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Your search keyword '"Eckstein, Jens"' showing total 2 results
Start Over Author "Eckstein, Jens" Publisher american college of physicians
2 results on '"Eckstein, Jens"'

1. An electrocardiogram-based algorithm to detect loss of left ventricular capture during cardiac resynchronization therapy

Author

Ammann, Peter, Sticherling, Christian, Kalusche, Dietrich, Eckstein, Jens, Bernheim, Alain, Schaer, Beat, and Osswald, Stefan

Subjects
Electrocardiograph -- Usage, Heart failure -- Risk factors, Heart failure -- Diagnosis, Electrocardiography -- Equipment and supplies, Electrocardiography -- Usage, Health
Abstract

Background: Loss of left ventricular capture in patients with cardiac resynchronization devices may account for worsening heart failure and can be difficult to diagnose without a programmer. Objective: To determine whether distinct morphologic changes on the surface electrocardiogram indicate loss of left ventricular capture. Design: After analysis of the R-S spike ratio in the 12-lead electrocardiogram during right ventricular and biventricular pacing in 10 patients, an algorithm to detect loss of left ventricular capture was developed. Setting: University hospital. Patients: 54 patients with a cardiac resynchronization device and underlying left bundle-branch block. Measurements: Leads V1 and I of a 12-lead electrocardiogram were assessed after biventricular pacing was confirmed and after the device was programmed to right ventricular pacing only (simulating loss of left ventricular capture). Results: The sensitivity of the algorithm to correctly identify loss of left ventricular capture was 94% (95% CI, 88.2% to 97.7%), and the specificity was 93% (CI, 86.3% to 95.8%). The likelihood ratio of a positive test result was 12.8 (CI, 6.443 to 23.310), and the likelihood ratio of a negative test result was 0.06 (CI, 0.024 to 0.137). Limitations: The algorithm was tested in patients in whom the right ventricular electrode was placed in the apex of the right ventricle only. Conclusion: Presence of biventricular capture--the prerequisite for successful cardiac resynchronization therapy--and loss of left ventricular capture can be accurately detected by an algorithm based on analysis of the R-S ratio on leads V1 and I of the surface electrocardiogram.

Published
2005

2. Effect of Bedside Compared With Outside the Room Patient Case Presentation on Patients' Knowledge About Their Medical Care : A Randomized, Controlled, Multicenter Trial.

Author

Becker, Christoph, Gamp, Martina, Schuetz, Philipp, Beck, Katharina, Vincent, Alessia, Hochstrasser, Seraina, Metzger, Kerstin, Widmer, Madlaina, Thommen, Emanuel, Mueller, Beat, Fux, Christoph A., Leuppi, Jörg D., Schaefert, Rainer, Langewitz, Wolf, Trendelenburg, Marten, Breidthardt, Tobias, Eckstein, Jens, Osthoff, Michael, Bassetti, Stefano, and Hunziker, Sabina

Subjects
MEDICAL care, PATIENT participation, VISUAL analog scale, MEDICAL teaching personnel, HOSPITAL rounds, RESEARCH, PHYSICIAN-patient relations, RESEARCH methodology, PATIENT-centered care, PATIENT satisfaction, MEDICAL cooperation, EVALUATION research, PATIENT psychology, INFORMATION literacy, COMPARATIVE studies, RANDOMIZED controlled trials, TERMS & phrases
Abstract

Background: Although bedside case presentation contributes to patient-centered care through active patient participation in medical discussions, the complexity of medical information and jargon-induced confusion may cause misunderstandings and patient discomfort.Objective: To compare bedside versus outside the room patient case presentation regarding patients' knowledge about their medical care.Design: Randomized, controlled, parallel-group trial. (ClinicalTrials.gov: NCT03210987).Setting: 3 Swiss teaching hospitals.Patients: Adult medical patients who were hospitalized.Intervention: Patients were randomly assigned to bedside or outside the room case presentation.Measurements: The primary endpoint was patients' average knowledge of 3 dimensions of their medical care (each rated on a visual analogue scale from 0 to 100): understanding their disease, the therapeutic approach being used, and further plans for care.Results: Compared with patients in the outside the room group (n = 443), those in the bedside presentation group (n = 476) reported similar knowledge about their medical care (mean, 79.5 points [SD, 21.6] vs. 79.4 points [SD, 19.8]; adjusted difference, 0.09 points [95% CI, -2.58 to 2.76 points]; P = 0.95). Also, an objective rating of patient knowledge by the study team was similar for the 2 groups, but the bedside presentation group had higher ratings of confusion about medical jargon and uncertainty caused by team discussions. Bedside ward rounds were more efficient (mean, 11.89 minutes per patient [SD, 4.92] vs. 14.14 minutes per patient [SD, 5.65]; adjusted difference, -2.31 minutes [CI, -2.98 to -1.63 minutes]; P < 0.001).Limitation: Only Swiss hospitals and medical patients were included.Conclusion: Compared with outside the room case presentation, bedside case presentation was shorter and resulted in similar patient knowledge, but sensitive topics were more often avoided and patient confusion was higher. Physicians presenting at the bedside need to be skilled in the use of medical language to avoid confusion and misunderstandings.Primary Funding Source: Swiss National Foundation (10531C_ 182422). [ABSTRACT FROM AUTHOR]

Published
2021
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