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5. Economic evaluation of remote monitoring of patients with an implantable cardiac defibrillator (REMOTE-CIED study)

Author

de Graaf, Gimon, Timmermans, Ivy, Meine, Mathias, Alings, Marco, Pedersen, Susanne S, Mabo, Philippe, Zitron, Edgar, Redekop, Ken, Versteeg, Henneke, de Graaf, Gimon, Timmermans, Ivy, Meine, Mathias, Alings, Marco, Pedersen, Susanne S, Mabo, Philippe, Zitron, Edgar, Redekop, Ken, and Versteeg, Henneke

Abstract

INTRODUCTION: Remote patient monitoring (RPM) of heart failure patients has the potential to reduce healthcare resource use and costs, but current evidence has been inconclusive. This study aims assess the impact of RPM of heart failure patients with an implantable cardioverter defibrillator on medical resource use, direct medical costs, quality-adjusted life years (QALYs), and travel time of patients, and to estimate its commercial headroom in the Netherlands and Germany.METHODS: Data from the REMOTE-CIED randomized controlled trial were used to calculate differences in length of hospital stay, outpatient clinic visits, telephone consults, emergency room visits, and travel time between patients on in-clinic follow-up and RPM in the Netherlands, Germany, and France. Incremental cardiac-related healthcare costs and QALYs were calculated and used to calculate the commercial headroom of RPM in the Netherlands and Germany. The impact of imputation, parameter, and case-mix uncertainty on these outcomes was explored using probabilistic analysis.RESULTS: Length of hospitalization, number of unscheduled admissions, and number of outpatient visits were lower in the remote monitoring group in all three countries. Number of hospital admissions was higher, and number of calls was lower in the Netherlands and Germany but not in France. Costs were lower in both the Netherlands (-€1041, 95% confidence interval (CI): -€3308, €1005) and Germany (-€2865, 95% CI: -€7619, €1105), while incremental effectiveness differed: -0.003 (95% CI: -0.114, 0.107) QALY in the Netherlands and +0.086 (95% CI: -0.083, 0.256) in Germany. Commercial headroom was estimated at €881 (95% CI: -€5430, €7208) in the Netherlands and €5005 (95% CI: -€1339, €11,960) in Germany.DISCUSSION: RPM was found to result in reduced medical resource use and travel time. Whether it is cost saving or cost effective strongly depends on the costs of remote monitoring.TRIAL REGISTRATION NUMBER AN

Published
2024

6. Virtual pacing of a patient's digital twin to predict left ventricular reverse remodelling after cardiac resynchronization therapy

Author

Onderzoek Device, Team Medisch, Circulatory Health, Koopsen, Tijmen, Gerrits, Willem, van Osta, Nick, van Loon, Tim, Wouters, Philippe, Prinzen, Frits W, Vernooy, Kevin, Delhaas, Tammo, Teske, Arco J, Meine, Mathias, Cramer, Maarten J, Lumens, Joost, Onderzoek Device, Team Medisch, Circulatory Health, Koopsen, Tijmen, Gerrits, Willem, van Osta, Nick, van Loon, Tim, Wouters, Philippe, Prinzen, Frits W, Vernooy, Kevin, Delhaas, Tammo, Teske, Arco J, Meine, Mathias, Cramer, Maarten J, and Lumens, Joost

Published
2024

9. Virtual pacing of a patient’s digital twin to predict left ventricular reverse remodelling after cardiac resynchronization therapy

Author

Koopsen, Tijmen, primary, Gerrits, Willem, additional, van Osta, Nick, additional, van Loon, Tim, additional, Wouters, Philippe, additional, Prinzen, Frits W, additional, Vernooy, Kevin, additional, Delhaas, Tammo, additional, Teske, Arco J, additional, Meine, Mathias, additional, Cramer, Maarten J, additional, and Lumens, Joost, additional

Published
2023
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11. Automatic measurement of Short-Term Variability of repolarization to indicate ventricular arrhythmias in a porcine model of cardiac ischemia

Author

Loen, Vera, primary, Smoczynska, Agnieszka, additional, Hernandez, Alfonso Aranda, additional, Scheerder, Coert O S, additional, van der Linde, Britt H R, additional, Beekman, Henriëtte D M, additional, Cervera-Barea, Aina, additional, Boink, Gerard J J, additional, Sluijter, Joost P G, additional, van der Heyden, Marcel A G, additional, Meine, Mathias, additional, and Vos, Marc A, additional

Published
2023
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17. Life-threatening ventricular arrhythmia prediction in patients with dilated cardiomyopathy using explainable electrocardiogram-based deep neural networks

Author

Sammani, Arjan, van de Leur, Rutger R., Henkens, Michiel T. H. M., Meine, Mathias, Loh, Peter, Hassink, Rutger J., Oberski, Daniel L., Heymans, Stephane R. B., Doevendans, Pieter A., Asselbergs, Folkert W., te Riele, Anneline S. J. M., van Es, Rene, Leerstoel Oberski, Methodology and statistics for the behavioural and social sciences, Cardiologie, RS: Carim - H02 Cardiomyopathy, MUMC+: MA Med Staf Spec Cardiologie (9), Leerstoel Oberski, and Methodology and statistics for the behavioural and social sciences

Subjects
Cardiomyopathy, Dilated, Male, Science & Technology, Cardiac & Cardiovascular Systems, Dilated cardiomyopathy, Arrhythmias, Cardiac, Stroke Volume, Middle Aged, Deep neural network, Prognosis, Ventricular Function, Left, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Electrocardiography, Sudden cardiac death, Death, Sudden, Cardiac, Risk Factors, Physiology (medical), Cardiovascular System & Cardiology, Humans, HEART, Female, Neural Networks, Computer, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine
Abstract

Aims While electrocardiogram (ECG) characteristics have been associated with life-threatening ventricular arrhythmias (LTVA) in dilated cardiomyopathy (DCM), they typically rely on human-derived parameters. Deep neural networks (DNNs) can discover complex ECG patterns, but the interpretation is hampered by their ‘black-box’ characteristics. We aimed to detect DCM patients at risk of LTVA using an inherently explainable DNN. Methods and results In this two-phase study, we first developed a variational autoencoder DNN on more than 1 million 12-lead median beat ECGs, compressing the ECG into 21 different factors (F): FactorECG. Next, we used two cohorts with a combined total of 695 DCM patients and entered these factors in a Cox regression for the composite LTVA outcome, which was defined as sudden cardiac arrest, spontaneous sustained ventricular tachycardia, or implantable cardioverter-defibrillator treated ventricular arrhythmia. Most patients were male (n = 442, 64%) with a median age of 54 years [interquartile range (IQR) 44–62], and median left ventricular ejection fraction of 30% (IQR 23–39). A total of 115 patients (16.5%) reached the study outcome. Factors F8 (prolonged PR-interval and P-wave duration, P Conclusion Inherently explainable DNNs can detect patients at risk of LTVA which is mainly driven by P-wave abnormalities.

Published
2022
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19. Non-invasive three-dimensional electrical activation mapping to predict cardiac resynchronization therapy response::site of latest left ventricular activation relative to pacing site

Author

Parreira, Leonor, Tsyganov, Alexey, Artyukhina, Elena, Vernooy, Kevin, Tondo, Claudio, Adragao, Pedro, Ascione, Ciro, Carmo, Pedro, Carvalho, Salomé, Egger, Matthias, Ferreira, Antonio, Ghossein, Mohammed, Holm, Magnus, Kalinin, Vitaly, Malakhova, Maria, Meine, Mathias, Nunes, Silvia, Podolyak, Dmitry, Revishvili, Amiran, Shapieva, Albina, Stepanova, Vera, van Stipdonk, Antonius, Taymasova, Irina, Wouters, Philippe, Zubarev, Stepan, Leyva, Francisco, Auricchio, Angelo, Varma, Niraj, Parreira, Leonor, Tsyganov, Alexey, Artyukhina, Elena, Vernooy, Kevin, Tondo, Claudio, Adragao, Pedro, Ascione, Ciro, Carmo, Pedro, Carvalho, Salomé, Egger, Matthias, Ferreira, Antonio, Ghossein, Mohammed, Holm, Magnus, Kalinin, Vitaly, Malakhova, Maria, Meine, Mathias, Nunes, Silvia, Podolyak, Dmitry, Revishvili, Amiran, Shapieva, Albina, Stepanova, Vera, van Stipdonk, Antonius, Taymasova, Irina, Wouters, Philippe, Zubarev, Stepan, Leyva, Francisco, Auricchio, Angelo, and Varma, Niraj

Abstract

AIMS: Pacing remote from the latest electrically activated site (LEAS) in the left ventricle (LV) may diminish response to cardiac resynchronization therapy (CRT). We tested whether proximity of LV pacing site (LVPS) to LEAS, determined by non-invasive three-dimensional electrical activation mapping [electrocardiographic Imaging (ECGI)], increased likelihood of CRT response. METHODS AND RESULTS: Consecutive CRT patients underwent ECGI and chest/heart computed tomography 6-24 months of post-implant. Latest electrically activated site and the distance to LVPS (dp) were assessed. Left ventricular end-systolic volume (LVESV) reduction of ≥15% at clinical follow-up defined response. Logistic regression probabilistically modelled non-response; variables included demographics, heart failure classification, left bundle branch block (LBBB), ischaemic heart disease (IHD), atrial fibrillation, QRS duration, baseline ejection fraction (EF) and LVESV, comorbidities, use of CRT optimization algorithm, angiotensin-converting enzyme inhibitor(ACE)/angiotensin-receptor blocker (ARB), beta-blocker, diuretics, and dp. Of 111 studied patients [64 ± 11 years, EF 28 ± 6%, implant duration 12 ± 5 months (mean ± SD), 98% had LBBB, 38% IHD], 67% responded at 10 ± 3 months post CRT-implant. Latest electrically activated sites were outside the mid-to-basal lateral segments in 35% of the patients. dp was 42 ± 23 mm [31 ± 14 mm for responders vs. 63 ± 24 mm non-responders (P < 0.001)]. Longer dp and the lack of use of CRT optimization algorithm were the only independent predictors of non-response [area under the curve (AUC) 0.906]. dp of 47 mm delineated responders and non-responders (AUC 0.931). CONCLUSION: The distance between LV pacing site and latest electrical activation is a strong independent predictor for CRT response. Non-invasive electrical evaluation to characterize intrinsic activation and guide LV lead deployment may improve CRT efficacy.

Published
2023

20. Prognostic implications of invasive hemodynamics during cardiac resynchronization therapy: Stroke work outperforms dP/dt max.

Author

Onderzoek Device, Team Medisch, Circulatory Health, Wouters, Philippe C, Zweerink, Alwin, van Everdingen, Wouter M, Ghossein, Mohammed A, de Roest, Gerben J, Cramer, Maarten J, Doevendans, Pieter A F M, Vernooy, Kevin, Prinzen, Frits W, Allaart, Cornelis P, Meine, Mathias, Onderzoek Device, Team Medisch, Circulatory Health, Wouters, Philippe C, Zweerink, Alwin, van Everdingen, Wouter M, Ghossein, Mohammed A, de Roest, Gerben J, Cramer, Maarten J, Doevendans, Pieter A F M, Vernooy, Kevin, Prinzen, Frits W, Allaart, Cornelis P, and Meine, Mathias

Published
2023

21. Association of vectorcardiographic T-wave area with clinical and echocardiographic outcomes in cardiac resynchronization therapy

Author

Onderzoek Device, Team Medisch, Circulatory Health, Dural, Muhammet, Ghossein, Mohammed A, Gerrits, Willem, Daniels, Fenna, Meine, Mathias, Maass, Alexander H, Rienstra, Michiel, Prinzen, Frits W, Vernooy, Kevin, van Stipdonk, Antonius M W, Onderzoek Device, Team Medisch, Circulatory Health, Dural, Muhammet, Ghossein, Mohammed A, Gerrits, Willem, Daniels, Fenna, Meine, Mathias, Maass, Alexander H, Rienstra, Michiel, Prinzen, Frits W, Vernooy, Kevin, and van Stipdonk, Antonius M W

Published
2023

22. Automatic measurement of short-term variability of repolarization to indicate ventricular arrhythmias in a porcine model of cardiac ischaemia

Author

Medische Fysiologie, Arts Assistenten Cardiologie, Onderzoek Cardiovasculair Reg. Med., Circulatory Health, Regenerative Medicine and Stem Cells, Team Medisch, Loen, Vera, Smoczynska, Agnieszka, Hernandez, Alfonso Aranda, Scheerder, Coert O S, van der Linde, Britt H R, Beekman, Henriëtte D M, Cervera-Barea, Aina, Boink, Gerard J J, Sluijter, Joost P G, van der Heyden, Marcel A G, Meine, Mathias, Vos, Marc A, Medische Fysiologie, Arts Assistenten Cardiologie, Onderzoek Cardiovasculair Reg. Med., Circulatory Health, Regenerative Medicine and Stem Cells, Team Medisch, Loen, Vera, Smoczynska, Agnieszka, Hernandez, Alfonso Aranda, Scheerder, Coert O S, van der Linde, Britt H R, Beekman, Henriëtte D M, Cervera-Barea, Aina, Boink, Gerard J J, Sluijter, Joost P G, van der Heyden, Marcel A G, Meine, Mathias, and Vos, Marc A

Published
2023

23. Cardiac CT in CRT as a Singular Imaging Modality for Diagnosis and Patient-Tailored Management

Author

Onderzoek Device, Cardiologie zorg, Team Medisch, Researchgr. Hart-brein as., Brain, Circulatory Health, Gezonde Vaten, MS Radiologie, Gerrits, Willem, Danad, Ibrahim, Velthuis, Birgitta, Mushtaq, Saima, Cramer, Maarten J., van der Harst, Pim, van Slochteren, Frebus J., Meine, Mathias, Suchá, Dominika, Guglielmo, Marco, Onderzoek Device, Cardiologie zorg, Team Medisch, Researchgr. Hart-brein as., Brain, Circulatory Health, Gezonde Vaten, MS Radiologie, Gerrits, Willem, Danad, Ibrahim, Velthuis, Birgitta, Mushtaq, Saima, Cramer, Maarten J., van der Harst, Pim, van Slochteren, Frebus J., Meine, Mathias, Suchá, Dominika, and Guglielmo, Marco

Published
2023

24. Comparison of the relation of the ESC 2021 and ESC 2013 definitions of left bundle branch block with clinical and echocardiographic outcome in cardiac resynchronization therapy

Author

Cardiologie, Onderzoek Device, Team Medisch, Circulatory Health, Rijks, Jesse, Ghossein, Mohammed A., Wouters, Philippe C., Dural, Muhammet, Maass, Alexander H., Meine, Mathias, Kloosterman, Mariëlle, Luermans, Justin, Prinzen, Frits W., Vernooy, Kevin, van Stipdonk, Antonius M.W., Cardiologie, Onderzoek Device, Team Medisch, Circulatory Health, Rijks, Jesse, Ghossein, Mohammed A., Wouters, Philippe C., Dural, Muhammet, Maass, Alexander H., Meine, Mathias, Kloosterman, Mariëlle, Luermans, Justin, Prinzen, Frits W., Vernooy, Kevin, and van Stipdonk, Antonius M.W.

Published
2023

25. Non-invasive three-dimensional electrical activation mapping to predict cardiac resynchronization therapy response: site of latest left ventricular activation relative to pacing site

Author

Team Medisch, Circulatory Health, Onderzoek Device, Parreira, Leonor, Tsyganov, Alexey, Artyukhina, Elena, Vernooy, Kevin, Tondo, Claudio, Adragao, Pedro, Ascione, Ciro, Carmo, Pedro, Carvalho, Salomé, Egger, Matthias, Ferreira, Antonio, Ghossein, Mohammed, Holm, Magnus, Kalinin, Vitaly, Malakhova, Maria, Meine, Mathias, Nunes, Silvia, Podolyak, Dmitry, Revishvili, Amiran, Shapieva, Albina, Stepanova, Vera, van Stipdonk, Antonius, Taymasova, Irina, Wouters, Philippe, Zubarev, Stepan, Leyva, Francisco, Auricchio, Angelo, Varma, Niraj, Team Medisch, Circulatory Health, Onderzoek Device, Parreira, Leonor, Tsyganov, Alexey, Artyukhina, Elena, Vernooy, Kevin, Tondo, Claudio, Adragao, Pedro, Ascione, Ciro, Carmo, Pedro, Carvalho, Salomé, Egger, Matthias, Ferreira, Antonio, Ghossein, Mohammed, Holm, Magnus, Kalinin, Vitaly, Malakhova, Maria, Meine, Mathias, Nunes, Silvia, Podolyak, Dmitry, Revishvili, Amiran, Shapieva, Albina, Stepanova, Vera, van Stipdonk, Antonius, Taymasova, Irina, Wouters, Philippe, Zubarev, Stepan, Leyva, Francisco, Auricchio, Angelo, and Varma, Niraj

Published
2023

26. On-Screen Image-Guided Lead Placement in Cardiac Resynchronization Therapy: Feasibility and Outcome in a Multicenter Setting

Author

Cardiologie, UMC Utrecht Holding, Onderzoek Device, Team Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Wouters, Philippe C., van Slochteren, Frebus J., Tuinenburg, Anton E., Doevendans, Pieter A., Cramer, Maarten Jan M., Delnoy, Peter Paul H.M., van Dijk, Vincent F., Meine, Mathias, Cardiologie, UMC Utrecht Holding, Onderzoek Device, Team Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Wouters, Philippe C., van Slochteren, Frebus J., Tuinenburg, Anton E., Doevendans, Pieter A., Cramer, Maarten Jan M., Delnoy, Peter Paul H.M., van Dijk, Vincent F., and Meine, Mathias

Published
2023

27. Electrocardiogram-based deep learning improves outcome prediction following cardiac resynchronization therapy

Author

Electrofysiologie, Onderzoek Device, Cardiovasculaire Immunologie, Team Onderzoek, Team Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Gezonde Vaten, Wouters, Philippe C., van de Leur, Rutger R., Vessies, Melle B., van Stipdonk, Antonius M.W., Ghossein, Mohammed A., Hassink, Rutger J., Doevendans, Pieter A., van der Harst, Pim, Maass, Alexander H., Prinzen, Frits W., Vernooy, Kevin, Meine, Mathias, van Es, René, Electrofysiologie, Onderzoek Device, Cardiovasculaire Immunologie, Team Onderzoek, Team Medisch, Circulatory Health, Regenerative Medicine and Stem Cells, Gezonde Vaten, Wouters, Philippe C., van de Leur, Rutger R., Vessies, Melle B., van Stipdonk, Antonius M.W., Ghossein, Mohammed A., Hassink, Rutger J., Doevendans, Pieter A., van der Harst, Pim, Maass, Alexander H., Prinzen, Frits W., Vernooy, Kevin, Meine, Mathias, and van Es, René

Published
2023

28. Chronically altered ventricular activation causes pro-arrhythmic cardiac electrical remodelling in the chronic AV block dog model

Author

Medische Fysiologie, Cardiologie Arts-onderzoekers, Arts Assistenten Cardiologie, Circulatory Health, Team Medisch, van Weperen, Valerie Y H, Ter Horst, Iris, Dunnink, Albert, Bossu, Alexandre, Salden, Odette A, Beekman, Henriette D M, Oros, Avram, Bourgonje, Vincent, Stams, Thom, Meine, Mathias, Vos, Marc A, Medische Fysiologie, Cardiologie Arts-onderzoekers, Arts Assistenten Cardiologie, Circulatory Health, Team Medisch, van Weperen, Valerie Y H, Ter Horst, Iris, Dunnink, Albert, Bossu, Alexandre, Salden, Odette A, Beekman, Henriette D M, Oros, Avram, Bourgonje, Vincent, Stams, Thom, Meine, Mathias, and Vos, Marc A

Published
2023

29. Virtual pacing of a patient's digital twin to predict left ventricular reverse remodelling after cardiac resynchronization therapy.

Author

Koopsen, Tijmen, Gerrits, Willem, Osta, Nick van, Loon, Tim van, Wouters, Philippe, Prinzen, Frits W, Vernooy, Kevin, Delhaas, Tammo, Teske, Arco J, Meine, Mathias, Cramer, Maarten J, and Lumens, Joost

Abstract

Aims Identifying heart failure (HF) patients who will benefit from cardiac resynchronization therapy (CRT) remains challenging. We evaluated whether virtual pacing in a digital twin (DT) of the patient's heart could be used to predict the degree of left ventricular (LV) reverse remodelling post-CRT. Methods and results Forty-five HF patients with wide QRS complex (≥130 ms) and reduced LV ejection fraction (≤35%) receiving CRT were retrospectively enrolled. Echocardiography was performed before (baseline) and 6 months after CRT implantation to obtain LV volumes and 18-segment longitudinal strain. A previously developed algorithm was used to generate 45 DTs by personalizing the CircAdapt model to each patient's baseline measurements. From each DT, baseline septal-to-lateral myocardial work difference (MWLW-S,DT) and maximum rate of LV systolic pressure rise (dP/dtmax,DT) were derived. Biventricular pacing was then simulated using patient-specific atrioventricular delay and lead location. Virtual pacing–induced changes ΔMWLW-S,DT and ΔdP/dtmax,DT were correlated with real-world LV end-systolic volume change at 6-month follow-up (ΔLVESV). The DT's baseline MWLW-S,DT and virtual pacing–induced ΔMWLW-S,DT were both significantly associated with the real patient's reverse remodelling ΔLVESV (r = −0.60, P < 0.001 and r = 0.62, P < 0.001, respectively), while correlation between ΔdP/dtmax,DT and ΔLVESV was considerably weaker (r = −0.34, P = 0.02). Conclusion Our results suggest that the reduction of septal-to-lateral work imbalance by virtual pacing in the DT can predict real-world post-CRT LV reverse remodelling. This DT approach could prove to be an additional tool in selecting HF patients for CRT and has the potential to provide valuable insights in optimization of CRT delivery. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Association of vectorcardiographic T-wave area with clinical and echocardiographic outcomes in cardiac resynchronization therapy.

Author

Dural, Muhammet, Ghossein, Mohammed A, Gerrits, Willem, Daniels, Fenna, Meine, Mathias, Maass, Alexander H, Rienstra, Michiel, Prinzen, Frits W, Vernooy, Kevin, and Stipdonk, Antonius M W van

Abstract

Aims Data on repolarization parameters in cardiac resynchronization therapy (CRT) are scarce. We investigated the association of baseline T-wave area, with both clinical and echocardiographic outcomes of CRT in a large, multi-centre cohort of CRT recipients. Also, we evaluated the association between the baseline T-wave area and QRS area. Methods and results In this retrospective study, 1355 consecutive CRT recipients were evaluated. Pre-implantation T-wave and QRS area were calculated from vectorcardiograms. Echocardiographic response was defined as a reduction of ≥15% in left ventricular end-systolic volume between 3 and 12 months after implantation. The clinical outcome was a combination of all-cause mortality, heart transplantation, and left ventricular assist device implantation. Left ventricular end-systolic volume reduction was largest in patients with QRS area ≥ 109 μVs and T-wave area ≥ 66 μVs compared with QRS area ≥ 109 μVs and T-wave area < 66 μVs (P = 0.004), QRS area < 109 μVs and T-wave area ≥ 66 μVs (P < 0.001) and QRS area < 109 μVs and T-wave area < 66 μVs (P < 0.001). Event-free survival rate was higher in the subgroup of patients with QRS area ≥ 109 μVs and T-wave area ≥ 66 μVs (n = 616, P < 0.001) and QRS area ≥ 109 μVs and T-wave area < 66 μVs (n = 100, P < 0.001) than the other subgroups. In the multivariate analysis, T-wave area remained associated with echocardiographic response (P = 0.008), but not with the clinical outcome (P = 0.143), when QRS area was included in the model. Conclusion Baseline T-wave area has a significant association with both clinical and echocardiographic outcomes after CRT. The association of T-wave area with echocardiographic response is independent from QRS area; the association with clinical outcome, however, is not. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Non-invasive three-dimensional electrical activation mapping to predict cardiac resynchronization therapy response: site of latest left ventricular activation relative to pacing site

Author

Parreira, Leonor, primary, Tsyganov, Alexey, additional, Artyukhina, Elena, additional, Vernooy, Kevin, additional, Tondo, Claudio, additional, Adragao, Pedro, additional, Ascione, Ciro, additional, Carmo, Pedro, additional, Carvalho, Salomé, additional, Egger, Matthias, additional, Ferreira, Antonio, additional, Ghossein, Mohammed, additional, Holm, Magnus, additional, Kalinin, Vitaly, additional, Malakhova, Maria, additional, Meine, Mathias, additional, Nunes, Silvia, additional, Podolyak, Dmitry, additional, Revishvili, Amiran, additional, Shapieva, Albina, additional, Stepanova, Vera, additional, van Stipdonk, Antonius, additional, Taymasova, Irina, additional, Wouters, Philippe, additional, Zubarev, Stepan, additional, Leyva, Francisco, additional, Auricchio, Angelo, additional, and Varma, Niraj, additional

Published
2023
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33. Electrocardiogram-based deep learning improves outcome prediction following cardiac resynchronization therapy

Author

Wouters, Philippe C, primary, van de Leur, Rutger R, additional, Vessies, Melle B, additional, van Stipdonk, Antonius M W, additional, Ghossein, Mohammed A, additional, Hassink, Rutger J, additional, Doevendans, Pieter A, additional, van der Harst, Pim, additional, Maass, Alexander H, additional, Prinzen, Frits W, additional, Vernooy, Kevin, additional, Meine, Mathias, additional, and van Es, René, additional

Published
2022
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36. Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study

Author

Maass, Alexander H, Vernooy, Kevin, Wijers, Sofieke C, van ’t Sant, Jetske, Cramer, Maarten J, Meine, Mathias, Allaart, Cornelis P, De Lange, Frederik J, Prinzen, Frits W, Gerritse, Bart, Erdtsieck, Erna, Scheerder, Coert O S, Hill, Michael R S, Scholten, Marcoen, Kloosterman, Mariëlle, ter Horst, Iris A H, Voors, Adriaan A, Vos, Marc A, Rienstra, Michiel, and Van Gelder, Isabelle C

Published
2018
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37. Chronically altered ventricular activation causes pro-arrhythmic cardiac electrical remodelling in the chronic AV block dog model

Author

van Weperen, Valerie Y H, primary, ter Horst, Iris, additional, Dunnink, Albert, additional, Bossu, Alexandre, additional, Salden, Odette A, additional, Beekman, Henriette D M, additional, Oros, Avram, additional, Bourgonje, Vincent, additional, Stams, Thom, additional, Meine, Mathias, additional, and Vos, Marc A, additional

Published
2022
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39. Life-threatening ventricular arrhythmia prediction in patients with dilated cardiomyopathy using explainable electrocardiogram-based deep neural networks

Author

Leerstoel Oberski, Methodology and statistics for the behavioural and social sciences, Sammani, Arjan, van de Leur, Rutger R., Henkens, Michiel T. H. M., Meine, Mathias, Loh, Peter, Hassink, Rutger J., Oberski, Daniel L., Heymans, Stephane R. B., Doevendans, Pieter A., Asselbergs, Folkert W., te Riele, Anneline S. J. M., van Es, Rene, Leerstoel Oberski, Methodology and statistics for the behavioural and social sciences, Sammani, Arjan, van de Leur, Rutger R., Henkens, Michiel T. H. M., Meine, Mathias, Loh, Peter, Hassink, Rutger J., Oberski, Daniel L., Heymans, Stephane R. B., Doevendans, Pieter A., Asselbergs, Folkert W., te Riele, Anneline S. J. M., and van Es, Rene

Published
2022

40. Life-threatening ventricular arrhythmia prediction in patients with dilated cardiomyopathy using explainable electrocardiogram-based deep neural networks

Author

Team Onderzoek, Team Medisch, Circulatory Health, Datascience, Regenerative Medicine and Stem Cells, Arts Assistenten Cardiologie, Onderzoek Precision medicine, Zabihi Sammani, Arjan, van de Leur, Rutger R, Henkens, Michiel T H M, Meine, Mathias, Loh, Peter, Hassink, Rutger J, Oberski, Daniel L, Heymans, Stephane R B, Doevendans, Pieter A, Asselbergs, Folkert W, te Riele, Anneline S J M, van Es, René, Team Onderzoek, Team Medisch, Circulatory Health, Datascience, Regenerative Medicine and Stem Cells, Arts Assistenten Cardiologie, Onderzoek Precision medicine, Zabihi Sammani, Arjan, van de Leur, Rutger R, Henkens, Michiel T H M, Meine, Mathias, Loh, Peter, Hassink, Rutger J, Oberski, Daniel L, Heymans, Stephane R B, Doevendans, Pieter A, Asselbergs, Folkert W, te Riele, Anneline S J M, and van Es, René

Published
2022

41. Does mechanical dyssynchrony in addition to QRS area ensure sustained response to cardiac resynchronization therapy?

Author

Onderzoek Device, Cardiologie Arts-onderzoekers, Medische Fysiologie, Circulatory Health, Team Medisch, Wouters, Philippe C, van Everdingen, Wouter M, Vernooy, Kevin, Geelhoed, Bastiaan, Allaart, Cornelis P, Rienstra, Michiel, Maass, Alexander H, Vos, Marc A, Prinzen, Frits W, Meine, Mathias, Cramer, Maarten J, Onderzoek Device, Cardiologie Arts-onderzoekers, Medische Fysiologie, Circulatory Health, Team Medisch, Wouters, Philippe C, van Everdingen, Wouter M, Vernooy, Kevin, Geelhoed, Bastiaan, Allaart, Cornelis P, Rienstra, Michiel, Maass, Alexander H, Vos, Marc A, Prinzen, Frits W, Meine, Mathias, and Cramer, Maarten J

Published
2022

42. Pacing therapy for atrioventricular dromotropathy: a combined computational-experimental-clinical study

Author

Onderzoek Device, Team Medisch, Circulatory Health, Salden, Floor C W M, Huntjens, Peter R, Schreurs, Rick, Willemen, Erik, Kuiper, Marion, Wouters, Philippe, Maessen, Jos G, Bordachar, Pierre, Delhaas, Tammo, Luermans, Justin, Meine, Mathias, Allaart, Cornelis P, van Stipdonk, Antonius M W, Prinzen, Frits W, Lumens, Joost, Vernooy, Kevin, Onderzoek Device, Team Medisch, Circulatory Health, Salden, Floor C W M, Huntjens, Peter R, Schreurs, Rick, Willemen, Erik, Kuiper, Marion, Wouters, Philippe, Maessen, Jos G, Bordachar, Pierre, Delhaas, Tammo, Luermans, Justin, Meine, Mathias, Allaart, Cornelis P, van Stipdonk, Antonius M W, Prinzen, Frits W, Lumens, Joost, and Vernooy, Kevin

Published
2022

43. Electrocardiogram-based deep learning improves outcome prediction following cardiac resynchronization therapy.

Author

Wouters, Philippe C, Leur, Rutger R van de, Vessies, Melle B, Stipdonk, Antonius M W van, Ghossein, Mohammed A, Hassink, Rutger J, Doevendans, Pieter A, van der Harst, Pim, Maass, Alexander H, Prinzen, Frits W, Vernooy, Kevin, Meine, Mathias, and Es, René van

Subjects
HEART assist devices, CARDIAC pacing, DEEP learning, MACHINE learning, EDUCATIONAL outcomes, HEART transplantation
Abstract

Aims This study aims to identify and visualize electrocardiogram (ECG) features using an explainable deep learning–based algorithm to predict cardiac resynchronization therapy (CRT) outcome. Its performance is compared with current guideline ECG criteria and QRSAREA. Methods and results A deep learning algorithm, trained on 1.1 million ECGs from 251 473 patients, was used to compress the median beat ECG, thereby summarizing most ECG features into only 21 explainable factors (FactorECG). Pre-implantation ECGs of 1306 CRT patients from three academic centres were converted into their respective FactorECG. FactorECG predicted the combined clinical endpoint of death, left ventricular assist device, or heart transplantation [c-statistic 0.69, 95% confidence interval (CI) 0.66–0.72], significantly outperforming QRSAREA and guideline ECG criteria [c-statistic 0.61 (95% CI 0.58–0.64) and 0.57 (95% CI 0.54–0.60), P < 0.001 for both]. The addition of 13 clinical variables was of limited added value for the FactorECG model when compared with QRSAREA (Δ c-statistic 0.03 vs. 0.10). FactorECG identified inferolateral T-wave inversion, smaller right precordial S- and T-wave amplitude, ventricular rate, and increased PR interval and P-wave duration to be important predictors for poor outcome. An online visualization tool was created to provide interactive visualizations (https://crt.ecgx.ai). Conclusion Requiring only a standard 12-lead ECG, FactorECG held superior discriminative ability for the prediction of clinical outcome when compared with guideline criteria and QRSAREA, without requiring additional clinical variables. End-to-end automated visualization of ECG features allows for an explainable algorithm, which may facilitate rapid uptake of this personalized decision-making tool in CRT. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Chronically altered ventricular activation causes pro-arrhythmic cardiac electrical remodelling in the chronic AV block dog model.

Author

Weperen, Valerie Y H van, Horst, Iris ter, Dunnink, Albert, Bossu, Alexandre, Salden, Odette A, Beekman, Henriette D M, Oros, Avram, Bourgonje, Vincent, Stams, Thom, Meine, Mathias, and Vos, Marc A

Abstract

Aims Altered ventricular activation (AVA) causes intraventricular mechanical dyssynchrony (MD) and impedes contraction, promoting pro-arrhythmic electrical remodelling in the chronic atrioventricular block (CAVB) dog. We aimed to study arrhythmogenic and electromechanical outcomes of different degrees of AVA. Methods and results Following atrioventricular block, AVA was established through idioventricular rhythm (IVR; n = 29), right ventricular apex (RVA; n = 12) pacing or biventricular pacing [cardiac resynchronization therapy (CRT); n = 10]. After ≥3 weeks of bradycardic remodelling, Torsade de Pointes arrhythmia (TdP) inducibility, defined as ≥3 TdP/10 min, was tested with specific IKr -blocker dofetilide (25 μg/kg/5 min). Mechanical dyssynchrony was assessed by echocardiography as time-to-peak (TTP) of left ventricular (LV) free-wall minus septum (ΔTTP). Electrical intraventricular dyssynchrony was assessed as slope of regression line correlating intraventricular LV activation time (AT) and activation recovery interval (ARI). Under sinus rhythm, contraction occurred synchronous (ΔTTP: −8.6 ± 28.9 ms), and latest activated regions seemingly had slightly longer repolarization (AT–ARI slope: −0.4). Acute AV block increased MD in all groups, but following ≥3 weeks of remodelling IVR animals became significantly more TdP inducible (19/29 IVR vs. 5/12 RVA and 2/10 CRT, both P < 0.05 vs. IVR). After chronic AVA, intraventricular MD was lowest in CRT animals (ΔTTP: −8.5 ± 31.2 vs. 55.80 ± 20.0 and 82.7 ± 106.2 ms in CRT, IVR, and RVA, respectively, P < 0.05 RVA vs. CRT). Although dofetilide steepened negative AT–ARI slope in all groups, this heterogeneity in dofetilide-induced ARI prolongation seemed least pronounced in CRT animals (slope to −0.8, −3.2 and −4.5 in CRT, IVR and RVA, respectively). Conclusion Severity of intraventricular MD affects the extent of electrical remodelling and pro-arrhythmic outcome in the CAVB dog model. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Does mechanical dyssynchrony in addition to QRS area ensure sustained response to cardiac resynchronization therapy?

Author

Wouters, Philippe C, primary, van Everdingen, Wouter M, additional, Vernooy, Kevin, additional, Geelhoed, Bastiaan, additional, Allaart, Cornelis P, additional, Rienstra, Michiel, additional, Maass, Alexander H, additional, Vos, Marc A, additional, Prinzen, Frits W, additional, Meine, Mathias, additional, and Cramer, Maarten J, additional

Published
2021
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46. Aetiology of Heart Failure, Rather than Sex, Determines Reverse LV Remodelling Response to CRT

Author

Said, Fatema, primary, ter Maaten, Jozine M., additional, Martens, Pieter, additional, Vernooy, Kevin, additional, Meine, Mathias, additional, Allaart, Cornelis P., additional, Geelhoed, Bastiaan, additional, Vos, Marc A., additional, Cramer, Maarten J., additional, van Gelder, Isabelle C., additional, Mullens, Wilfried, additional, Rienstra, Michiel, additional, and Maass, Alexander H., additional

Published
2021
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48. Abstract 10161: Predicting Life-Threatening Ventricular Arrhythmias in Patients with Non-Ischemic Dilated Cardiomyopathy Using Electrocardiogram-Based Deep Neural Networks

Author

Sammani, Arjan, primary, Leur, Rutger R, additional, Meine, Mathias, additional, Loh, Peter, additional, Hassink, Rutger J, additional, Oberski, Daniel L, additional, Henkens, Michiel T, additional, Heymans, Stephane, additional, Doevendans, Pieter, additional, te Riele, Anneline S, additional, van Es, Rene, additional, and Asselbergs, Folkert W, additional

Published
2021
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49. Abstract 13300: Does Mechanical Dyssynchrony in Addition to QRS Area Ensure Sustained Response to Cardiac Resynchronization Therapy?

Author

Wouters, Philippe C, primary, van Everdingen, Wouter, additional, Vernooy, Kevin, additional, Geelhoed, Bastiaan, additional, Allaart, Cornelis, additional, Rienstra, Michiel, additional, Maass, Alexander H, additional, Vos, Marc A, additional, PRINZEN, Frits W, additional, Meine, Mathias, additional, and Cramer, Maarten J, additional

Published
2021
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