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Herzschrittmachertherapie & Elektrophysiologie

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https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#1
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29138937/effects-of-propofol-sedation-on-pacing-thresholds-results-from-an-observational-cohort-study
#2
Jakob Lüker, Arian Sultan, Tobias Plenge, Samuel Lee, Jan-Hendrik van den Bruck, Daniel Steven
BACKGROUND: Propofol is one of the most commonly used intravenous anaesthetic drugs for surgical procedures. The use of propofol for sedation is also common practice during endoscopic procedures, electrophysiology studies, and ablation procedures, as well as pacemaker and defibrillator implantation. It was found that propofol alters the electrophysiologic properties of the heart and its conduction system. The effects of propofol on pacing thresholds are unknown and could have implications for pacemaker (PM) and defibrillator (ICD) implantation procedures, as well as sedation and anaesthesia in PM and ICD patients in general...
November 14, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29101545/-recent-and-upcoming-randomized-trials-for-left-atrial-appendage-occlusion-need-for-a-definite-assessment-of-the-situation
#3
REVIEW
Carsten Skurk, Johannes Jakob Hartung, Ulf Landmesser
Atrial fibrillation (AF) is the most common arrhythmia affecting more than 1.6 million patients in Germany. Based on demographic developments, an the number is expected to increase. Embolic strokes in AF patients are particularly severe, and individualized new oral anticoagulant (NOAC) therapy reduces the incidence of stroke in these patients by approximately 70%. Besides vitamin K antagonists, the NOACs rivaroxaban, dabigatran, apixaban, and edoxaban have been introduced into clinical practice; however, major bleeding still occurs at a rate of 2-3% per year...
November 3, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29101544/anatomy-of-the-atria-a%C3%A2-road-map-to-the-left-atrial-appendage
#4
REVIEW
Umberto Barbero, Siew Yen Ho
The left atrial appendage (LAA) has received increasing attention in recent years because of thrombi formation in patients with atrial fibrillation, which increases the risk of stroke. In patients who have contraindications for long-term oral anticoagulation therapy, percutaneous procedures are used to occlude the LAA and there are now several devices available for implantation, both endocardially and epicardially. Despite the high-resolution imaging techniques on hand today, limitations remain in providing information about wall thickness and neighboring structures; therefore, in-depth knowledge of the normal atrial anatomy is mandatory when considering such interventions...
November 3, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29080014/-available-transvenous-occluder-designs-and-implantation-techniques
#5
REVIEW
P Sick, T Lewalter
In this article, most of the present or available in the near future left atrial appendage (LAA) occlusion devices are discussed in terms of structure of the devices and principle technique for implantation. Thus, the Watchman™ device from Boston, the Amulet™ device from Abbot, the Lambre™ device from Lifetech, the Occlutech® device from Occlutech®, and the WaveCrest® device from Biosense Webster (former Coherex) are discussed. The systems differ in terms of the concept of occlusion. Several devices consist of only one part (Watchman™ and Occlutech®) that is implanted in the body, ending up in the orifice of the LAA...
October 27, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29071390/-current-indications-for-left-atrial-appendage-occlusion
#6
REVIEW
Clemens Jilek, Thorsten Lewalter
Among patients with atrial fibrillation, the bleeding risk is linked to the stroke risk. Left atrial appendage (LAA) occlusion may reduce bleeding risk in high-risk patients. On the basis of a literature analysis and the Consensus Document of European Heart Rhythm Association (EHRA), the indications for a LAA occluder are clarified and a clear decision strategy for daily clinical practice is presented.
October 25, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28852834/-legal-considerations-of-telemedical-care
#7
REVIEW
Hendrik Schneider
Telemedical methods are on the rise in patient care. In addition to the actual changes for both sides in the physician-patient relationship, the use of information and communication technology also involves legal challenges. This article deals with the legal framework of telemedical care. Thereby the article discusses the prohibition of remote treatment (§ 7 Abs. 4 MBO-Ä) and the question to what extent the omission of a telemedical method of treatment can fulfill a medical breach of duty. A distinction must be drawn between the question as to whether telemedical monitoring shall be executed and the question how to use telemedical systems, in order to mitigate liability risks for the physicians...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28852772/-telemedicine-requirements-and-concepts-for-change
#8
EDITORIAL
Jörg O Schwab
No abstract text is available yet for this article.
August 29, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28849391/-current-status-and-future-of-telemonitoring-scenarios-for-telemedical-care-in-2025
#9
REVIEW
Bettina Zippel-Schultz, Carsten Schultz, Thomas M Helms
Telemonitoring is an already realized implementation of digital transformation in the healthcare system. It has the potential to support and secure a sustainable and comprehensive provision of healthcare for a rising number of chronically ill patients, e. g. patients with chronic heart failure. Remote regions in particular can profit from the benefits of telemonitoring; however, so far telemonitoring services have not become truly established in the German healthcare market. Together with experts from politics, science and practice, a scenario analysis "Health Care System 2025 - A Place for Telemonitoring?" was carried out with the aim to examine the future development of the healthcare market and to draw conclusions for providers of telemonitoring services or devices...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28840364/perservative-paroxysmal-atrioventricular-block-cardiac-syncope-misdiagnosed-as-anxiety-for-more-than-20%C3%A2-years
#10
Sona Tribunyan, Carsten W Israel, Mihran Martirosyan
A 42-year-old woman was referred for cardiac diagnostic work-up of loss of recurrent consciousness over the past 25 years. She received medication with an anxiolytic, an antidepressant, and a neuroleptic drug. After a normal resting ECG, there were 112 episodes of paroxysmal atrioventricular block III° in her 24 h Holter recording with asystole for up to 27 s. The patient was symptomatic only once with dizziness due to an asystole of 8.8 s while she was awake in the early morning. After DDDR pacemaker implantation, the patient was asymptomatic during the following 2 years...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28840315/right-bundle-branch-block-and-anterior-wall-st-elevation-myocardial-infarction
#11
Monica Trofin, Carsten W Israel, S Serge Barold
We report the case of an acute anterior wall ST elevation myocardial infarction with new left anterior fascicular block and pre-existing right bundle branch block. Due to a wide right bundle branch block, no ST segment elevation was visible in lead V1. The left anterior fascicular block was caused by proximal occlusion of the left artery descending and disappeared after acute revascularization. However, also the R' of the right bundle branch block became significantly shorter after revascularization, dismanteling a minor ST segment elevation...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28840312/-the-telemedical-service-centre-as-an-essential-element-of-the-conceptual-approach-for-telemonitoring-of-cardiac-patients-requirements-on-the-service-quality-and-technical-realization-of-telemonitoring
#12
REVIEW
T M Helms, A Müller, C Perings, F Köhler, V Leonhardt, K Rybak, S Sack, M Stockburger
Telemonitoring as part of a treatment strategy supports and facilitates the monitoring, disease management and education of patients with heart failure and cardiac arrhythmias. Therefore, telemonitoring affects quality and success of the therapy. Thus, meeting the needs of the patients and of the involved health care professionals is important for the success of the telemonitoring service. Moreover, a high quality of the service has to be ensured. The following article describes several configuration options for telemonitoring services considering technical as well as quality- and service-related aspects...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28831556/-active-cardiac-implantable-electronic-devices-what-is-possible-in-ambulatory-health-care-in-2017
#13
REVIEW
Karin Rybak
Telemonitoring (TM) features are implemented in nearly all cardiac implantable electronic devices (CIEDs) that have recently been released to the market. In combination with pacemakers, defibrillators and systems for cardiac resynchronization it is a safe and efficient method for routine technical aftercare of the devices as well as for monitoring heart failure and arrhythmias. Using TM has the potential to optimize patient care with regard to economic, clinical and safety aspects. Despite the good availability of existing data and clear recommendations of the responsible scientific societies, it is often seen as an isolated solution which is not fully integrated into standard care, although it has its own EBM number for implantable cardioverter-defibrillators and cardiac resynchronization therapy systems...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28831544/-non-device-based-telemonitoring-toy-or-tool
#14
REVIEW
Martin Stockburger
Non-device-based telemedical management can be useful to prevent decompensation and death in patients suffering from easily disequilibrated conditions like diabetes mellitus, chronic obstructive pulmonary disease and heart failure (HF). This article summarizes current knowledge on non-device-based telemedical care for patients with HF. Several parameters (heart rate, heart rate variability, systolic blood pressure, pulse pressure, body weight, physical activity as derived from accelerometry, and occurrence of atrial and ventricular arrhythmias) have been identified as being associated with imminent clinical deterioration of HF patients...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28831494/-erratum-to-diagnosis-of-ischemia-and-revascularization-in-patients-with-ventricular-tachyarrhythmia
#15
Thomas Deneke, Carsten W Israel
No abstract text is available yet for this article.
August 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28819689/beware-of-the-coronary-arteries-with-implantable-cardiac-electronic-devices
#16
REVIEW
S Serge Barold, Benjamin J Pang, Harry G Mond
The transvenous implantation of cardiac devices may sometimes cause serious complications involving the coronary arteries. The left anterior descending artery may be injured during nonapical right ventricular implantation while a right atrial lead may injure the right or circumflex coronary artery. Injury of a left internal mammary graft to a coronary artery may cause myocardial infarction.
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28812138/-telemetric-follow-up-of-implantable-electronic-cardiac-devices-optimisation-of-care-in-clinical-practice
#17
REVIEW
Ralph Bosch, Ingrid Mutscher
Remote follow-up of patients with implantable electronic cardiac devices (IECD) is a scientifically well-evaluated and technically mature method. Advantages over conventional follow-up include rapid detection of clinically relevant events (i. e. arrhythmias) and of technical problems. Additionally, telemetric follow-up of IECDs has a high degree of acceptance among both patients as well as health care professionals and carries the potential to reduce health care costs. The implementation of a remote follow-up programme is associated with organisational, infrastructural and legal aspects, which are reviewed...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28812129/-device-based-remote-monitoring-current-evidence
#18
REVIEW
David Duncker, Roman Michalski, Johanna Müller-Leisse, Christos Zormpas, Thorben König, Christian Veltmann
Telemedicine is increasingly used in clinical cardiology. It offers early detection of arrhythmias, technical device follow-up and support of heart failure management. Regarding technical device follow-up, remote monitoring significantly reduces usage of the health care system. Furthermore, remote monitoring is associated with a significantly reduced time from device malfunction to physician's perception of the event. Using remote monitoring, inappropriate ICD (implantable cardioverter defibrillator) shocks can be significantly reduced compared to routine in-office follow-up...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28695373/catheter-ablation-of-persistent-atrial-fibrillation-circumferential-pulmonary-vein-ablation-beneficial-effect-of-an-additional-linear-lesion-at-the-roof-of-the-left-atrium-on-the-long-term-outcome
#19
Klaus Kettering, Dag-Hau Yim, Felix Gramley
BACKGROUND: Circumferential pulmonary vein ablation is still the standard approach in patients with persistent atrial fibrillation. However, the results are not very favourable and more complex ablation strategies are the subject of current controversy. Therefore, we have evaluated the effect of an additional linear lesion at the roof of the left atrium on the long-term outcome. METHODS: A total of 125 patients with symptomatic persistent atrial fibrillation underwent a circumferential pulmonary vein ablation procedure in combination with an additional linear lesion at the roof of the left atrium (group A)...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28660476/a%C3%A2-review-of-the-atrial-upper-rate-algorithms-of-st-jude-medical-abbott-cardiac-implantable-electronic-devices-incidence-of-repetitive-nonreentrant-ventriculoatrial-synchrony-rnrvas
#20
REVIEW
S S Barold
This review focuses on the manifestations of the three triggered atrial upper rate functions of St Jude Medical cardiac implantable electronic devices. The occurrence of repetitive nonreentrant ventriculoatrial synchrony (RNRVAS) is also evaluated as a basis for the development of automatic mode switching (AMS) and as a trigger for atrial tachycardia/atrial fibrillation (AT/AF) event recordings. RNRVAS is a common trigger for AMS because all the atrial events or intervals are used to calculate the filtered atrial rate interval (FARI)...
September 2017: Herzschrittmachertherapie & Elektrophysiologie
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