149 research outputs found
Automated electrocardiographic quantification of myocardial scar in patients undergoing primary prevention implantable cardioverter-defibrillator implantation: Association with mortality and subsequent appropriate and inappropriate therapies
No full textBACKGROUND: Myocardial scarring from infarction or nonischemic fibrosis forms an arrhythmogenic substrate. The Selvester QRS score has been developed to estimate myocardial scar from the 12-lead electrocardiogram. OBJECTIVE: We aimed to assess the value of an automated version of the Selvester QRS score for the prediction of implantable cardioverter-defibrillator (ICD) therapy and death in patients undergoing primary prevention ICD implantation. METHODS: Unselected patients undergoing primary prevention ICD implantation were included in this retrospective, observational, multicenter study. The QRS score was calculated automatically from a digital standard preimplantation 12-lead electrocardiogram and was correlated to the occurrence of death and appropriate and inappropriate shocks during follow-up. Analyses were performed in groups defined by QRS duration .05). CONCLUSION: The automatically calculated Selvester QRS score, an indicator of myocardial scar burden, predicts mortality and appropriate and inappropriate shocks in patients undergoing primary prevention ICD implantation with a prolonged QRS duration.sponsorship: This work was supported by the Swiss Heart Foundation, Switzerland, and the European Community's Seventh Framework Programme FP7/2007-2013 under grant agreement no. 602299, EU-CERT-ICD. Dr Reichlin has received speaker/consulting honoraria or travel support from Abbott/SJM, AstraZeneca, Brahms, Bayer, Biosense Webster, Biotronik, Boston Scientific, Daiichi Sankyo, Medtronic, Pfizer-BMS, and Roche, all for work outside the submitted study. He has received support for his institution's fellowship program from Abbott/SJM, Biosense Webster, Biotronik, Boston Scientific, and Medtronic for work outside the submitted study. Dr Vos is a co-PI on Netherlands Cardiovascular Research Initiative (CVON): Dutch Heart Foundation, Dutch Federation of University Medical Centers, Netherlands Organisation for Health Research and Development, and Royal Netherlands Academy of Science: CVON PREDICT 1 and 2 and has received grants from Holland Health: the Public-Private Partnership grant of the Dutch Heart Foundation together with Medtronic. Dr Willems reports research funding from Biotronik, Boston Scientific, and Medtronic; speakers and consultancy fees from Medtronic, Boston Scientific, Biotronik, Abbott, and MicroPort. He is supported as postdoctoral clinical researcher by the Fund for Scientific Research Flanders. Drs Hnatkova and Malik report a research grant from the British Heart Foundation for work outside the submitted study. Dr Schaer is a member of the speaker's bureau of Medtronic. Dr Sticherling reports grants from Biosense Webster and lecture fees from Medtronic, Biosense Webster, Boston Scientific, MicroPort, Pfizer, and Biotronik. The rest of the authors report no conflicts of interest. 1Drs Reichlin and Asatryan contributed equally to this work and are co-first authors. (Swiss Heart Foundation, Switzerland, European Community|602299, EU-CERT-ICD, Holland Health: the Public-Private Partnership grant of the Dutch Heart Foundation, Biotronik, Boston Scientific, Medtronic, Fund for Scientific Research Flanders, Biosense Webster)status: Publishe
Battery longevity of implantable cardioverter-defibrillators and cardiac resynchronization therapy defibrillators: technical, clinical and economic aspects. An expert review paper from EHRA
No full textIn recent years an extension of devices longevity has been obtained for implantable cardioverter-defibrillators (ICDs), including ICDs for cardiac resynchronization therapy (CRT-D) through improved battery chemistry and device technology and this implies important clinical benefits (reduced need for device replacements and associated complications, particularly infections), as well as economic benefits, in line with patient preferences and needs. From a clinical point of view, the availability of this improvement in technology allows to better tune the choice of the device to be implanted, taking into account that the reasons supporting the value of an extended device longevity as a clinical priority may differ according to the clinical setting (purely electrical diseases or left ventricular dysfunction/heart failure, respectively). From an economic point of view, extension of device longevity may have an important impact in reducing long-term costs of device therapy, with substantial daily savings in favour of devices with extended longevity, up to 30%, depending on clinical scenarios. In studies based on projections, an extension of device longevity allowed to calculate that the cost per day of ICDs may be substantially reduced, and this allows to overcome the frequent perception of ICD and CRT-D devices as treatments with unaffordable costs and to overturn the misconception that up-front costs are the only metric with which to value device treatments. In view of its clinical and economic value, device longevity should be a determining factor in device choice by physicians and healthcare commissioners and should be appropriately considered and valued in comparative tenders
Necessity for surgical revision of defibrillator leads implanted long-term : causes and management
No full textBACKGROUND: Defibrillator lead malfunction is a potential long-term complication in patients with an implantable cardioverter-defibrillator (ICD). The aim of this study was to determine the incidence and causes of lead malfunction necessitating surgical revision and to evaluate 2 approaches to treat lead malfunction. METHODS AND RESULTS: We included 1317 consecutive patients with an ICD implanted at 3 European centers between 1993 and 2004. The types and causes of lead malfunction were recorded. If the integrity of the high-voltage part of the lead could be ascertained, an additional pace/sense lead was implanted. Otherwise, the patients received a new ICD lead. Of the 1317 patients, 38 experienced lead malfunction requiring surgical revision and 315 died during a median follow-up of 6.4 years. At 5 years, the cumulative incidence was 2.5% (95% confidence interval, 1.5 to 3.6). Lead malfunction resulted in inappropriate ICD therapies in 76% of the cases. Implantation of a pace/sense lead was feasible in 63%. Both lead revision strategies were similar with regard to lead malfunction recurrence (P=0.8). However, the cumulative incidence of recurrence was high (20% at 5 years; 95% confidence interval, 1.7 to 37.7). CONCLUSIONS: ICD lead malfunction necessitating surgical revision becomes a clinically relevant problem in 2.5% of ICD recipients within 5 years. In selected cases, simple implantation of an additional pace/sense lead is feasible. Regardless of the chosen approach, the incidence of recurrent ICD lead-related problems after lead revision is 8-fold higher in this population
Development and Utilization of an E-learning Course on Heat Exchangers at ENSIC
No full textInternational audienceThis paper deals with the development and utilization of an e-learning course at ENSIC in France. Some definitions and examples of problem based learning (PBL) or e-learning utilizations in the world of chemical engineering are first given. This survey results from discussions held in the frame of the Working Party on Education of the European Federation of Chemical Engineering. The e-learning course developed at ENSIC is described and its use, according to an original pedagogy mixing e-learning and PBL, is detailed. The results show that this new pedagogy does not reduce the time of training but induces much more active learning, a better comprehension of technology and the possibility for the students to progress at their own rhythm. Author(s): E. Schaer 1, *, | C. Roizard 2, | N. Christmann 3, | A. Lemaitre
Publication Rate and Impact Factor of Abstracts Presented at SSC Congresses 2011 to 2014
No full textBACKGROUND: The annual congress of the Swiss Societies of Cardiology and Cardiac Surgery is the most important national platform for Swiss researchers in these specialities. Every year there are a high number of oral presentations and posters. However, more important is their publication in international journals. We determined publication rates, impact factors (IFs) and their temporal trends in seven cardiological domains. METHODS: The abstract booklets of the congresses 2011–2014 were downloaded and all talks and posters presented during the meeting extracted. In PubMed we assessed whether each of these papers was published, the journal and its IF in the respective publication year. We excluded case reports, papers published >6 months before the congress and abstracts presenting national data from multicentre studies (unless the first/last author of the paper was from Switzerland). The percentage of published papers and their mean/median IF were calculated overall and per year separately for each domain. We also compared major Swiss hospitals regarding their individual publication rates. RESULTS: A total of 715 abstracts were included, of which 52% were published as of February 2017. The lowest average publication rate in a domain was 36% and the highest 69%, with mean IFs between 2.5 and 7.8. The lowest average publication rate in one of the major hospitals was 16% and the highest 70%. CONCLUSIONS: Abstracts presented during the congresses had a high chance of being published, usually in papers with a good IF. This reflects the good quality of research in cardiology in Switzerland
Fahreignung und kardiovaskuläre Erkrankungen: gemeinsame Richtlinien der Schweizerischen Gesellschaft für Kardiologie und der Schweizerischen Gesellschaft für Rechtsmedizin
No full textDevice-Therapie der chronischen Herzinsuffizienz
No full textBesides optimal drug therapy, cardiac resynchronisation therapy offers a further therapy option for selected patients. Additional ICD implantation should be evaluated as well to prevent sudden cardiac death
Mechanism of Sudden Cardiac Death in Coronary Artery Disease
No full textAn 87-year-old lady with hypertension being her only cardiovascular risk factor was investigated for dyspnoea and chest oppression three years ago, and acute coronary syndrome could be excluded [...
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