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Fidenza, Italy

Corradi D.,University of Parma | Callegari S.,Fidenza Hospital | Gelsomino S.,Careggi Hospital | Lorusso R.,Cardiac Surgery Unit | Macchi E.,University of Parma
International Journal of Cardiology | Year: 2013

Experimental and clinical evidence suggests that the natural history of atrial fibrillation is characterised by increased structural remodelling, which may play a pivotal role in maintaining the arrhythmia and clinically favours progression from paroxysmal to persistent atrial fibrillation. In this setting, anti-arrhythmic therapy gradually becomes inefficient, and this limitation has led to the introduction of new non-pharmacological interventions such as surgical or catheter ablation. At the same time, interest in the functional morphology and electrophysiological properties of the atria and their related anatomical structures has greatly increased. This article is the first of a two-part review whose main purpose is to describe the anatomical and functional details of some of the principal anatomical locations that are commonly targeted by ablative procedures to treat this supraventricular arrhythmia. In particular, this manuscript has dealt with the atrial structures (atrial myocardium and coronary sinus). General information on ablation procedures has also been provided. © 2013 Elsevier Ireland Ltd. All rights reserved. Source

Corradi D.,University of Parma | Callegari S.,Fidenza Hospital | Gelsomino S.,Careggi Hospital | Lorusso R.,Cardiac Surgery Unit | Macchi E.,University of Parma
International Journal of Cardiology | Year: 2013

The inadequate long-term efficacy of anti-arrhythmic therapy has been one of the main reasons for the development of non-pharmacological interventions for patients with atrial fibrillation such as catheter and surgical ablation. This has greatly increased interest in the functional morphology and electrophysiological properties of the atria and related anatomical structures. This article is the second of a two-part review that aims to provide anatomical and functional details concerning some of the principal anatomical sites commonly targeted by ablative procedures for treating atrial fibrillation, and covers pulmonary veins, ganglionated plexi, caval veins, and the ligament of Marshall. It also provides some general information about site-specific ablation procedures. © 2013 Elsevier Ireland Ltd. All rights reserved. Source

Rossi S.,University of Parma | Fortunati I.,University of Parma | Carnevali L.,University of Parma | Baruffi S.,University of Parma | And 8 more authors.
PLoS ONE | Year: 2014

Advanced age alone appears to be a risk factor for increased susceptibility to cardiac arrhythmias. We previously observed in the aged rat heart that sinus rhythm ventricular activation is delayed and characterized by abnormal epicardial patterns although conduction velocity is normal. While these findings relate to an advanced stage of aging, it is not yet known when and how ventricular electrical impairment originates and which is the underlying substrate. To address these points, we performed continuous telemetry ECG recordings in freely moving rats over a six-month period to monitor ECG waveform changes, heart rate variability and the incidence of cardiac arrhythmias. At the end of the study, we performed in-vivo multiple lead epicardial recordings and histopathology of cardiac tissue. We found that the duration of ECG waves and intervals gradually increased and heart rate variability gradually decreased with age. Moreover, the incidence of cardiac arrhythmias gradually increased, with atrial arrhythmias exceeding ventricular arrhythmias. Epicardial multiple lead recordings confirmed abnormalities in ventricular activation patterns, likely attributable to distal conducting system dysfunctions. Microscopic analysis of aged heart specimens revealed multifocal connective tissue deposition and perinuclear myocytolysis in the atria. Our results demonstrate that aging gradually modifies the terminal part of the specialized cardiac conducting system, creating a substrate for increased arrhythmogenesis. These findings may open new therapeutic options in the management of cardiac arrhythmias in the elderly population. Copyright: © 2014 Rossi et al. Source

Corradi D.,University of Parma | Maestri R.,University of Parma | MacChi E.,University of Parma | Callegari S.,Fidenza Hospital
Journal of Cardiovascular Electrophysiology | Year: 2011

Functional Anatomy of the Atria. The fact that some atrial and ventricular disorders (e.g., atrial fibrillation and heart failure) have a structural basis and cause atrial myocardial remodeling has led to increasing attention being paid to the atrial chambers. Furthermore, the rapid development of mapping and ablative procedures as a means of diagnosing and treating supraventricular arrhythmias has generated considerable interest in atrial gross anatomy, histology and ultrastructure. The aim of this article is to provide a comprehensive overview of the structure of the left and right atria (at macroscopic, histological and ultrastructural level) in relation to their function. In addition to analyzing normal atria, we also discuss functional anatomy in the case of atrial fibrillation and heart failure. © 2010 Wiley Periodicals, Inc. Source

Taverna G.,Istituto Clinico Humanitas | Benecchi L.,Fidenza Hospital | Grizzi F.,Quantitative Medicine | Seveso M.,Istituto Clinico Humanitas | And 6 more authors.
Journal of Oncology | Year: 2012

Prostate cancer (PC) remains a cause of death worldwide. Here we investigate whether a single microfocus of PC at the biopsy (graded as Gleason 6 or less, ≤5 occupancy) and the PSA <10ng/mL can define the archetype of low-risk prostate disease. 4500 consecutive patients were enrolled. Among them, 134 patients with a single micro-focus of PC were followed up, and the parameters influencing the biochemical relapse (BR) were analysed. Out of 134 patients, 94 had clinically significant disease, specifically in 74.26 of the patients with PSA < 10ng/mL. Positive surgical margins and the extracapsular invasion were found in 29.1 and 51.4 patients, respectively. BR was observed in 29.6 of the patients. Cox regression evidenced a correlation between the BR and Gleason grade at the retropubic radical prostatectomy (RRP), capsular invasion, and the presence of positive surgical margins. Multivariate regression analysis showed a statistically significant correlation between the presence of surgical margins at the RRP and BR. Considering a single micro-focus of PC at the biopsy and PSA serum level 10ng/mL, clinically significant disease was found in 74.26 patients and only positive surgical margins are useful for predicting the BR. © Copyright 2012 Gianluigi Taverna et al. Source

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