Publications by authors named "Philippe Debruyne"

19 Publications

  • Page 1 of 1

Variable Presentation of Leber Hereditary Optic Neuropathy in Children of a Family Harboring a Rare m.13051G>A mtDNA Mutation.

J Neuroophthalmol 2020 12;40(4):569-571

Exploration de la Vision et Neuro-Ophtalmologie (VMS, CM, PD, SD-D), CHU de Lille, Lille, France; Université de Lille (VMS), Faculté de Médecine, Lille Cedex, France; Neurologie pédiatrique (J-MC), CHU de Lille, Lille, France; and Université de Lille (C-MD), Inserm UMRS 1172, CHU Lille, Biochemistry and Molecular Biology Department UF Génopathies, Lille, France.

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http://dx.doi.org/10.1097/WNO.0000000000001083DOI Listing
December 2020

Letter by Debruyne regarding article "Selective ablation of atrial ganglionated plexus attenuates vasovagal reflex in a canine model".

Pacing Clin Electrophysiol 2019 03 14;42(3):390. Epub 2019 Jan 14.

Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium.

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http://dx.doi.org/10.1111/pace.13597DOI Listing
March 2019

Unifocal Right-Sided Ablation Treatment for Neurally Mediated Syncope and Functional Sinus Node Dysfunction Under Computed Tomographic Guidance.

Circ Arrhythm Electrophysiol 2018 09;11(9):e006604

The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group (W.W.).

Background Biatrial, extensive, and complex ablation strategies have been published for the treatment of neurally mediated syncope, sinus node dysfunction, and functional atrioventricular block. We have developed a less extensive and more specific approach compared with previously published cardioneuroablation strategies, called cardio-neuromodulation. It is based on tailored vagolysis of the sinoatrial node through partial ablation of the anterior right-ganglionated plexus, preferentially through a right-sided approach. Methods Patients with syncope were enrolled between December 2016 and December 2017. They were assigned to group A if they had a positive head-up tilt test and to group B if they presented with a pause ≥3 seconds. The area to target during cardio-neuromodulation was designed offline on a computed tomographic scan. Slow heart rates and pauses were compared during 24-hour rhythm registration at baseline, at 1-month follow-up, and 6-month follow-up. Syncope burden was assessed before the procedure and at 3- and 6-month follow-up. Results Twenty patients underwent cardio-neuromodulation through a right-sided approach (12 in group A, 8 in group B). The first application of radiofrequency energy led to a P-P interval shortening >120 ms in all 20 patients. After a mean±SD ablation time of 7±4 minutes and mean ablated surface area of 11±6 mm, the P-P interval shortened by 219±160 ms ( P<0.001). The number of beats <50/min during 24-hour rhythm registration was reduced by a median of 100% at 6-month follow-up ( P<0.001). Syncope burden was reduced by 95% at 6-month follow-up ( P<0.001). Conclusions These data indicate that cardio-neuromodulation, through a right-sided and computed tomographic-guided procedure, is safe, fast, and highly reproducible in preventing inappropriate functional sinus bradycardia and syncope recurrence.
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http://dx.doi.org/10.1161/CIRCEP.118.006604DOI Listing
September 2018

Cardio-Neuromodulation: The Right-Sided Approach.

JACC Clin Electrophysiol 2017 Sep 29;3(9):1056-1057. Epub 2017 Mar 29.

The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, Ireland; Saolta University Healthcare Group, Galway, Ireland.

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http://dx.doi.org/10.1016/j.jacep.2016.12.027DOI Listing
September 2017

Assessing the landscape of percutaneous coronary chronic total occlusion treatment in Belgium and Luxembourg: the Belgian Working Group on Chronic Total Occlusions (BWGCTO) registry.

Acta Cardiol 2018 Oct 28;73(5):427-436. Epub 2017 Nov 28.

Faculty of Medicine and Life Sciences, Universiteit Hasselt , Hasselt , Belgium.

Important developments in materials, devices, and techniques have improved outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI), and resulted in a growing interest in CTO-PCI. The Belgian Working Group on Chronic Total Occlusions BWGCTO) working group aims to assess the evolution within the CTO-PCI landscape over the next years. From May 2016 onwards, patients undergoing CTO-PCI were included in the BWGCTO registry by 15 centres in Belgium and Luxemburg. Baseline, angiographic, and procedural data were collected. Here, we report on the one-year in-hospital outcomes. Over the course of one year, 411 procedures in 388 patients were included with a mean age of 64 ± 11 years. The majority were male (81%). Relatively complex CTOs were treated (Japanese CTO score =2.2 ± 1.2) with a high procedure success rate (82%). Patient- and lesion-wise success rates were 83 and 85%, respectively. Major adverse in-hospital events were acceptably low (3.4%). Antegrade wire escalation technique was applied most frequently (82%). On the other hand, antegrade dissection and re-entry and retrograde strategies were more frequently applied in higher volume centres and successful for lesions with higher complexity. Satisfactory procedural outcomes and a low rate of adverse events were obtained in a complex CTO population, treated by operators with variable experience levels. Antegrade wire escalation was the preferred strategy, regardless of operator volume.
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http://dx.doi.org/10.1080/00015385.2017.1408891DOI Listing
October 2018

Transcatheter left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: results from the Belgian registry.

EuroIntervention 2018 01;13(13):1603-1611

Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Aims: This study aimed to assess the safety and efficacy at midterm follow-up of left atrial appendage occlusion (LAAO) using different devices, in real life in Belgium.

Methods And Results: Between June 2009 and November 2016, 457 consecutive patients (63% male, 75±12 yrs, CHA2DS2-VASc 4±0.6, HAS-BLED 3.5±0.7) undergoing LAAO were included. Technical success was 97.1%. There were 19 periprocedural major adverse events (4.1%) including three deaths (0.6%), nine tamponades (1.9%), four major bleedings (0.8%) and two device embolisations (0.4%). Among patients successfully implanted having a complete follow-up (672 patient-years, median follow-up 370 days), the actual annual stroke rate was 1.2%, lower than the expected stroke risk of 4% (70% reduction). The observed bleeding rate was 2%, while the calculated risk was 3.7% (46% reduction). Kaplan-Meier analysis showed a similar overall survival (93±2% and 87±3% versus 91±3% and 87±4%; p=0.35) and event-free survival (92±2% and 84±3% versus 88±3% and 80±5%; p=0.17) at one and two years, for the ACP/Amulet versus the WATCHMAN groups of patients, respectively.

Conclusions: The data from the Belgian left atrial appendage occlusion registry suggest that the procedure is effective and relatively safe in a real-world setting, using either the WATCHMAN or the ACP/Amulet device.
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http://dx.doi.org/10.4244/EIJ-D-17-00076DOI Listing
January 2018

Letter by Debruyne Regarding Article, "Targets and End Points in Cardiac Autonomic Denervation Procedures".

Circ Arrhythm Electrophysiol 2017 08;10(8)

Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium.

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http://dx.doi.org/10.1161/CIRCEP.117.005261DOI Listing
August 2017

Dual intraventricular response after cardiac resynchronization.

HeartRhythm Case Rep 2017 Jun 4;3(6):311-314. Epub 2017 May 4.

Imeldaziekenhuis, Bonheiden, Belgium.

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http://dx.doi.org/10.1016/j.hrcr.2017.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5469316PMC
June 2017

"Cardio-Neuromodulation" With a Multielectrode Irrigated Catheter: A Potential New Approach for Patients With Cardio-Inhibitory Syncope.

J Cardiovasc Electrophysiol 2016 09 1;27(9):1110-3. Epub 2016 Aug 1.

Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium.

Syncope is frequently neurally mediated and can seriously affect quality of life. Different ablation strategies have been successfully performed. These approaches have not gained wide acceptance and are quite extensive and complex, exposing patients to significant risks. This article reports the case of a 16-year-old girl who was severely affected by frequent and prolonged episodes of syncope and was treated by tailored ablation of the anterior right ganglionated plexus with a multielectrode irrigated catheter. She had fainted >30 times in the 5 years preceding treatment, experiencing approximately 10 severe episodes of syncope in the previous 12 months. After 3 minutes of ablation, the P-P interval was reduced by >400 milliseconds. Syncope disappeared and the patient has remained completely asymptomatic over a follow-up of 22 months. The "reset" basal P-P interval has remained unchanged (follow-up electrocardiogram at 16 months). At 6 months, there was no residual heart rate activity <50 bpm. On 24-hour rhythm registration, P-P intervals ≥1,000 milliseconds (corresponding to a heart rate of ≤60 bpm) were reduced by >16,000 beats. We believe that this case report is original for several reasons: the unusual clinical presentation; the unique structure targeted; the very limited ablation, implying much lower risks for the patient; the anatomical approach; and the different endpoint. This new "cardio-neuromodulation" approach could be useful for the treatment of patients with neurally mediated syncope.
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http://dx.doi.org/10.1111/jce.13031DOI Listing
September 2016

An unusual cause of intermittent broad QRS complexes.

Circ Arrhythm Electrophysiol 2013 Oct;6(5):e73-4

Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium.

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http://dx.doi.org/10.1161/CIRCEP.113.000432DOI Listing
October 2013

Formation of thermal coagulum on multielectrode catheters during phased radiofrequency energy ablation of persistent atrial fibrillation.

Pacing Clin Electrophysiol 2014 Feb 11;37(2):188-96. Epub 2013 Sep 11.

Imelda Hospital, Bonheiden, Belgium.

Background: Radiofrequency ablation (RFA) can unfavorably cause coagulum on the ablation electrode. The aim of this study was to assess this phenomenon on three different multielectrode catheters used to treat persistent atrial fibrillation with duty-cycled RFA.

Methods And Results: Twenty-six consecutive patients have been treated with the pulmonary vein ablation catheter (PVAC) and the multiarray ablation catheter (MAAC). In 13 patients, additional ablation with the multiarray septal catheter (MASC) has been performed. The multichannel RF generator GENius™ (Medtronic Inc., Minneapolis, MN, USA) independently delivered energy in a bipolar and unipolar mode (ratio of 4/1, 2/1, or 1/1) to any of the electrodes. Versions 14.2, 14.3, and 14.4 of the generator were used. Coagulum presence was determined postablation by careful visual inspection of the catheter electrodes. No coagulum formation was visualized on the PVACs. Coagulum formation was visualized in 59% of the electrodes of the MAACs using a 2/1 mode and the 14.2 software version versus 69% using the 14.4 version and a 2/1 mode (P = 0.7) versus 14% of the electrodes applying a 1/1 ratio and the 14.4 software version (P < 0.001).

Conclusions: Duty-cycled RFA in 2/1 bipolar/unipolar ratio generates a substantial frequency of coagulum formation on the multielectrode catheters MAAC and MASC. The use of the 14.4 version of the software to drive the RF generator and the use of energy in the default 1/1 bipolar/unipolar ratio could significantly reduce the frequency of coagulum formation, but so far, could not completely overcome it. The PVAC did not form coagulum, regardless of generator version or energy ratio used.
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http://dx.doi.org/10.1111/pace.12256DOI Listing
February 2014

Evaluation and reduction of asymptomatic cerebral embolism in ablation of atrial fibrillation, but high prevalence of chronic silent infarction: results of the evaluation of reduction of asymptomatic cerebral embolism trial.

Circ Arrhythm Electrophysiol 2013 Oct 27;6(5):835-42. Epub 2013 Aug 27.

Southlake Regional Health Center, Newmarket, Ontario, Canada.

Background: This prospective, multicenter study sought to evaluate the incidence of asymptomatic cerebral emboli (ACE) during ablation of atrial fibrillation (AF) using a multielectrode radiofrequency (MER) system when specific procedural changes were applied.

Methods And Results: Sixty subjects (age 60±10 years; 87% paroxysmal; CHADS2 score, 0.6±0.7) undergoing AF ablation with a circular MER catheter were studied. Three procedural changes were specified: (1) ablation was performed under therapeutic vitamin K antagonist and heparin to maintain activated clotting time>350 seconds; (2) submerged loading of the catheter into the introducer before sheath insertion to minimize air ingress; and (3) either the distal or proximal electrode of the circular MER catheter was deactivated to prevent inadvertent bipolar radiofrequency interaction. MRI was performed <7 days preablation and 2 days postablation. Subjects with new cerebral findings after ablation underwent repeat MRI after 1 month. An acute ACE lesion was defined by a new hyperintensity on diffusion-weighted and fluid-attenuated inversion recovery cerebral MRI sequences. Neurological function was evaluated at baseline, postablation, and 1 month. All target pulmonary veins were isolated. In 60% (36/60) of patients, pre-existing cerebral lesions were seen on the preprocedure MRI (8 lesions per subject; interquartile range, 3-22). New postprocedural ACE occurred in only 1/60 patients (incidence, 1.7%; 95% confidence interval, 0.04-8.9), which was no longer visible on MRI after 1 month.

Conclusions: Applying procedural changes to MER ablation significantly reduces the ACE incidence to 1.7%, which is on the low end of reported ACE rates of any technology.

Clinical Trial Registration Information: ClinicalTrials.gov; Identifier: NCT01520532.
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http://dx.doi.org/10.1161/CIRCEP.113.000612DOI Listing
October 2013

Decapitate or strangulate?

Circulation 2011 Jun;123(23):2748

Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium.

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http://dx.doi.org/10.1161/CIRCULATIONAHA.110.016618DOI Listing
June 2011

Thickening of peripapillar retinal fibers for the diagnosis of autosomal recessive spastic ataxia of Charlevoix-Saguenay.

Cerebellum 2011 Dec;10(4):758-62

Service d'Exploration de la Vision et Neuro-Ophtalmologie, Hôpital Roger-Salengro, Lille, France.

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is characterized by the presence of myelinated retinal fibers. This typical feature is very helpful for the diagnosis but is not always observed in patients outside Quebec. Apart from phenotype variations, misinterpretation of the funduscopy may explain discrepancies and misdiagnosis. We analyze the modification of retinal fibers layer using the funduscopy and the optical coherence tomography (OCT) in two French patients having spinocerebellar ataxia associated with a spastic paraparesia with genetically confirmed ARSACS. In both patients the funduscopy showed a swollen and striated aspect of peripapillar fibers along the retinal vessels and in the intermaculopapillar region. The OCT displayed an important thickening of the optical fibers layer mainly in upper and lower temporal area without attenuation of deep layers, as well as a filling in of the foveolar depression with thickening of the ganglion cell layer normally absent from the foveola. The aspect of funduscopy and OCT in our patients does not correspond to the classical description of myelin fibers encountered in 0.3% to 1% of the population. Thus, ARSACS might be underdiagnosed because of an erroneous interpretation of funduscopy. When considering the diagnosis of ARSACS, the neurologist should ask the ophthalmologist to search for thickening of peripapillar retinal fibers by both funduscopy and OCT rather than myelinated retinal fibers. This ophthalmological consideration has avoided misdiagnosis and led to the description of new mutations in our cases.
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http://dx.doi.org/10.1007/s12311-011-0286-xDOI Listing
December 2011

Optical coherence tomography in clinically isolated syndrome: no evidence of subclinical retinal axonal loss.

Arch Neurol 2009 Nov;66(11):1373-7

Department of Neurology, Université Lille Nord de France, Lille, France.

Background: Optical coherence tomography has emerged as a new tool for quantifying axonal loss in multiple sclerosis (MS). A reduction in retinal nerve fiber layer (RNFL) thickness is correlated with Expanded Disability Status Scale score and brain atrophy.

Objective: To investigate RNFL and macular volume measurements using optical coherence tomography in the clinically isolated syndrome population.

Design: Prospective case series. Settings Neurologic clinics at the university hospitals of Lille and Strasbourg (France).

Participants: Fifty-six consecutive patients with clinically isolated syndrome (18 with optic neuritis and 38 without optic neuritis) and 32 control subjects.

Main Outcome Measures: Macular volume and RNFL thickness.

Results: Mean (SD) overall RNFL thickness (98.98 [10.26] microm) and macular volume (6.86 [0.32] microm(3)) in the clinically isolated syndrome population were not significantly different compared with the controls (98.71 [9.08] mum and 6.92 [0.38] microm(3), respectively). No link was noted between atrophy of the RNFL or macula and conversion to MS at 6 months.

Conclusions: Optical coherence tomography does not reveal retinal axonal loss at the earliest clinical stage of MS and does not predict conversion to MS at 6 months.
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http://dx.doi.org/10.1001/archneurol.2009.265DOI Listing
November 2009

Who is guilty?

J Cardiovasc Electrophysiol 2009 Aug;20(8):942-3

Imeldaziekenhuis, Bonheiden, Belgium.

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http://dx.doi.org/10.1111/j.1540-8167.2008.01399.xDOI Listing
August 2009

Quantification of metamorphopsia in patients with epiretinal membranes before and after surgery.

Graefes Arch Clin Exp Ophthalmol 2007 Aug;245(8):1123-9

Ophtalmologie, Hopital Gui de Chauliac, CHU de Montpellier, 80 avenue Augustin Fliche, 34295 Montpellier 05, France.

Background: To evaluate quantification of metamorphopsia before and after the removal of unilateral epiretinal membrane (ERM).

Methods: One hundred and four consecutive patients with unilateral ERM scheduled for membrane peeling were prospectively enrolled. A complete ophthalmologic examination was performed. Metamorphopsia was evaluated, with standard Amsler grids and a laser grid generated with a scanning laser ophthalmoscope (SLO). The SLO procedure determined the area of distortion and was performed twice at a 30-minute interval to evaluate its reproducibility. The result was considered to be reliable when the area of distortion was identical in both SLO test sessions. One year after surgery, a complete ophthalmologic examination was performed. Metamorphopsia was again quantified with the SLO procedure.

Results: Before surgery, a reliable quantification of metamorphopsia (defined as area of distortion) could be performed in 98 patients (94%). Among these patients, 85 completed the follow-up of 12 months after surgery. Of these 85 patients, visual distortions had been detected preoperatively in 48 patients (56%). One year after surgery, visual distortions were detected in only 11 patients (13%). In 48 patients with preoperative distortions, the decrease of the area of distortion correlated with the change in visual acuity (r = -0.460, p = 0.011).

Conclusions: SLO-based evaluation of metamorphopsia made it possible to provide a fast and reliable method for preoperative and post-operative quantification of visual distortion in patients undergoing ERM removal.
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http://dx.doi.org/10.1007/s00417-006-0505-1DOI Listing
August 2007

Useful tip to improve electrode positioning in markedly angulated coronary sinus tributaries.

J Cardiovasc Electrophysiol 2003 Apr;14(4):415-6

Department of Cardiology, Imeldaziekenhuis, Bonheiden, Belgium.

The anatomic variability of the cardiac veins limits the feasibility of cardiac resynchronization therapy. This report describes another way to position the pacemaker electrode in sharply angulated coronary sinus branches.
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http://dx.doi.org/10.1046/j.1540-8167.2003.02484.xDOI Listing
April 2003