Di Matteo Dott.ssa Irene
Pubblicazioni su PubMed
A Tailored Antithrombotic Approach for Patients with Atrial Fibrillation Presenting with Acute Coronary Syndrome and/or Undergoing PCI: A Case Series.
J Clin Med2022 Jul;11(14):. doi: 4089.
Giubilato Simona, Lucà Fabiana, Pozzi Andrea, Caretta Giorgio, Cornara Stefano, Pilleri Anna, Di Nora Concetta, Amico Francesco, Di Matteo Irene, Favilli Silvia, Rossini Roberta, Riccio Carmine, Colivicchi Furio, Gulizia Michele Massimo,
The combination of oral anticoagulants (OAC) and dual antiplatelet therapy (DAPT) is the mainstay for the treatment of patients with atrial fibrillation (AF) presenting with acute coronary syndrome (ACS) and/or undergoing PCI. However, this treatment leads to a significant increase in risk of bleeding. In most cases, according to the most recent guidelines, triple antithrombotic therapy (TAT) consisting of OAC and DAPT, typically aspirin and clopidogrel, should be limited to one week after ACS and/or PCI (default strategy). On the other hand, in patients with a high ischemic risk (i.e., stent thrombosis) and without increased risk of bleeding, TAT should be continued for up to one month. Direct oral anticoagulants (DOAC) in triple or dual antithrombotic therapy (OAC and P2Y12 inhibitor) should be favored over vitamin K antagonists (VKA) because of their favorable risk/benefit profile. The choice of the duration of TAT (one week or one month) depends on a case-by-case evaluation of a whole series of hemorrhagic or ischemic risk factors for each patient. Likewise, the specific DOAC treatment should be selected according to the clinical characteristics of each patient. We propose a series of paradigmatic clinical cases to illustrate the decision-making work-up in clinical practice.
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osteomyelitis in a Poodle dog: case report and literature review.
J Vet Diagn Invest2022 Jul;34(4):703-708. doi: 10.1177/10406387221100996.
Rampacci Elisa, Sforna Monica, Dentini Alfredo, Di Matteo Irene, Lidano Plinio, Capucci Cristiana, Passamonti Fabrizio
Paenibacilli are gram-variable, endospore-forming bacteria that occupy various ecologic niches. These microorganisms have been known to infect humans occasionally at various anatomic sites. However, in humans, as well as in other vertebrate animals, the relationship between disease and isolation of spp. remains poorly understood. We report here a case of infection in an adult Poodle dog. The animal had nodules in the lungs and multifocal osteolytic expansile bone lesions. From bone, was recovered by culture and identified by MALDI-TOF mass spectroscopy and 16S rDNA sequencing; pyogranulomatous inflammation was observed in lung and bone specimens. The microorganism was resistant to clindamycin and imipenem. Four-month treatment with amoxicillin-clavulanate resulted in clinical resolution of disease in this dog. Nevertheless, therapy for more prolonged periods should be considered because recurrent infections can occur as a result of the transition of spores to vegetative cells. Disease caused by a species has not been reported previously in dogs, to our knowledge.
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[Giant negative T-waves: a multi-headed monster].
G Ital Cardiol (Rome)2022 Jan;23(1):28. doi: 10.1714/3715.37059.
Di Matteo Irene, Tavecchia Giovanni Amedeo, Giannattasio Cristina
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Negative concordant T waves during paced ventricular rhythm: An honest enemy is better than a false friend.
J Electrocardiol2017 ;50(4):507-509. doi: 10.1016/j.jelectrocard.2017.03.006.
di Matteo Irene, Crea Pasquale
The ECG diagnosis of myocardial infarction and ischemia in pacemaker patients is often challenging. The three criteria, proposed by Sgarbossa et al. in 1996, useful to suspect myocardial ischaemia in patient with left bundle branch block were demonstrated to be valid also in pacemaker patients. In the last years, concordant negative T waves in patients with ventricular paced rhythm were linked to various expressions of acute myocardial injury. If available, comparison with previous ECG is crucial. Partial persistence of cardiac memory during fusion beats created an anomalous concordance between negative T waves and QRS axis and could induce erroneous suspicions. AV delay modification could help to unmask this situation.
Copyright © 2017 Elsevier Inc. All rights reserved.
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Coronary sinus activation patterns in patients with and without left bundle branch block undergoing electroanatomic mapping system-guided cardiac resynchronization therapy device implantation.
Heart Rhythm2017 Feb;14(2):225-233. doi: 10.1016/j.hrthm.2016.10.025.
Del Greco Maurizio, Zorzi Alessandro, Di Matteo Irene, Cima Anna, Maines Massimiliano, Angheben Carlo, Catanzariti Domenico
Implantation of the left ventricular (LV) lead in segments with delayed electrical activation may improve response to cardiac resynchronization therapy (CRT).
The purpose of this study was to evaluate the amount and regional distribution of LV electrical delay (LVED) in patients with or without left bundle branch block (LBBB).
We enrolled 60 patients who underwent electroanatomic mapping system-guided CRT device implantation. Activation mapping of the coronary sinus (CS) branches was performed using an insulated guidewire. LVED was defined as the interval between the beginning of the QRS complex on the surface electrocardiogram (ECG) and the local electrogram and expressed in milliseconds or as percentage of the total QRS duration (LVED%).
Forty-three patients showed a LBBB and 17 a non-LBBB electrocardiographic pattern. A total of 148 CS branches (mean 2.5 per patient; range 2-4 per patient) were mapped. Patients with LBBB showed higher maximum LVED (135 ms [108-150 ms] vs 100 ms [103-110 ms]; P 50% of the total QRS duration, >75% of the total QRS duration, and >85 ms was significantly higher in patients with LBBB than in patients without LBBB.
Patients without LBBB showed lower LVED and more heterogeneous electrical activation of the CS than did patients with LBBB. This finding may contribute to a lower rate of response to CRT of patients without LBBB and suggests the use of activation mapping to guide LV lead placement.
Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
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Three-Dimensional Electroanatomic Mapping System-Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry.
J Cardiovasc Electrophysiol2017 Jan;28(1):85-93. doi: 10.1111/jce.13120.
Del Greco Maurizio, Maines Massimiliano, Marini Massimiliano, Colella Andrea, Zecchin Massimo, Vitali-Serdoz Laura, Blandino Alessandro, Barbonaglia Lorella, Allocca Giuseppe, Mureddu Roberto, Marenna Biondino, Rossi Paolo, Vaccari Diego, Chianca Roberto, Indiani Stefano, DI Matteo Irene, Angheben Carlo, Zorzi Alessandro
Cardiac resynchronization therapy (CRT) device implantation guided by an electroanatomic mapping system (EAMS) is an emerging technique that may reduce fluoroscopy and angiography use and provide information on coronary sinus (CS) electrical activation. We evaluated the outcome of the EAMS-guided CRT implantation technique in a multicenter registry.
During the period 2011-2014 we enrolled 125 patients (80% males, age 74 [71-77] years) who underwent CRT implantation by using the EnSite system to create geometric models of the patient's cardiac chambers, build activation mapping of the CS, and guide leads positioning. Two hundred and fifty patients undergoing traditional CRT implantation served as controls. Success and complication rates, fluoroscopy and total procedure times in the overall study population and according to center experience were collected. Centers that performed ?10 were defined as highly experienced.
Left ventricular lead implantation was successful in 122 (98%) cases and 242 (97%) controls (P = 0.76). Median fluoroscopy time was 4.1 (0.3-10.4) minutes in cases versus 16 (11-26) minutes in controls (P
EAMS-guided CRT implantation proved safe and effective in both high- and low-experienced centers and allowed to reduce fluoroscopy use by ?75% and angiography rate by ?70%.
© 2016 Wiley Periodicals, Inc.
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