Centro ricerche aritmie cardiache

DIRETTORE

Dott. Giovanni B. Perego

ÉQUIPE

 ATTIVITÀ DI RICERCA

Telemedicina

L’attività di ricerca sulla telemedicina realizzata per mezzo di dispositivi impiantabili è cominciata all’inizio degli anni 2000. Sono stati condotti diversi progetti sulla diagnosi precoce dello scompenso e degli eventi aritmici tramite pace maker e defibrillatori. L’attività di ricerca si è estesa al monitoraggio della pressione polmonare mediante dispositivi impiantabili dedicati.  Attualmente stiamo partecipando ad uno studio per la valutare la possibilità di integrare le informazioni fornite dalla tecnologia impiantabile e quelle fornite dal paziente nell’ambito di un progetto generale di empowerment del soggetto affetto da scompenso cardiaco

Terapia di resincronizzazione

Tra i primi gruppi in Italia a sviluppare un programma di stimolazione biventricolare, abbiamo studiato in particolare la fisiologia della resincronizzazione atrioventricolare ed intraventricolare applicando tecnologie di monitoraggio invasivo dei volumi e delle pressioni intracardiache 

Fibrillazione atriale

L’attività di ricerca si è focalizzata sul trattamento ablativo della fibrillazione atriale con particolare riferimento ai pazienti con cardiopatia strutturale e forme non parossistiche, nonché su popolazioni di pazienti ad elevato rischio di recidiva (in particolare soggetti obesi).

MALATTIE OGGETTO DI RICERCA

RISULTATI DI PARTICOLARE IMPORTANZA RAGGIUNTI

Elenco delle pubblicazioni

  • Brasca FM, Perego GB. Remote monitoring of implantable electronic devices to predict heart failure decompensation. Expert Rev Med Devices. 2021 Dec;18(sup1):9-12. doi: 10.1080/17434440.2021.2018298. Epub 2021 Dec 29. PMID: 34913778.
  • Perego GB. Why is PAP guided therapy effective? Int J Cardiol. 2018 May 15;259:137. doi: 10.1016/j.ijcard.2017.12.096. PMID: 29579592.
  • Brasca FMA, Menè R, Perego GB. Catheter Ablation for Atrial Fibrillation in Structural Heart Disease: A Review. J Clin Med. 2023 Feb 10;12(4):1431. doi:10.3390/jcm12041431. PMID: 36835964; PMCID: PMC9966488.
  • Achilli A, Turreni F, Gasparini M, Lunati M, Sassara M, Santini M, Landolina M, Padeletti L, Puglisi A, Bocchiardo M, Orazi S, Perego GB, Valsecchi S, Denaro. A. Efficacy of cardiac resynchronization therapy in very old patients: the Insync/Insync ICD Italian Registry. Europace. 2007 Sep;9(9):732-8. doi: 10.1093/europace/eum143. Epub 2007 Jul 18. PMID: 17636304.
  • Laurenzi F, Achilli A, Avella A, Peraldo C, Orazi S, Perego GB, Cesario A, Valsecchi S, De Santo T, Puglisi A, Tondo C. Biventricular upgrading in patients with conventional pacing system and congestive heart failure: results and response predictors. Pacing Clin Electrophysiol. 2007 Sep;30(9):1096-104. doi:10.1111/j.1540-8159.2007.00819.x. PMID: 17725752.
  • Manfrin M, Verlato R, Arena G, Pieragnoli P, Molon G, Tondo C, Perego GB, Rovaris G, Sciarra L, Mantica M, Sacchi R, Ricciardi D, Marini M, Iacopino S. Second versus fourth generation of cryoballoon catheters: The 1STOP real-world multicenter experience. Pacing Clin Electrophysiol. 2022 Aug;45(8):968-974. doi: 10.1111/pace.14494. Epub 2022 May 2. PMID: 35417055.
  • Perego GB, Iacopino S, Molon G, Arena G, Verlato R, Pieragnoli P, Curnis A, Allocca G, Nicolis D, Sciarra L, Catanzariti D, Senatore G, Rovaris G, Brasca F, Tondo C; ClinicalService 1STOP project i Project Investigators. Cryoablation for paroxysmal and persistent AF in patients with structural heart disease and preserved ejection fraction: Clinical outcomes from 1STOP, a multicenter observational project. J Cardiol. 2019 Jul;74(1):19-26. doi:10.1016/j.jjcc.2019.02.015. Epub 2019 Apr 1. PMID: 30948185.
  • Styczkiewicz K, Spadacini G, Tritto M, Perego GB, Facchini M, Bilo G, Kawecka-Jaszcz K, Czarnecka D, Malfatto G, Parati G. Cardiac autonomic regulation in patients undergoing pulmonary vein isolation for atrial fibrillation. J Cardiovasc Med (Hagerstown). 2019 May;20(5):297-305. doi: 10.2459/JCM.0000000000000791. PMID: 30921268.
  • Achilli A, Peraldo C, Sassara M, Orazi S, Bianchi S, Laurenzi F, Donati R, Perego GB, Spampinato A, Valsecchi S, Denaro A, Puglisi A; SCART Study Investigators. Prediction of response to cardiac resynchronization therapy: the selection of candidates for CRT (SCART) study. Pacing Clin Electrophysiol. 2006 Dec;29 Suppl 2:S11-9. doi: 10.1111/j.1540-8159.2006.00486.x. PMID: 17169127.
  • Cipriani M, Lunati M, Landolina M, Proclemer A, Boriani G, Ricci RP, Rordorf R, Matassini MV, Padeletti L, Iacopino S, Molon G, Perego GB, Gasparini M; Italian ClinicalService Project Investigators. Prognostic implications of mitral regurgitation in patients after cardiac resynchronization therapy. Eur J Heart Fail. 2016 Aug;18(8):1060-8. doi: 10.1002/ejhf.569. Epub 2016 Jul 13. PMID: 27412374.
  • Landolina M, Perego GB, Lunati M, Curnis A, Guenzati G, Vicentini A, Parati G, Borghi G, Zanaboni P, Valsecchi S, Marzegalli M. Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study. Circulation. 2012 Jun 19;125(24):2985-92. doi: 10.1161/CIRCULATIONAHA.111.088971. Epub 2012 May 24. PMID: 22626743.
  • Rordorf R, Iacopino S, Verlato R, Arena G, Tondo C, Molon G, Manfrin M, Rovaris G, Perego GB, Sciarra L, Mantica M, Sacchi R, Pieragnoli P. Role of CHA<sub>2</sub>DS<sub>2</sub>-VASc score in predicting atrial fibrillation recurrence in patients undergoing pulmonary vein isolation with cryoballoon ablation. J Interv Card Electrophysiol. 2022 Nov 23. doi: 10.1007/s10840-022-01430-7. Epub ahead of print. PMID: 36417124.
  • Caravita S, Baratto C, Perego GB, Cecchi F, Crotti L, Parati G. Invasive Hemodynamics of Hypertrophic Cardiomyopathy: Exercise Versus Isoproterenol. Circ Heart Fail. 2020 Jun;13(6):e007000. doi: 10.1161/CIRCHEARTFAILURE.120.007000. Epub 2020 Jun 2. PMID: 32482090.
  • Pieragnoli P, Perego GB, Ricciardi G, Sacchi S, Padeletti M, Michelucci A, Valsecchi S, Padeletti L. Cardiac resynchronization therapy acutely improves ventricular-arterial coupling by reducing the arterial load: assessment by pressure-volume loops. Pacing Clin Electrophysiol. 2015 Apr;38(4):431-7. doi: 10.1111/pace.12585. Epub 2015 Jan 28. PMID: 25628069.
  • Boriani G, Iacopino S, Arena G, Pieragnoli P, Verlato R, Manfrin M, Molon G, Rovaris G, Curnis A, Perego GB, Dello Russo A, Landolina M, Vitolo M, Tondo C, On Behalf Of The Stop ClinicalService Investigators. Chronic Kidney Disease with Mild and Mild to Moderate Reduction in Renal Function and Long-Term Recurrences of Atrial Fibrillation after Pulmonary Vein Cryoballoon Ablation. J Cardiovasc Dev Dis. 2022 Apr 21;9(5):126. doi: 10.3390/jcdd9050126. PMID: 35621837; PMCID: PMC9147782.
  • Perego GB, Iacopino S, Pieragnoli P, Verlato R, Arena G, Molon G, Rovaris G, Manfrin M, Mantica M, Senatore G, Stabile G, Bertaglia E, Brasca F, Tondo C; ClinicalService 1STOP project investigators. Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation: An Evaluation of Cohorts With and Without Structural Heart Disease. Heart Lung Circ. 2020 Jul;29(7):1078-1086. doi: 10.1016/j.hlc.2019.07.020. Epub 2019 Sep 18. PMID: 31594723.
  • Brasca FM, Franzetti J, Rella V, Malfatto G, Brambilla R, Facchini M, Parati G, Perego GB. Retrospective application of Program to Access and Review Trending iNformation and Evaluate coRrelation to Symptoms in patients with Heart Failure criteria for the remote management of patients with cardiac resynchronisation therapy. J Telemed Telecare. 2017 May;23(4):470-475. doi: 10.1177/1357633X16647633. Epub 2016 Jun 20. PMID: 27325432.
  • Perego GB, Landolina M, Vergara G, Lunati M, Zanotto G, Pappone A, Lonardi G, Speca G, Iacopino S, Varbaro A, Sarkar S, Hettrick DA, Denaro A; Optivol-CRT Clinical Service Observational Group. Implantable CRT device diagnostics identify patients with increased risk for heart failure hospitalization. J Interv Card Electrophysiol. 2008 Dec;23(3):235-42. doi: 10.1007/s10840-008-9303-5. Epub 2008 Sep 23. PMID: 18810621.
  • Valsecchi S, Perego GB, Schreuder JJ, Censi F, Jansen JR. Cardiac output derived from left ventricular pressure during conductance catheter evaluations: an extended Modelflow method. J Clin Monit Comput. 2007 Aug;21(4):227-35. doi: 10.1007/s10877-007-9078-8. Epub 2007 Jun 1. PMID: 17541715.
  • Occhetta E, Perego GB. Le nuove linee guida europee 2013 su pacing cardiaco e terapia di resincronizzazione cardiaca: tra conferme e novità [The new 2013 European guidelines on pacing and cardiac resynchronization therapy: between confirmation and novelty]. G Ital Cardiol (Rome). 2014 Apr;15(4):215-20. Italian. doi: 10.1714/1497.16495. PMID: 24873809.
  • Perego GB, Valsecchi S, Censi F, Schreuder JJ, Padeletti L. Coherent averaging improves the evaluation of left ventricular dyssynchrony by
  • conductance catheter. J Clin Monit Comput. 2008 Dec;22(6):435-43. doi: 10.1007/s10877-008-9153-9. Epub 2008 Dec 12. PMID: 19082868.
  • Bertaglia E, Iacopino S, Verlato R, Arena G, Pieragnoli P, Tondo C, Molon G, Manfrin M, Perego GB, Rovaris G, Rivezzi F, Mantica M, Startari U, Sciarra L. Safety and efficacy of cryoablation for atrial fibrillation in young patients: A multicenter experience in the 1STOP project. Clin Cardiol. 2023 Feb;46(2):142-150. doi: 10.1002/clc.23951. Epub 2022 Nov 29. PMID: 36448243; PMCID: PMC9933101.
  • Marzegalli M, Lunati M, Landolina M, Perego GB, Ricci RP, Guenzati G, Schirru M, Belvito C, Brambilla R, Masella C, Di Stasi F, Valsecchi S, Santini M. Remote monitoring of CRT-ICD: the multicenter Italian CareLink evaluation--ease of use, acceptance, and organizational implications. Pacing Clin Electrophysiol. 2008 Oct;31(10):1259-64. doi: 10.1111/j.1540-8159.2008.01175.x. PMID: 18811805.
  • Zanaboni P, Landolina M, Marzegalli M, Lunati M, Perego GB, Guenzati G, Curnis A, Valsecchi S, Borghetti F, Borghi G, Masella C. Cost-utility analysis of the EVOLVO study on remote monitoring for heart failure patients with implantable defibrillators: randomized controlled trial. J Med Internet Res. 2013 May 30;15(5):e106. doi: 10.2196/jmir.2587. PMID: 23722666; PMCID: PMC3670725.
  • Perego GB, Chianca R, Facchini M, Frattola A, Balla E, Zucchi S, Cavaglià S, Vicini I, Negretto M, Osculati G. Simultaneous vs. sequential biventricular pacing in dilated cardiomyopathy: an acute hemodynamic study. Eur J Heart Fail. 2003 Jun;5(3):305-13. doi: 10.1016/s1388-9842(02)00204-0. PMID: 12798828.
  • Brasca FMA. Comment to "Chronic disease management in heart failure: focus on telemedicine and remote monitoring". Rev Cardiovasc Med. 2021 Dec 22;22(4):1077. doi: 10.31083/j.rcm2204118. PMID: 34957753.
  • Santini M, Ricci RP, Lunati M, Landolina M, Perego GB, Marzegalli M, Schirru M, Belvito C, Brambilla R, Guenzati G, Gilardi S, Valsecchi S. Remote monitoring of patients with biventricular defibrillators through the CareLink system improves clinical management of arrhythmias and heart failure episodes. J Interv Card Electrophysiol. 2009 Jan;24(1):53-61. doi: 10.1007/s10840-008-9321-3. Epub 2008 Oct 31. PMID: 18975066.
  • Catanzariti D, Lunati M, Landolina M, Zanotto G, Lonardi G, Iacopino S, Oliva F, Perego GB, Varbaro A, Denaro A, Valsecchi S, Vergara G; Italian Clinical Service Optivol-CRT Group. Monitoring intrathoracic impedance with an implantable defibrillator reduces hospitalizations in patients with heart failure. Pacing Clin Electrophysiol. 2009 Mar;32(3):363-70. doi: 10.1111/j.1540-8159.2008.02245.x. PMID: 19272067.
  • Sohal M, Hamid S, Perego G, Della Bella P, Adhya S, Paisey J, Betts T, Kamdar R, Lambiase P, Leyva F, McComb JM, Behar J, Jackson T, Claridge S, Mehta V, Elliott M, Niederer S, Razavi R, Rinaldi CA. A multicenter prospective randomized controlled trial of cardiac resynchronization therapy guided by invasive dP/dt. Heart Rhythm O2. 2021 Jan 22;2(1):19-27. doi: 10.1016/j.hroo.2021.01.005. PMID: 34113901; PMCID: PMC8183864.
  • Perego GB, Oldani M, Pellegrini D, Brasca FMA, Malfatto G, Villani A, Brambilla R, Rella V, Parati G. Correlation between pulmonary artery pressureand thoracic impedance: Insights from daily monitoring through an implanted device in chronic heart failure. Int J Cardiol. 2017 Oct 15;245:196-200. doi: 10.1016/j.ijcard.2017.07.042. Epub 2017 Jul 17. PMID: 28735754.
  • Malfatto G, Facchini M, Branzi G, Brambilla R, Fratianni G, Tortorici E, Balla E, Perego GB. Reverse ventricular remodeling and improved functional capacity after ventricular resynchronization in advanced heart failure. ItalHeart J. 2005 Jul;6(7):578-83. PMID: 16274020.
  • Oliva F, Frigerio M, Lunati M, Turazza FM, Cattafi G, Paolucci M, Garascia A, Garbellini M, Magenta G, Vicini I, Vitali E, Perego GB. Cardiac resynchronisation therapy for advanced heart failure. J Heart Lung Transplant. 2001 Feb;20(2):216. doi: 10.1016/s1053-2498(00)00472-1. PMID: 11250399.

English version