dysfunction. Besides, we analyzed whether magnetic resonance imaging could predict cardiac outcomes in patients with an implantable cardioverter defibrillator better than echocardiography. We also reported the outcomes of the cardiac resynchronization therapy in patients ≥75 years old compared to younger patients. Finally, we studied the results of a novel ultra-high density mapping system to guide ablation procedures of complex atrial arrhythmias in heart failure patients compared to controls.
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Laure Champ-Rigot. Nouvelles perspectives diagnostiques et thérapeutiques dans la prise en charge rythmologique des patients en situation d'insuffisance cardiaque. Médecine humaine et pathologie. Normandie Université, 2019. Français. ⟨NNT : 2019NORMC430⟩. ⟨tel-02495723⟩

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