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Tschorn M, Rieckmann N, Arolt V, Beer K, Haverkamp W, Martus P, Waltenberger J, Müller-Nordhorn J, Ströhle A. Erkennungsgüte dreier deutschsprachiger Screeninginstrumente für Depression bei hospitalisierten Patienten mit koronarer Herzerkrankung. PSYCHIATRISCHE PRAXIS 2017; 46:41-48. [DOI: 10.1055/s-0042-123434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Zusammenfassung
Ziel Vergleich der Erkennungsgüte von drei Depressions-Screeninginstrumenten bei Patienten mit koronarer Herzerkrankung (KHK).
Methodik 1019 KHK-Patienten erhielten den Patient Health Questionnaire (PHQ-9 und PHQ-2) und die Hospital Anxiety and Depression Scale (HADS-D) sowie ein klinisches Interview (Composite International Diagnostic Interview) als Referenzstandard.
Ergebnisse Bezüglich der Erkennungsgüte waren PHQ-9 und HADS-D dem PHQ-2 überlegen. Optimale Cut-off-Werte waren 7 (PHQ-9 und HADS-D) und 2 (PHQ-2).
Schlussfolgerung PHQ-9 und HADS-D haben eine vergleichbare Diskriminationsfähigkeit für depressive Störungen bei KHK-Patienten.
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Kochhäuser S, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Impact of acute atrial fibrillation termination and prolongation of atrial fibrillation cycle length on the outcome of ablation of persistent atrial fibrillation: A substudy of the STAR AF II trial. Heart Rhythm 2017; 14:476-483. [DOI: 10.1016/j.hrthm.2016.12.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Indexed: 10/20/2022]
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Attanasio P, Lacour P, Ernert A, Pieske B, Haverkamp W, Blaschke F, Dalle Vedove F, Huemer M. Cardiac device implantations in obese patients: Success rates and complications. Clin Cardiol 2017; 40:230-234. [PMID: 28333397 DOI: 10.1002/clc.22650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/28/2016] [Accepted: 11/02/2016] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Obesity is associated with increased complications and potentially worse outcomes for various cardiac interventions. This study analyzed the success rate and complication rates associated with implantation of cardiac implantable electronic devices (CIEDs) in obese patients. HYPOTHESIS Success rates are lower and complication rates higher in obese patients. METHODS Consecutive patients undergoing CIED implantation between 2011 and 2015 in our hospital were included. Patients were categorized into obese and nonobese groups according to body mass index (BMI); cutoff was 30 kg/m2 . Patient characteristics, complication rates, procedural duration, and fluoroscopy data were compared between the 2 groups. RESULTS A total of 965 patients (mean age, 69.0 ± 12.9 years; 67% male) were included. Of these, 249 (25.8%) patients were classified obese and 716 (74.2%) nonobese. Mean BMI was 34.7 ± 4.7 kg/m2 vs 25.1 ± 3.0 kg/m2 , respectively. There was no difference in procedural success rates between the 2 groups (97.2% vs 97.1%, respectively). Major complications were significantly lower in the obese group compared with the nonobese group (11 [4.4%] vs 62 [8.7%]; P < 0.05). Procedural duration and fluoroscopy duration were not different between the 2 groups, but the total dose-area product was significantly higher in obese patients vs nonobese patients (4012 ± 5416 cGcm2 vs 2692 ± 5277 cGcm2 ; P < 0.005). CONCLUSIONS CIED implantation can be safely and effectively achieved in patients with BMI >30 kg/m2 . However, total radiation dose was significantly higher in the obese group, emphasizing that efforts should be made to reduce radiation exposure in these patients.
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Lacour P, Dang PL, Huemer M, Parwani AS, Attanasio P, Pieske B, Boldt LH, Haverkamp W, Blaschke F. Performance of the New BioMonitor 2-AF Insertable Cardiac Monitoring System: Can Better be Worse? PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:516-526. [PMID: 28220938 DOI: 10.1111/pace.13059] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/31/2017] [Accepted: 02/11/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Implantable loop recorders (ILR) are valuable tools for the investigation of patients with suspected arrhythmias. The BioMonitor 2-AF is a novel insertable ILR with enhanced atrial fibrillation (AF) detection algorithm and remote monitoring capability. OBJECTIVE The objective of this first-in-human study with the BioMonitor 2-AF was to analyze course of P-wave sensing performance and R-wave amplitude, prevalence of false and correctly sensed and classified episodes, and effectiveness of remote monitoring. METHODS All 19 patients who underwent ILR insertion were included in the BIOTRONIK Home Monitoring® system (BIOTRONIK GmbH, Berlin, Germany). Daily changes in P-wave and R-wave sensing were analyzed over 6 weeks. A breathing test (in- and expiration) was performed in two different body positions at baseline and during a 6-week in-house follow-up to investigate alterations of P-wave and R-wave sensing. RESULTS R-wave amplitude and the high P-wave visibility (94.4%) remained unchanged during the follow-up period. In most patients both an increase and decrease of R-wave amplitude, and in some cases a complete R-wave vector change (31.6%), was documented during the "breathing test." Change of body position did not alter R-wave sensing amplitude mostly. "Breathing test" and change of body position had no effect on P-wave sensing performance. In 15.8% of the patients, misclassification of episodes as AF or high ventricular rates due to P-wave oversensing occurred. No ILR-related complication occurred. Automatic transmission via BIOTRONIK Home Monitoring® was successful 100% of the time. CONCLUSION This study demonstrates that the BioMonitor 2-AF is a safe and effective tool for continuous cardiac monitoring.
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Attanasio P, Schreiber T, Pieske B, Blaschke F, Boldt LH, Haverkamp W, Huemer M. Pushing the limits: establishing an ultra-low framerate and antiscatter grid-less radiation protocol for left atrial ablations. Europace 2017; 20:604-607. [DOI: 10.1093/europace/eux010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/20/2017] [Indexed: 11/14/2022] Open
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Kuhlmann SL, Tschorn M, Arolt V, Beer K, Brandt J, Grosse L, Haverkamp W, Müller-Nordhorn J, Rieckmann N, Waltenberger J, Warnke K, Hellweg R, Ströhle A. Serum brain-derived neurotrophic factor and stability of depressive symptoms in coronary heart disease patients: A prospective study. Psychoneuroendocrinology 2017; 77:196-202. [PMID: 28092760 DOI: 10.1016/j.psyneuen.2016.12.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Brain-derived neurotrophic factor (BDNF) supports neurogenesis, angiogenesis, and promotes the survival of various cell types in the brain and the coronary system. Moreover, BDNF is associated with both coronary heart disease (CHD) and depression. The current study aims to investigate whether serum BDNF levels are associated with the course of depressive symptoms in CHD patients. METHODS At baseline, N=225 CHD patients were enrolled while hospitalized. Of these, N=190 (84%) could be followed up 6 months later. Depressive symptoms were assessed both at baseline and at the 6-months follow-up using the Patient Health Questionnaire (PHQ-9). Serum BDNF concentrations were measured using fluorometric Enzyme-linked immunosorbent assays (ELISA). RESULTS Logistic regression models showed that lower BDNF levels were associated with persistent depressive symptoms, even after adjustment for age, sex, smoking and potential medical confounders. The incidence of depressive symptoms was not related to lower BDNF levels. However, somatic comorbidity (as measured by the Charlson Comorbidity Index) was significantly associated with the incidence of depressive symptoms. CONCLUSIONS Our findings suggest a role of BDNF in the link between CHD and depressive symptoms. Particularly, low serum BDNF levels could be considered as a valuable biomarker for the persistence of depressive symptoms among depressed CHD patients.
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Limmroth V, Ziemssen T, Lang M, Richter S, Wagner B, Haas J, Schmidt S, Gerbershagen K, Lassek C, Klotz L, Hoffmann O, Albert C, Schuh K, Baier-Ebert M, Wendt G, Schieb H, Hoyer S, Dechend R, Haverkamp W. Electrocardiographic assessments and cardiac events after fingolimod first dose - a comprehensive monitoring study. BMC Neurol 2017; 17:11. [PMID: 28100182 PMCID: PMC5241949 DOI: 10.1186/s12883-016-0789-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background First dose observation for cardiac effects is required for fingolimod, but recommendations on the extent vary. This study aims to assess cardiac safety of fingolimod first dose. Individual bradyarrhythmic episodes were evaluated to assess the relevance of continuous electrocardiogram (ECG) monitoring. Methods START is an ongoing open-label, multi-center study. At the time of analysis 3951 patients were enrolled. The primary endpoints are the incidence of bradycardia (heart rate < 45 bpm) and second-/third-degree AV blocks during treatment initiation. The relevance of Holter was assessed by matching ECG findings with the occurrence of clinical symptoms as well as by rigorous analysis of AV blocks with regard to the duration of pauses and the minimal heart rate recorded during AV block. Results Thirty-one patients (0.8%) developed bradycardia (<45 bpm), 62 patients (1.6%) had second-degree Mobitz I and/or 2:1 AV blocks with a lowest reading (i.e. mean of ten consecutive beats) of 35 bpm and the longest pause lasting for 2.6 s. No Mobitz II or third-degree AV blocks were observed. Only one patient complained about mild chest discomfort and fatigue. After 1 week, there was no second-/third-degree AV block. Conclusions Continuous Holter ECG monitoring in this large real-life cohort revealed that bradycardia and AV conduction abnormalities were rare, transient and benign. No further unexpected abnormalities were detected. The data presented here give an indication that continuous Holter ECG monitoring does not add clinically relevant value to patients’ safety. Trial registration NCT01585298; registered April 23, 2012.
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Anker MS, Ebner N, Hildebrandt B, Springer J, Sinn M, Riess H, Anker SD, Landmesser U, Haverkamp W, von Haehling S. Resting heart rate is an independent predictor of death in patients with colorectal, pancreatic, and non-small cell lung cancer: results of a prospective cardiovascular long-term study. Eur J Heart Fail 2016; 18:1524-1534. [DOI: 10.1002/ejhf.670] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 08/28/2016] [Accepted: 09/02/2016] [Indexed: 12/18/2022] Open
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Lewalter T, Weiss C, Mewis C, Jung W, Haverkamp W, Proff J, Bauer W. An optimized approach for right atrial flutter ablation: a post hoc analysis of the AURUM 8 study. J Interv Card Electrophysiol 2016; 48:159-166. [DOI: 10.1007/s10840-016-0202-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/11/2016] [Indexed: 11/29/2022]
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85
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Lauschke J, Busch M, Haverkamp W, Bulava A, Schneider R, Andresen D, Nägele H, Israel C, Hindricks G, Bänsch D. New implantable cardiac monitor with three-lead ECG and active noise detection. Herz 2016; 42:585-592. [DOI: 10.1007/s00059-016-4492-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 09/27/2016] [Accepted: 10/04/2016] [Indexed: 01/14/2023]
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Attanasio P, Blaschke F, Pieske B, Tschöpe C, Haverkamp W. Risikostratifizierung bei familiärer hypertropher Kardiomyopathie anhand der neuen ESC-Leitlinien. Dtsch Med Wochenschr 2016; 141:1035-9. [DOI: 10.1055/s-0041-107679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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87
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Parwani AS, Boldt LH, Blaschke F, Lacour P, Huemer M, Attanasio P, Pieske B, Haverkamp W. 136-39: Leadless pacemaker: choosing the right intervention for the right patient: a case report. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i100] [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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88
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Huemer M, Franke A, Tscholl V, Attanasio P, Lacour P, Parwani AS, Roser M, Boldt LH, Haverkamp W, Blaschke F. 16-41: Effects of radiation therapy on cardiac implantable electronic devices - Evaluation of a standardized safety protocol. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i11] [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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89
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Huemer M, Pawlowicz J, Attanasio P, Parwani AS, Lacour P, Haverkamp W, Blaschke F, Boldt LH. 216-41: Electrocautery compared to electrical plasma surgery in patients undergoing device generator replacement - A prospective randomized study. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i151b] [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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90
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Blaschke F, Krackhardt F, Kherad B, Pieske B, Haverkamp W, Rief M. A Rare Case of Single Coronary Artery with Atherosclerotic Lesions Arising from the Right Sinus of Valsalva. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2016; 8:114-6. [PMID: 27042610 PMCID: PMC4791898 DOI: 10.4103/1947-2714.177345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Context: Congenital coronary anomalies, including anomalous origin, distribution, intercoronary communications, and coronary fistulae occur at a rate of approximately 1% in the general population and are the most incidental findings. Case Report: A 49-year-old male patient presented to the emergency department with exercise-induced dyspnea and atypical angina pectoris. Coronary angiography (CAG) and contrast-enhanced 320-slice multidetector cardiac computed tomography with subsequent three-dimensional reconstructions revealed a single coronary artery (SCA) arising from the right sinus of Valsalva with a proximal branch giving rise to the left anterior descending coronary artery. The left anterior descending coronary artery shows severe atherosclerotic lesions and it is occluded afterwards. Adenosine stress perfusion cardiac magnetic resonance imaging (MRI) revealed a stress myocardial ischemia at the anterior wall without signs of fibrosis, scar, or necrosis. Conclusion: We present an extremely rare case of a SCA, with the solitary vessel arising from the right sinus of Valsalva. In our patient's case, the atherosclerotic lesions and occlusion in the branch supplying the anterior wall were considered eligible for neither percutaneous intervention nor bypass graft surgery.
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Morris DA, Krisper M, Nakatani S, Köhncke C, Otsuji Y, Belyavskiy E, Radha Krishnan AK, Kropf M, Osmanoglou E, Boldt LH, Blaschke F, Edelmann F, Haverkamp W, Tschöpe C, Pieske-Kraigher E, Pieske B, Takeuchi M. Normal range and usefulness of right ventricular systolic strain to detect subtle right ventricular systolic abnormalities in patients with heart failure: a multicentre study. Eur Heart J Cardiovasc Imaging 2016; 18:212-223. [DOI: 10.1093/ehjci/jew011] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/13/2016] [Indexed: 01/08/2023] Open
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Ma XX, Boldt LH, Zhang YL, Zhu MR, Hu B, Parwani A, Belyavskiy E, Radha Krishnan AK, Krisper M, Köhncke C, Osmanoglou E, Kropf M, Lacour P, Blaschke F, Edelmann F, Tschöpe C, Haverkamp W, Pieske-Kraigher E, Pieske B, Morris DA. Clinical Relevance of Left Atrial Strain to Predict Recurrence of Atrial Fibrillation after Catheter Ablation: A Meta-Analysis. Echocardiography 2016; 33:724-33. [DOI: 10.1111/echo.13184] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Wutzler A, von Ulmenstein S, Attanasio P, Huemer M, Parwani AS, Völk K, Blaschke F, Boldt LH, Haverkamp W. Where There's Smoke, There's Fire? Significance of Atrial Fibrillation in Young Patients. Clin Cardiol 2016; 39:229-33. [PMID: 26848930 DOI: 10.1002/clc.22516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 11/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF), a disease of the elderly, occasionally occurs at younger age. Pathophysiology of AF in younger patients is diverse, including channelopathies and cardiomyopathies. Data on the significance and complications of AF in young patients are scarce. HYPOTHESIS Atrial fibrillation is the first manifestation of cardiovascular disease (CVD) in young patients. METHODS From 11 888 patients in a university hospital database, patients age ≤35 years were identified. A composite of stroke/transient ischemic attack, thromboembolic events, major bleeding, and death was the primary endpoint. Stroke/transient ischemic attack, thromboembolic events, major bleeding, death, AF during follow-up, diagnosis of arrhythmia other than AF, and new diagnosis of any CVD were secondary endpoints. Endpoints were compared between patients with and without comorbidities. RESULTS We identified 124 patients (29.1± 5 years). Of those, 84 were followed over 48.4 ± 39.8 months. Comorbidities were present in 40.5%. Incidence of the primary endpoint was not different between the groups. Arrhythmias other than AF were more common in patients without comorbidities (36% vs 14.7%; P = 0.032). A supraventricular tachycardia (SVT) was found in 57.1% of patients who underwent electrophysiological testing and was treated with catheter ablation. None of those patients had AF during follow-up. CONCLUSIONS Atrial fibrillation occurs in young patients with and without structural heart disease. Young AF patients without comorbidities rarely develop CVD during the first years after diagnosis. Yet, an SVT is found in a high proportion of young AF patients; AF may be first manifestation of SVT. Therefore, young patients should undergo further evaluation for SVT.
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Huemer M, Meloh H, Attanasio P, Wutzler A, Parwani AS, Matsuda H, Blaschke F, Boldt LH, Haverkamp W. The Lewis Lead for Detection of Ventriculoatrial Conduction Type. Clin Cardiol 2016; 39:126-31. [PMID: 26812168 DOI: 10.1002/clc.22505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/15/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Identification of a possible ventriculoatrial (VA) dissociation in wide QRS complex tachycardias is one of the most reliable criteria for differentiation of tachycardia origin. The Lewis lead has been proposed for detection of atrial activity during ventricular tachycardias. HYPOTHESIS A modified Lewis-lead-ECG will be superior to the standard-lead ECG for detection of ventriculoatrial conduction during ventricular tachycardia. METHODS Forty-seven patients underwent electrophysiological study, stimulated with a fixed cycle length of 400 ms in the ventricle. During stimulation, a standard-lead ECG and a modified Lewis-lead ECG were recorded. Simultaneously, VA conduction was documented by intracardiac electrograms. Surface ECGs were presented to 6 blinded examiners for VA conduction assessment. RESULTS Type of VA conduction was correctly diagnosed in significantly more ECGs in the Lewis-lead ECG group (mean, 35.0 [75%]) than in the standard-lead ECG group (mean, 29.2 [62%]; P = 0.045). Ventriculoatrial dissociation also was significantly more often correctly diagnosed in the Lewis-lead ECG group (mean, 17.7 [71%]) than in the standard-lead ECG group (mean, 12.7 [49%]; P = 0.014). Interobserver agreement was moderate in both groups (κ = 0.45 and κ = 0.49, respectively). CONCLUSIONS Compared with standard-lead ECG, modified Lewis-lead ECG is associated with significantly improved detection of VA conduction type during fast ventricular pacing and thus may help improve ECG diagnosis.
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Blaschke F, Lacour P, Wutzler A, Huemer M, Parwani AS, Attanasio P, Pieske B, Boldt LH, Haverkamp W. Managing periprocedural anticoagulation therapy in patients undergoing device implantation: survey in Germany, Austria and Switzerland. Acta Cardiol 2016; 71:549-556. [PMID: 27695012 DOI: 10.2143/ac.71.5.3167498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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96
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Blaschke F, Lacour P, Walter T, Wutzler A, Huemer M, Parwani A, Attanasio P, Boldt LH, Markowski M, Denecke T, Haverkamp W. Cardiovascular Magnetic Resonance Imaging in Patients with an Implantable Loop Recorder. Ann Noninvasive Electrocardiol 2015; 21:319-324. [PMID: 26701418 DOI: 10.1111/anec.12333] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Implantable loop recorders (ILRs) allow continuous cardiac monitoring for 3-6 years and are a valuable tool for the investigation of syncopal episodes, palpitations, and atrial fibrillations as well as risk stratification after myocardial infarction. Although magnetic resonance imaging (MRI) in patients with ILRs has been shown to be safe, the impact of ILRs on cardiac MRI image quality has not been investigated yet. Thus, we tested the diagnostic value of cardiac MRI in patients with various types of ILRs. METHODS Two patients with an ILR and a clinical indication to assess myocardial burden of scarring and fibrosis or stress-induced myocardial ischemia underwent cardiac MRI. Device interrogation was performed prior to, immediately after, and 3 months after cardiac MRI. RESULTS The post-MRI follow-ups revealed no change in programmed ILR parameters, sensing fidelity, and battery parameters. However, ILRs caused significant, uninterpretable hyperintensity artifacts in cardiac MRI. CONCLUSIONS Further clinical studies are warranted to investigate whether modified MRI techniques are helpful to eliminate imaging artifacts.
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Huemer M, Attanasio P, Wutzler A, Parwani AS, Boldt LH, Haverkamp W. [Mapping and ablation of a mechanically blocked concealed accessory pathway under repeated adenosine bolus infusions]. Herzschrittmacherther Elektrophysiol 2015; 26:371-373. [PMID: 26264483 DOI: 10.1007/s00399-015-0395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/27/2015] [Indexed: 06/04/2023]
Abstract
During mapping and catheter ablation of an accessory pathway, a mechanically induced conduction block can occur. Adenosine is used to detect dormant conduction of incomplete ablation lesions. Presented in this article is the case of a patient with a left-sided accessory pathway, which was mechanically blocked during the mapping procedure and could only be successfully ablated after repeated adenosine bolus infusions, which resulted in intermittent restitution of conduction via the accessory pathway.
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Attanasio P, Bissinger R, Haverkamp W, Pieske B, Wutzler A, Lang F. Enhanced suicidal erythrocyte death in acute cardiac failure. Eur J Clin Invest 2015; 45:1316-24. [PMID: 26479159 DOI: 10.1111/eci.12555] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 10/15/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND A common complication of acute cardiac failure (AHF) is anaemia, which negatively influences the clinical outcome. Causes of anaemia include enhanced eryptosis, a suicidal erythrocyte death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation. Signalling triggering eryptosis include oxidative stress, increase of cytosolic Ca(2+) -activity ([Ca(2+) ]i ) and ceramide. The present study explored whether AHF is associated with accelerated eryptosis. MATERIALS AND METHODS Erythrocytes were drawn from healthy volunteers (n = 10) and patients hospitalized for AHF (n = 22). Phosphatidylserine exposure was estimated from annexin-V-binding, cell volume from forward scatter, [Ca(2+) ]i from Fluo3-fluorescence, ceramide abundance utilizing specific antibodies and reactive oxygen species (ROS) abundance from 2',7'-dichlorodihydrofluorescein diacetate (DCFDA) fluorescence, as determined by flow cytometry. RESULTS In AHF-patients, haemoglobin concentration (11·5 ± 0·5 g/dL), and haematocrit (35·6 ± 1·2%) were significantly lower than haemoglobin concentration (14·1 ± 0·4 g/dL), and haematocrit (40·1 ± 1·0%) in healthy volunteers, even though reticulocyte number was significantly higher in AHF patients (2·3 ± 0·3%) than in healthy volunteers (1·1 ± 0·2%). The percentage of erythrocytes exposing phosphatidylserine was significantly higher in AHF patients (1·8 ± 0·1%) than in healthy volunteers (1·2 ± 0·2%). The forward scatter was significantly lower and the ROS abundance significantly larger in AHF patients than in healthy volunteers. In erythrocytes drawn from healthy volunteers, phosphatidylserine and ROS abundance was increased to significantly higher values following a 24 h treatment with plasma from AHF patients than with plasma from healthy volunteers. CONCLUSION AHF leads to anaemia despite increased reticulocyte number and at least partially due to enhanced eryptosis. Underlying mechanisms include oxidative stress imposed by a plasma borne component.
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Wutzler A, Attanasio P, Haverkamp W, Blaschke F. Near-Fatal ICD Lead Dysfunction with Implications for ICD Testing. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 39:105-6. [PMID: 26519249 DOI: 10.1111/pace.12776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 10/18/2015] [Accepted: 10/23/2015] [Indexed: 12/20/2022]
Abstract
A 31-year-old male patient with an implantable cardioverter defibrillator (ICD) experienced ventricular fibrillation. After resuscitation, no communication between the device and an ICD programmer was possible. The ICD was explanted, no signs of destruction were visible, and the ICD leads revealed normal values. A new ICD was implanted, interrogation values were stable. However, immediately after defibrillation testing the connection between programmer and ICD was interrupted and could not be established again. The device showed burn marks and a hole in the can. Analysis revealed an isolation defect of the ICD lead, which was not detectable with standard interrogation.
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Wutzler A, von Ulmenstein S, Attanasio P, Huemer M, Parwani AS, Boldt LH, Haverkamp W. Treatment of Nonagenarians With Atrial Fibrillation: Insights From the Berlin Atrial Fibrillation (BAF) Registry. J Am Med Dir Assoc 2015; 16:969-72. [DOI: 10.1016/j.jamda.2015.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 05/27/2015] [Indexed: 12/19/2022]
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