Eusebio García‐Izquierdo

Hospital Universitario Puerta de Hierro Majadahonda

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Ignacio Fernández Lozano

Hospital Universitario Puerta de Hierro Majadahonda

Víctor Castro‐Urda

Hospital Universitario Puerta de Hierro Majadahonda

Diego Jiménez‐Sánchez

Hospital Universitario Puerta de Hierro Majadahonda

Jorge Toquero‐Ramos

Hospital Universitario Puerta de Hierro Majadahonda

D García-Rodríguez

Hospital Universitario Puerta de Hierro Majadahonda

Susana Mingo‐Santos

Hospital Universitario Puerta de Hierro Majadahonda

Cristina Aguilera‐Agudo

Hospital Universitario Puerta de Hierro Majadahonda

Susana Mingo Santos

Hospital Universitario Puerta de Hierro Majadahonda

Vanessa Moñivas‐Palomero

Hospital Universitario Puerta de Hierro Majadahonda

Javier Segovia

Hospital Universitario Puerta de Hierro Majadahonda

Cooperative Institutions

Hospital Universitario Puerta de Hierro Majadahonda

188

Universidad Autónoma de Madrid

Centro de Investigación en Red en Enfermedades Cardiovasculares

Centro de Investigación Biomédica en Red

Instituto de Salud Carlos III

Inserm

Universitat de Barcelona

Hospital Universitario 12 De Octubre

Spanish National Centre for Cardiovascular Research

Hospital Clínic de Barcelona

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An echocardiographic artifact gave us the diagnosis

Intensive Care Medicine (2016)

Eusebio García‐Izquierdo Jorge Vázquez López-Ibor Susana Mingo Santos Juan Manuel Escudier-Villa

Pain medicine

Artifact (error)

10.1007/s00134-016-4540-z

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Citations (1)

Dizziness in a patient with a permanent VVI pacemaker

The American Journal of Emergency Medicine (2017)

Eusebio García‐Izquierdo Carolina Parra Jorge Toquero

Atrioventricular block

Permanent pacemaker

Artificial cardiac pacemaker

Implantable loop recorder

Programmer

Cardiac Pacing

10.1016/j.ajem.2017.11.051

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Citations (1)

Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure

European Heart Journal - Cardiovascular Imaging (2020)

Katsuji Inoue F H Khan Espen W. Remme Nobuyuki Ohte Eusebio García‐Izquierdo

Abstract Aims The aim of this study is to investigate determinants of left atrial (LA) reservoir and pump strain and if these parameters may serve as non-invasive markers of left ventricular (LV) filling pressure. Methods and results In a multicentre study of 322 patients with cardiovascular disease of different aetiologies, LA strain and other echocardiographic parameters were compared with invasively measured LV filling pressure. The strongest determinants of LA reservoir and pump strain were LV global longitudinal strain (GLS) (r-values 0.64 and 0.51, respectively) and LV filling pressure (r-values −0.52 and −0.57, respectively). Left atrial volume was another independent, but weaker determinant of both LA strains. For both LA strains, association with LV filling pressure was strongest in patients with reduced LV ejection fraction. Left atrial reservoir strain <18% and LA pump strain <8% predicted elevated LV filling pressure better (P < 0.05) than LA volume and conventional Doppler parameters. Accuracy to identify elevated LV filling pressure was 75% for LA reservoir strain alone and 72% for pump strain alone. When combined with conventional parameters, accuracy was 82% for both LA strains. In patients with normal LV systolic function by GLS, LA pump strain >14% identified normal LV filling pressure with 92% accuracy. Conclusion Left atrial reservoir and pump strain are determined predominantly by LV GLS and filling pressure. Accuracy of LA strains to identify elevated LV filling pressure was best in patients with reduced LV systolic function. High values of LA pump strain, however, identified normal LV filling pressure with good accuracy in patients with normal systolic function.

Left atrial pressure

Strain (injury)

Ventricular pressure

10.1093/ehjci/jeaa415

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Citations (209)

Efficacy and safety of Proglide use and early discharge after atrial fibrillation ablation compared to standard approach. PROFA trial

Pacing and Clinical Electrophysiology (2023)

Víctor Castro‐Urda Melodi Segura‐Dominguez Diego Jiménez‐Sánchez Cristina Aguilera‐Agudo Eusebio García‐Izquierdo

Abstract Background and Objectives The common practice after atrial fibrillation ablation is to admit patients for an overnight stay. The aim of this study was to compare a strategy of vascular suture mediated closure system utilization and early discharge (strategy A) compared to traditional closure and overnight hospitalization (strategy B) regarding feasibility, safety, quality of life and health care cost effectiveness. Methods and Results Hundred patients were randomized to compare both strategies. No clinical differences were reported except diabetes mellitus. Six patients (6%) had and emergency visit or were admitted in the first 30 days after procedure. Three occurred in strategy A versus three in strategy B ( p = 1) ( p < .005 for non‐inferiority). Forty out of 50 patients (80%) were safely discharged in a time frame of 3 h and 42 patients (84%) were discharged in the same day of the procedure in strategy A. Time to discharge was shorter in strategy A compared to strategy B. (5.89 ± 7.47 h vs. 27.09 ± 2.29 p < .005). No differences were obtained in quality‐of‐life outcomes. Mean (95% CI) euros cost saving per patient in strategy A was 379.16 ± 93.55 p < .001. Ten acute complications (10% patients CI 95% 4.02%–15.98%) were reported during the trial. Seven (14% CI 95% 4.04%–23.96%) occurred in strategy A patients versus 3 (6% CI 95% 0.8%–12.8%) in strategy B. ( p = .182) Conclusion A strategy of vascular suture mediated closure system utilization and early discharge was feasible, reduced time to discharge, saved costs and was not associated with more complications or admissions/emergency visits in a 30‐day time frame after procedure compared to a strategy of regular admission and discharge after overnight stay. There were no differences regarding quality‐of‐life parameters between both strategies.

10.1111/pace.14753

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Citations (6)

Focal activation patterns: breaking new grounds in the pathophysiology of atrial fibrillation

Expert Review of Cardiovascular Therapy (2018)

Rohit K. Kharbanda Eusebio García‐Izquierdo Ad J.J.C. Bogers Natasja M.S. de Groot

Introduction: High-resolution atrial mapping studies have provided novel insights in the pathophysiology of atrial fibrillation (AF) in the last few years. Increasing attention is being drawn to the so-called focal activation patterns (FAPs); however, there is no consensus on criteria to identify and characterize these patterns.Areas covered: In this expert review, an overview of definitions and criteria used to examine FAPs obtained from atrial mapping studies is provided and studies reporting on the underlying mechanisms are discussed.Expert commentary: High-resolution cardiac mapping has revealed the importance of FAPs in the pathophysiology of AF. There is increasing evidence supporting the concept of endo-epicardial (E-E) asynchrony enabling transmural conduction of electrical waves resulting in FAPs. Uniform reports of FAPs in future studies are needed to provide more knowledge on its clinical importance.

Pathophysiology

10.1080/14779072.2018.1485488

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Citations (6)

Bacterial infections in patients hospitalized with COVID-19

Internal and Emergency Medicine (2021)

Víctor Moreno‐Torres Carmen de Mendoza Sara de la Fuente Enrique Sánchez María Martínez‐Urbistondo

Bacterial infections may complicate the course of COVID-19 patients. The rate and predictors of bacterial infections were examined in patients consecutively admitted with COVID-19 at one tertiary hospital in Madrid between March 1st and April 30th, 2020. Among 1594 hospitalized patients with COVID-19, 135 (8.5%) experienced bacterial infectious events, distributed as follows: urinary tract infections (32.6%), bacteremia (31.9%), pneumonia (31.8%), intra-abdominal infections (6.7%) and skin and soft tissue infections (6.7%). Independent predictors of bacterial infections were older age, neurological disease, prior immunosuppression and ICU admission (p < 0.05). Patients with bacterial infections who more frequently received steroids and tocilizumab, progressed to lower Sap02/FiO2 ratios, and experienced more severe ARDS (p < 0.001). The mortality rate was significantly higher in patients with bacterial infections as compared to the rest (25% vs 6.7%, respectively; p < 0.001). In multivariate analyses, older age, prior neurological or kidney disease, immunosuppression and ARDS severity were associated with an increased mortality (p < 0.05) while bacterial infections were not. Conversely, the use of steroids or steroids plus tocilizumab did not confer a higher risk of bacterial infections and improved survival rates. Bacterial infections occurred in 8.5% of patients hospitalized with COVID-19 during the first wave of the pandemic. They were not independently associated with increased mortality rates. Baseline COVID-19 severity rather than the incidence of bacterial infections seems to contribute to mortality. When indicated, the use of steroids or steroids plus tocilizumab might improve survival in this population.

Tocilizumab

Bacteremia

Bacterial pneumonia

Immunosuppression

Spontaneous bacterial peritonitis

10.1007/s11739-021-02824-7

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Citations (42)

Experience and insights from a prolonged electrocardiographic monitorization with a wearable system after an embolic stroke of unknown source

Pacing and Clinical Electrophysiology (2023)

Daniel de Castro Jorge Toquero‐Ramos Diego Jiménez‐Sánchez Eusebio García‐Izquierdo Víctor Castro‐Urda

Embolic cerebrovascular events that remain of unknown etiology after a thorough diagnostic evaluation, are known as Embolic Strokes of Undetermined Source (ESUS). Subclinical atrial fibrillation (AF) represents a significant underlying cause of ESUS. Our aims were to examine the overall diagnostic yield of a prolonged cardiac monitoring wearable system (PCMw) after an ESUS to detect AF and factors associated with it, including the time frame from the ESUS event to PCMw initiation. Additionally, to evaluate the frequency of unexpected arrhythmic events (UAE) and their prognostic implications.We retrospectively analyzed 200 ECG recordings (3-leads, 30 days duration) by means of a PCMw in patients with an ESUS to detect AF lasting longer than 30 s, between 2017 and 2021. UAE were defined as arrhythmia events that were not correlated to the main reason of prolonged cardiac monitoring.AF was detected in 21 patients (10.5%). Patients with AF had more left atrial enlargement (OR = 4.22 [1.59-6.85]; p = .01) and atrial arrythmias in the initial 24-h Holter during hospitalization (OR = 5.73 [2.03-16.49]; p = .001). The detection of AF was significatively higher if the PCMw was worn within the first 30 days after the ESUS compared to beyond 30 days (17% vs. 10.3%; p = .002). Fifty three patients (26.5%) had UAE during PCMw. In six of them these findings led to targeted treatment.PCMw represents a feasible non-invasive device that could reliably detect subclinical AF episodes after an ESUS. Diagnostic yield was significatively higher when used within the first 30 days after the event, especially in selected patients. UAE were common, but did not impact prognosis.

Subclinical infection

Etiology

Stroke

Left atrial enlargement

10.1111/pace.14816

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Citations (0)

Coronary septic embolism: an unusual presentation of acute myocardial infarction

Kardiologia Polska (2017)

Eusebio García‐Izquierdo Marta Jiménez-Blanco Carolina Parra Javier Escaned

Presentation (obstetrics)

10.5603/kp.2017.0106