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Sultan A, Lüker J, Andresen D, Kuck KH, Hoffmann E, Brachmann J, Hochadel M, Willems S, Eckardt L, Lewalter T, Senges J, Steven D. Predictors of Atrial Fibrillation Recurrence after Catheter Ablation: Data from the German Ablation Registry. Sci Rep 2017; 7:16678. [PMID: 29192223 PMCID: PMC5709464 DOI: 10.1038/s41598-017-16938-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 11/09/2022] Open
Abstract
Catheter ablation (CA) for atrial fibrillation (AF) has emerged as a widespread first or second line treatment option. However, up to 45% of patients (pts) show recurrence of AF within 12 month after CA. We present prospective multicenter registry data comparing characteristics of pts with and without recurrence of AF within the first year after CA. This study comprises all pts with complete follow-up one year after CA (1-y-FU; n = 3679). During 1y-FU in 1687 (45.9%) pts recurrence of AF occurred. The multivariate analysis revealed female sex and AF type prior to the procedure as predictors for AF recurrence. Furthermore, comorbidities such as valvular heart disease and renal failure as well as an early AF relapse were also predictors of AF recurrence during 1-y-FU. However, despite an AF recurrence rate of 45.9%, the majority of these pts (72.4%) reported a significant alleviation of clinical symptoms. In conclusion in pts with initially successful CA for AF female sex, AF type, in-hospital AF relapse and comorbidities such as renal failure and valvular heart disease are independent predictors for AF recurrence during 1-y-FU. However, the majority of pts deemed their interventions as successful with significant reduction of symptoms irrespective of AF.
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Castro L, Pecha S, Linder M, Vogler J, Gosau N, Meyer C, Willems S, Reichenspurner H, Hakmi S. The wearable cardioverter defibrillator as a bridge to reimplantation in patients with ICD or CRT-D-related infections. J Cardiothorac Surg 2017; 12:99. [PMID: 29178898 PMCID: PMC5702096 DOI: 10.1186/s13019-017-0669-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/16/2017] [Indexed: 10/03/2023] Open
Abstract
Background The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable cardioverter defibrillator (WCD) seems to be a valuable solution. Therefore, we investigated the management and outcome of patients with ICD or CRT-D infections using the WCD as a bridge to re-implantation after lead extraction procedures. Methods We conducted a retrospective study on consecutive patients who underwent ICD or CRT-D removal due to device-related local or systemic infections. All patients were prescribed a WCD at our center between 01/2012 and 10/2015. All patients returned to our outpatient clinic for regular ICD or CRT-D monitoring initially 1 and 3 months after reimplantation followed by 6-months intervals. Results Twenty-one patients (mean age 65.0 ± 8.0 years, male 76.2%) were included in the study. Complete lead extraction was achieved in all patients. While waiting for reimplantation one patient experienced a symptomatic episode of sustained ventricular tachycardia. This episode was converted successfully into sinus rhythm by a single 150 J shock. Mean follow-up time 392 ± 206 days, showing survival rate of 100% and freedom from reinfection in all patients. Conclusion The WCD seems to be a valuable bridging option for patients with ICD or CRT-D infections, showing no recurrent device infection.
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Lüker J, Sultan A, Plenge T, van den Bruck J, Heeger CH, Meyer S, Mischke K, Tilz RR, Vollmann D, Nölker G, Schäffer B, Willems S, Steven D. Electrical cardioversion of patients with implanted pacemaker or cardioverter-defibrillator: results of a survey of german centers and systematic review of the literature. Clin Res Cardiol 2017; 107:249-258. [PMID: 29151182 DOI: 10.1007/s00392-017-1178-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/06/2017] [Indexed: 01/08/2023]
Abstract
AIMS A relevant number of patients presenting for electrical cardioversion carry a pacemaker (PM) or ICD. Case reports suggest a potential hazard of external cardioversion/defibrillation. The incidence of shock related device complications is unknown. No guidelines or recommendations by international medical societies for a cardioversion protocol of cardiovascular implantable electronic device (CIED) patients exist. We conducted a nationwide survey to gather real-world clinical data on the current clinical approach towards these patients during electrical cardioversion and to estimate the incidence of shock-related complications. METHODS AND RESULTS Ninety hospitals with > 380 ECV in 2014 were identified from mandatory hospital quality reports and 60 were randomly selected. All centers were provided with a standardized questionnaire on the general proceedings and complications during electrical cardioversion of pacemaker, ICD and CRT patients (CIED patients). Thirty-two centers (53%) participated in the survey. In total, 16,554 ECV were reported (534 ± 314 per center). Biphasic cardioversion with a first shock energy of ≥ 150 J via adhesive patches in antero-posterior orientation was preferred by most centers (78%). Eleven percent (n = 1809) of pts were reported to carry a PM/ICD. The ECV protocol was heterogeneous among centers. Complications associated with electrical cardioversion were reported in 11/1809 patients (0.6%), all were transitory elevations of pacing thresholds. CONCLUSIONS In this nationwide snapshot survey of cardioversion procedures in Germany, approximately 11% of patients presenting for elective electrical cardioversion were pacemaker or ICD carriers. Cardioversion protocols in these patients are heterogeneous throughout centers and mostly not in accordance with recommendation of the German Cardiac Society. Complications associated with external electrical cardioversion are rare. Controlled trials and large registries are necessary to provide evidence for future recommendations.
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Ligtenberg H, Willems S, Jager E, Terhaard C, Philippens M, Raaijmakers C. Validation of the CTV Margin for Laryngeal and Hypopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wong T, McElderry T, Weiner S, Jais P, Garcia-Bolao JI, Ji SY, Willems S, Mounsey J, Maury P, Tung R, Raciti G, Hindricks G. 68Clinical use of the 3D Rhythmia Mapping System For Ablation of Arrhythmias: preliminary data from the TRUE-HD study. Europace 2017. [DOI: 10.1093/europace/eux283.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Moser J, Hoffmann B, Andresen D, Kuck KH, Brachmann J, Eckardt L, Hoffmann E, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P786Factors associated with acute pacemaker implantation after carvo- tricuspidal isthmus ablation - results from the German ablation registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lemoine M, Prondzynski M, Mearini G, Kraemer E, Redwood C, Patten M, Willems S, Hansen A, Eschenhagen T, Christ T, Carrier L. P5839Patient-specific iPSC-derived cardiomyocytes reveal a disease-causing role of an ACTN2 mutation in HCM and an unexpected LQT phenotype. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Moser J, Hoffmann B, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck KH, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P2672Which factors are associated with acute pacemaker implantation after ablation of atrial fibrillation? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moser A, Schulte Steinberg B, Zeller T, Eickholt C, Ojeda-Echevarria F, Mayer-Runge U, Schultze A, Blankenberg S, Willems S, Schnabel R, Karakas M. P2682Efficacy of acute intravenous therapy with potassium, magnesium and metoprolol in recent-onset atrial fibrillation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moser J, Schaeffer B, Akbulak R, Nuerich J, Eickholt C, Jularic M, Willems S, Hoffmann B. P804Sedation monitoring with processed electroencephalogram signals under propofol sedation: a potential benefit on mapping and catheter ablation of ventricular premature contractions. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Schulte Steinberg B, Moser A, Zeller T, Eickholt C, Ojeda-Echevarria F, Mayer-Runge U, Schultze A, Blankenberg S, Willems S, Schnabel R, Karakas M. P810Previous catheter ablation is the strongest predictor of conversion in recent-onset atrial fibrillation - Results from the prospective HAMBURG-AF study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moser J, Hoffmann B, Andresen D, Brachmann J, Eckardt L, Hoffmann E, Kuck K, Lewalter T, Schumacher B, Spitzer S, Hochadel M, Senges J, Willems S. P783Influencing factors of in-hospital pacemaker implantation after ablation of AV-nodal reentry- and AV-reentry tachycardia: results from the German ablation registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hakmi S, Pecha S, Castro L, Gosau N, Willems S, Reichenspurner H. P1757Laser lead extraction in patients with venous stenosis or occlusion. Europace 2017. [DOI: 10.1093/ehjci/eux161.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pecha S, Willems S, Reichenspurner H, Hakmi S. P1753Laser lead extraction: Comparison of infected vs. non-infected leads. Europace 2017. [DOI: 10.1093/ehjci/eux161.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dinshaw L, Muench J, Dickow J, Willems S, Patten M, Hoffmann BA. P1624Elevated risk of ventricular tachyarrhythmia and appropriate ICD therapy in patients with hypertrophic cardiomyopathy and a prolonged T-peak to T-end interval. Europace 2017. [DOI: 10.1093/ehjci/eux158.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hakmi S, Pecha S, Vogler J, Gosau N, Willems S, Reichenspurner H. P1769The bridge occlusion balloon as a safety net in high-risk transvenous lead extraction procedures: a novel approach. Europace 2017. [DOI: 10.1093/ehjci/eux161.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pecha S, Linder M, Castro L, Gosau N, Willems S, Reichenspurner H, Hakmi S. P1767The challenge of aggressive adhesions: tool combination for successful lead extraction. Europace 2017. [DOI: 10.1093/ehjci/eux161.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pecha S, Linder M, Castro L, Vogler J, Gosau N, Willems S, Reichenspurner H, Hakmi S. P1766Do we need to interrupt oral anticoagulation for transvenous lead extraction with powered sheaths? Europace 2017. [DOI: 10.1093/ehjci/eux161.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hakmi S, Pecha S, Gosau N, Meyer C, Willems S, Reichenspurner H. P1517SVC intraoperative selective venography during transvenous lead extraction. Europace 2017. [DOI: 10.1093/ehjci/eux158.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hakmi S, Pecha S, Vogler J, Gosau N, Willems S, Reichenspurner H. P1768Transvenous extraction of superfluous leads: worth the effort? Europace 2017. [DOI: 10.1093/ehjci/eux161.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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71
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Kuijpers C, Hendriks L, Derks J, Dingemans AM, Van Lindert A, Van den Heuvel M, Damhuis R, Willems S. Correlation of molecular status and anatomic sites of metastases (mets) at diagnosis (Dx) of non-small cell lung cancer (NSCLC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx094.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Linder M, Pecha S, Castro L, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. The Challenge of Aggressive Adhesions: Tool Combination for Successful Lead Extraction. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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73
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Pecha S, Ghandili S, Willems S, Reichenspurner H, Wagner F. Surgical Ablation for Atrial Fibrillation: Predictors for Long-Term Success. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Castro L, Pecha S, Linder M, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. CRT Device Explantation: A Temporary Bridging Solution for Bi-Ventricular Pacing is Needed. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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75
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Seoudy H, Pecha S, Gosau N, Linder M, Zipfel S, Willems S, Treede H, Reichenspurner H, Hakmi S. Limitations in the Extraction of Active Fixation Coronary Sinus Leads. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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