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1. Sondenlose Schrittmacher und subkutan implantierbare Kardioverter-Defibrillatoren

Author

B. Hansky, C. Stellbrink, and D. Meyer zu Vilsendorf

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Internal Medicine, Medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology, business
Abstract

Obwohl Herzschrittmacher und implantierbare Defibrillatoren heute der therapeutische Standard in der Behandlung bradykarder und tachykarder Herzrhythmusstorungen sind, kommt es doch insbesondere durch die transvenosen Stimulations- und Defibrillationselektroden im Langzeitverlauf nicht selten zu Komplikationen wie Elektrodenbruch, Infektionen und Trikuspidalinsuffizienzen. Daher sind in den letzten Jahren sondenlose Herzschrittmacher und rein subkutan implantierbare Kardioverter-Defibrillatoren (S-ICD) entwickelt worden, die ohne transvenose Elektroden implantiert werden und so die Langzeitkomplikationsrate der Implantate reduzieren sollen. Allerdings sind bisher verfugbare sondenlose Herzschrittmacher auf die einfache 1‑Kammer-Stimulation und der S‑ICD auf einen reinen Defibrillator ohne die Moglichkeit der antibrady- bzw. antitachykarden Stimulation oder kardialen Resynchronisation beschrankt. Daher konnen diese Gerate nicht als Mehrkammerschrittmacher bzw. -defibrillatoren dienen, obwohl gerade bei diesen aufgrund der Zahl der transvenosen Sonden auch mit mehr Langzeitkomplikationen zu rechnen ist. Der vorliegende Beitrag fasst die aktuelle Datenlage zu den sondenlosen Schrittmachern und S‑ICD zusammen, diskutiert die Limitationen dieser Systeme und gibt einen Ausblick, wohin sich die Therapien entwickeln konnten.

Published
2018
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2. Gleichzeitiges Vorliegen einer hypertrophisch-obstruktiven Kardiomyopathie sowie eines Long-QT-Syndroms: eine potentiell maligne Assoziation

Author

Claudia Strunk-Mueller, D. Meyer zu Vilsendorf, H. Kuhn, and F. Gietzen

Subjects
medicine.medical_specialty, Pediatrics, Heart disease, business.industry, Long QT syndrome, Disease, medicine.disease, QT interval, Sudden death, Comorbidity, Surgery, Sudden cardiac death, Ventricular fibrillation, medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Hypertrophic obstructive cardiomyopathy (HOCM) and long-QT syndrome (LQTS) are cardiac diseases with known genetic disorders. They are inherited in an autosomal-dominant way. From a clinical point of view, both diseases share a disturbed repolarization and the risk of sudden cardiac death. In 1998, during the annual meeting of the German Cardiac Society, we presented the case report of two patients (mother and daughter) with the combination of both diseases, being the first scientific communication on this subject. Both patients experienced sudden cardiac death due to ventricular fibrillation more than 10 years after the first diagnosis of the diseases. Resuscitation resulted in an apallic syndrome in both. The mother died from complications during the course of the apallic syndrome. In contrast to actual therapeutic strategies and data on prophylactic ICD-implantation available today, the daughter received no defibrillator. Sudden death in the presented cases may be due to either disease or their possible malignant association. Thus, the combination of both diseases forms the argument for early prophylactic ICD-implantation in these rare cases. Moleculargenetic studies are needed in large families to elucidate the potential of a common etiology.

Published
2002
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3. [Simultaneous hypertrophic obstructive cardiomyopathy and long QT syndrome: a potentially malignant association]

Author

D Meyer, zu Vilsendorf, C, Strunk-Mueller, F H, Gietzen, and H, Kuhn

Subjects
Adult, Chromosome Aberrations, Resuscitation, Comorbidity, Cardiomyopathy, Hypertrophic, Pedigree, Long QT Syndrome, Death, Sudden, Cardiac, Echocardiography, Risk Factors, Humans, Brain Damage, Chronic, Female, Follow-Up Studies, Genes, Dominant
Abstract

Hypertrophic obstructive cardiomyopathy (HOCM) and long-QT syndrome (LQTS) are cardiac diseases with known genetic disorders. They are inherited in an autosomal-dominant way. From a clinical point of view, both diseases share a disturbed repolarization and the risk of sudden cardiac death. In 1998, during the annual meeting of the German Cardiac Society, we presented the case report of two patients (mother and daughter) with the combination of both diseases, being the first scientific communication on this subject. Both patients experienced sudden cardiac death due to ventricular fibrillation more than 10 years after the first diagnosis of the diseases. Resuscitation resulted in an apallic syndrome in both. The mother died from complications during the course of the apallic syndrome. In contrast to actual therapeutic strategies and data on prophylactic ICD-implantation available today, the daughter received no defibrillator. Sudden death in the presented cases may be due to either disease or their possible malignant association. Thus, the combination of both diseases forms the argument for early prophylactic ICD-implantation in these rare cases. Moleculargenetic studies are needed in large families to elucidate the potential of a common etiology.

Published
2002

4. Poster Session 2

Author

T. Andersson, A. Magnusson, I.- L. Bryngelsson, O. Frobert, K. M. Henriksson, N. Edvardsson, D. Poci, M. Polovina, T. Potpara, M. Licina, N. Mujovic, A. Kocijancic, D. Simic, M. C. Ostojic, R. A. Providencia, A. Botelho, J. Trigo, J. Nascimento, N. Quintal, P. Mota, A. M. Leitao-Marques, R. F. Bosch, W. Kirch, L. Rosin, S. N. Willich, D. Pittrow, H. Bonnemeier, M. C. Valenza, L. Martin, T. Munoz Casaubon, G. Valenza, M. Botella, M. Serrano, B. Valenza, I. Cabrera, K. Anderson, B. S. Benzaquen, N. Koziolova, J. Nikonova, Y. Shilova, D. Scherr, S. Narayan, M. Wright, D. Krummen, A. Jadidi, P. Jais, M. Haissaguerre, M. Hocini, R. Hunter, Y. Liu, Y. Lu, W. Wang, R. J. Schilling, S. Bernstein, B. Wong, R. Rooke, C. Vasquez, R. Shah, S. Rosenberg, L. Chinitz, G. Morley, M. Bashir Choudhary, F. Holmqvist, J. Carlson, H.- J. Nilsson, P. G. Platonov, A. S. Jadidi, H. Cochet, S. Miyazaki, A. J. Shah, N. Marrouche, N. Calvo, M. Nadal, D. Andreu, D. Tamborero, F. E. Diaz, A. Berruezo, J. Brugada, L. Mont, S. Fichtner, G. Hessling, H. L. Estner, C. Jilek, T. Reents, S. Ammar, J. Wu, I. Deisenhofer, H. Nakanishi, K. Kashiwase, A. Hirata, M. Wada, Y. Ueda, J. Skoda, P. Neuzil, J. Popelova, J. Petru, L. Sediva, V. Y. Reddy, L. Uldry, A. Forclaz, N. Virag, J.- M. Vesin, L. Kappenberger, R. Sehra, C. Briggs, W.- J. Rappel, M. Janotka, M. Chovanec, K. Yamashiro, K. Takami, Y. Sakamoto, K. Satoh, T. Suzuki, H. Nakagawa, A. Romanov, E. Pokushalov, S. Artemenko, V. Shabanov, I. Stenin, D. Elesin, A. Turov, A. Yakubov, M. Hioki, S. Matsuo, K. Ito, R. Narui, S. Yamashita, K. Sugimoto, M. Yoshimura, T. Yamane, L. Di Biase, J. D. Gallinghouse, K. Rajappan, J. Kautzner, A. Dello Russo, C. Tondo, F. Lorgat, A. Natale, O. Balta, K. Buenz, M. Paessler, H. Anders, M. Horlitz, T. Deneke, L. Lickfett, I. Liberman, M. Linhart, R. Andrie, E. Mittmann-Braun, F. Stockigt, G. Nickenig, J. Schrickel, R. Tilz, A. Rillig, B. Feige, A. Metzner, A. Fuernkranz, A. Burchard, E. Wissner, F. Ouyang, T. R. Betts, M. A. Jones, K. C. K. Wong, N. Qureshi, Y. Bashir, G. Corbucci, D. Losik, V. Selina, M. A. Crandall, C. Daniels, E. Daoud, S. Kalbfleisch, H. Yamaji, T. Murakami, H. Kawamura, M. Murakami, K. Hina, S. Kusachi, G. Dakos, V. Vassilikos, S. Paraskevaidis, A. Mantziari, S. Theophylogiannakos, I. Chouvarda, I. Chatzizisis, I. Styliadis, T. Kimura, K. Fukumoto, N. Nishiyama, Y. Aizawa, Y. Fukuda, T. Sato, S. Miyoshi, S. Takatsuki, A. J. Navarrete Casas, I. Ali, F. C. Conte, M. Moran, B. G. Graham, O. Kalejs, R. Lacis, P. Stradins, A. Koris, I. Putnins, M. Vikmane, A. Lejnieks, A. Erglis, A. Estrada, A. Perez Silva, S. Castrejon, D. Doiny, J. L. Merino, A. Baranchuk, I. Greiss, C. S. Simpson, H. Abdollah, D. P. Redfearn, M. Buys-Topart, R. Nitzsche, B. Thibault, S. Kathan, C. Kolb, S. Reif, S. Schade, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, M. Schmidt, O. Cano Perez, F. Buendia, B. Igual, J. M. Osca, J. M. Sanchez, M. J. Sancho-Tello, J. M. Olague, A. Salvador, J. M. Tolosana, J. Fernandez-Armenta, M. Matas, M. C. Barbarin, M. Habibovic, K. C. Van Den Broek, D. A. M. J. Theuns, L. Jordaens, M. Alings, P. H. Van Der Voort, S. S. Pedersen, G. Pupita, S. Molini, M. Brambatti, A. Capucci, S. Molodykh, E. M. Idov, O. V. Belyaev, L. Segreti, E. Soldati, G. Zucchelli, A. Di Cori, S. Viani, L. Paperini, R. De Lucia, M. G. Bongiorni, L. Binner, M. Taborsky, D. Bello, H. Heuer, B. Ramza, I. Jenniskens, W. B. Johnson, M. S. Silvetti, L. Rava', M. S. Russo, C. Di Mambro, A. Ammirati, G. Gimigliano, M. Prosperi, F. Drago, A. R. Santos, B. Picarra, P. Semedo, P. Dionisio, R. Matos, M. Leitao, A. Jacinto, M. Trinca, P. Mazzone, G. Ciconte, A. Marzi, G. Paglino, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, P. Koppitz, A. Fach, S. Hobbiesiefken, E. Fiehn, R. Hambrecht, J. Sperzel, M. Jung, J. Schmitt, D. Pajitnev, H. Burger, G. Goebel, W. Ehrlich, T. Walther, T. Ziegelhoeffer, V. Vancura, D. Wichterle, V. Melenovsky, M. Glikson, G. Goldenberg, A. Segev, D. Dvir, J. Kuzniec, A. Finkelstein, I. Hay, V. Guetta, W. K. Choo, S. Gupta, R. Kirkfeldt, J. Johansen, E. Nohr, M. Moller, P. Arnsbo, J. Nielsen, M. Banha, P. Stojanov, S. Raspopovic, D. Vasic, D. Savic, G. Nikcevic, V. Jovanovic, P. Defaye, B. Mondesert, A. Mbaye, R. Cassagneau, V. Gagniere, J. Jacon, V. Sanfins, H. R. Reis, J. N. Nobre, V. M. Martins, L. D. Duarte, C. M. Morais, J. C. Conceicao, M. Hero, J. L. Rey, A. Ducharme, C. Simpson, C. Stuglin, L. Blier, M. Senaratne, Y. Khaykin, A. Pinter, A. Mlynarska, R. Mlynarski, M. Sosnowski, J. Wilczek, C. Iorgulescu, S. Bogdan, D. Constantinescu, C. Caldararu, M. Dorobantu, A. Radu, R.- G. Vatasescu, S. Yusu, T. Ikeda, H. Mera, Y. Miwa, A. Abe, M. Miyakoshi, T. Tsukada, H. Yoshino, V. Nayar, P. Cantelon, A. Rawling, M. R. D. Belham, P. J. Pugh, J. Osca Asensi, O. Cano, D. Tejada, B. Munoz, M. Rodriguez, J. Olague, L. Wecke, A. Van Hunnik, T. Thompson, L. Di Carlo, M. Zdeblick, A. Auricchio, F. Prinzen, A. Doltra Magarolas, B. Bijnens, E. Silva, D. Penela, M. Sitges, P. Ofman, L. Navaravong, J. Leng, A. Peralta, P. Hoffmeister, R. Levine, J. Cook, M. Stoenescu, M. E. Tettamanti, A. Revilla Orodea, J. Lopez Diaz, L. De La Fuente Galan, R. Arnold, E. Garcia Moran, J. A. San Roman Calvar, I. Gomez Salvador, K. Nakamura, M. Takami, T. Keida, A. Mesato, S. Higa, M. Shimabukuro, H. Masuzaki, R. Proietti, A. Sagone, G. Domenichini, H. Burri, C. Valzania, M. Biffi, H. Sunthorn, G. Gavaruzzi, H. Foulkes, G. Boriani, S. Koh, W. Hou, J. Snell, J. Poore, N. Dalal, G. Bornzin, A. Kloppe, D. Mijic, H. Bogossian, I. Ninios, M. Zarse, B. Lemke, L. Guedon-Moreau, C. Kouakam, D. Klug, C. Marquie, F. Ziglio, S. Kacet, H. Mohamed Fereig Hamed, A. M. A. L. Hamdy, A. H. M. E. D. Abd El Aziz, M. R. V. A. T. Nabih, R. E. H. A. B. Hamdy, A. Yaminisaharif, G. H. Davoudi, A. Kasemisaeid, S. Sadeghian, A. Vasheghani Farahani, P. Yazdanifard, A. Shafiee, C. Alonso, C. Grimard, G. Jauvert, A. Lazarus, L. L. Mont, J. Ortiz-Perez, T. Caralt, J. Escudero, F. Perez, K. M. Griffith, R. Ferreyra, P. Urena, M. Demas, C. Muratore, H. Mazzetti, J. Guardado, M. Fernandes, V. H. Pereira, F. Canario-Almeida, F. Ferreira, B. Rodrigues, J. Almeida, A. Sokal, E. Jedrzejczyk, R. Lenarczyk, S. Pluta, O. Kowalski, P. Pruszkowska, A. Swiatkowski, Z. Kalarus, M. Heinke, B. Ismer, H. Kuehnert, T. Heinke, R. Surber, N. Osypka, D. Prochnau, H. R. Figulla, S. Iacopino, M. Landolina, A. Proclemer, L. Padeletti, V. Calvi, A. Pierantozzi, P. Di Stefano, A. Bauer, F. Bode, F. Le Gal, J. C. Deharo, M. Delay, J. Clementy, M. Kawamura, Y. Munetsugu, K. Tanno, Y. Kobayashi, D. Cannom, J. Hosoda, T. Ishikawa, K. Andoh, M. Nobuyoshi, S. Fujii, S. Shizuta, T. Isshiki, M. A. Castel, F. Perez-Villa, B. Vidal, P. Pruszkowska-Skrzep, M. Szulik, T. Kukulski, L. Gianfranchi, K. Bettiol, F. Pacchioni, P. Alboni, R. Abu Sham'a, J. Buber, E. Nof, R. Kuperstein, M. Feinberg, D. Luria, M. Eldar, K. Parks, J. R. Stone, J. P. Singh, E. Hatzinikolaou-Kotsakou, M. Kotsakou, T. H. Beleveslis, G. Moschos, E. Reppas, P. Latsios, K. Tsakiridis, A. Kazemisaeid, G. Davoodi, A. Yamini Sharif, M. Sheikhvatan, M. Toniolo, G. Zanotto, A. Rossi, L. Tomasi, C. Vassanelli, H. Versteeg, P. M. C. Mommersteeg, G. Vergara, J. Blauer, R. Ranjan, S. Vijayakumar, E. Kholmovski, N. Volland, R. Macleod, L. E. Aguinaga Arrascue, A. Bravo, P. Garcia Freire, P. Gallardo, E. Hasbani, J. Dantur, R. Quintana, P. P. Adragao, D. Cavaco, L. Parreira, K. Reis Santos, P. Carmo, R. Miranda, S. Marcelino, D. Cabrita, P. Sommer, T. Gaspar, S. Rolf, A. Arya, C. Piorkowski, G. Hindricks, E. Valles Gras, V. Bazan, L. Portillo, F. Suarez, J. Bruguera, J. Marti, Y. Huo, S. Richter, R. Schoenbauer, N. Rivas, J. Casaldaliga, I. Roca, L. Dos, J. Perez-Rodon, A. Pijuan, D. Garcia-Dorado, A. Moya, H. B. Carter, A. Garg, J. Hegrenes, H. J. Sih, L. R. Teplitsky, K. Kuroki, H. Tada, Y. Seo, T. Ishizu, M. Igawa, Y. Sekiguchi, K. Kuga, K. Aonuma, C. Rodriguez A, J. Mejias, P. Hidalgo, J. A. Hidalgo L, M. Orczykowski, P. Derejko, F. Walczak, E. Szufladowicz, P. Urbanek, R. Bodalski, K. Bieganowska, L. Szumowski, P. Peichl, R. Cihak, I. Skalsky, P. Kubus, P. Vit, L. Zaoral, R. A. Gebauer, M. Fiala, J. Janousek, K. Hiroshima, M. Goya, M. Ohe, K. Hayashi, Y. Makihara, M. Nagashima, Y. An, M. Schloesser, T. Lawrenz, D. Meyer Zu Vilsendorf, C. Strunk-Mueller, C. Stellbrink, J. Papagiannis, D. Avramidis, C. Kokkinakis, G. Kirvassilis, G. Eidelman, A. Arenal, T. Datino, F. Atienza, E. Gonzalez Torrecilla, A. Miracle, J. Hernandez, F. Fernandez Aviles, E. Ene, P. Insulander, H. Bastani, F. Braunschweig, N. Drca, G. Kenneback, J. Schwieler, J. Tapanainen, M. Jensen-Urstad, B. Andrea, E. M. A. Andrea, W. M. Maciel, L. S. Siqueira, R. C. Cosenza, F. M. Mittidieri, S. F. Farah, J. A. Atie, E. Kanoupakis, E. Kallergis, H. Mavrakis, C. Goudis, I. Saloustros, N. Malliaraki, G. Chlouverakis, P. Vardas, J. L. Bonnes, J. Jaspers Focks, S. W. Westra, M. A. Brouwer, J. L. R. M. Smeets, G. Inama, C. Pedrinazzi, F. Oliva, M. Senni, M. Zoni Berisso, S. Mostov, M. Haim, R. Nevzorov, D. Hasadi, B. Starsberg, A. Porter, J. Kuschyk, A. Schoene, F. Streitner, C. G. Veltmann, R. Schimpf, M. Borggrefe, U. Luesebrink, A. Gardiwal, H. Oswald, T. Koenig, D. Duncker, G. Klein, R. Bastiaenen, V. Batchvarov, O. Atty, J. H. Cheng, E. R. Behr, M. M. Gallagher, A. H. Starrenburg, K. Kraaier, M. F. Scholten, J. Van Der Palen, S. Adhya, L. A. Smith, T. Zhao, C. Bannister, R. H. Kamdar, M. Martinelli, S. Siqueira, R. Greco, S. A. D. Nishioka, A. A. A. Pedrosa, R. Alkmim-Teixeira, G. L. Peixoto, R. Costa, J. C. Nielsen, P. T. Mortensen, J. B. Johansen, W. Kwasniewski, A. Filipecki, D. Urbanczyk-Swic, W. Orszulak, M. Trusz - Gluza, J. Jimenez-Candil, J. Morinigo, C. Ledesma, C. Martin-Luengo, T. Vogtmann, M. Gomer, S. Stiller, V. Kuehlkamp, G. Zach, S. Loescher, S. Kespohl, G. Baumann, J. D. Snell, N. Korsun, J. R. Snell, B. Morley, R. Bharmi, Y. Nabutovsky, M. Mollerus, L. Naslund, A. Meyer, M. Lipinski, B. Libey, K. Dornfeld, A. Martin, M. Gallego, M. K. De Bie, J. B. Van Rees, C. J. Borleffs, J. Thijssen, J. W. Jukema, M. J. Schalij, L. Van Erven, E. T. Van Der Velde, T. A. Witteman, H. Foeken, T. Szili-Torok, F. Akca, K. Caliskan, F. Ten Cate, M. Michels, D. C. Cozma, L. Petrescu, C. Mornos, S. I. Dragulescu, J. A. Groeneweg, B. K. Velthuis, M. G. P. J. Cox, P. Loh, D. Dooijes, M. J. Cramer, J. M. T. De Bakker, R. N. W. Hauer, S. D. Park, S. H. Shin, S. I. Woo, J. Kwan, K. S. Park, D. H. Kim, A. Iorio, L. Vitali Serdoz, F. Brun, E. Daleffe, M. Zecchin, M. Dal Ferro, S. Santangelo, G. F. Sinagra, S. Ouali, R. Hammemi, S. Hammas, S. Kacem, R. Gribaa, E. Neffeti, F. Remedi, E. Boughzela, P. Korantzopoulos, K. Letsas, Z. Christogiannis, K. Kalantzi, A. Ntorkos, J. Goudevenos, P. W. X. Foley, L. Yung, E. Barnes, M. Kikuchi, H. Ito, F. Miyoshi, R. Pecini, J. M. Marott, G. B. Jensen, J. Theilade, T. Mine, T. Kodani, T. Masuyama, I. M. Mozos, C. Serban, C. Costea, L. Susan, P. Barthel, A. Mueller, M. Malik, G. Schmidt, O. Karakurt, H. Kilic, D. R. Munevver Sari, D. Mroczek-Czernecka, A. Z. Pietrucha, A. Borowiec, M. Wnuk, I. Bzukala, O. Kruszelnicka, E. Konduracka, J. Nessler, Y. Kikuchi, A. Meireles, C. Gomes, D. Anjo, C. Roque, A. Pinheiro Vieira, V. Lagarto, A. Hipolito Reis, S. Torres, L. Miller, G. Vedrenne, E. Bruguiere, A. Redheuil, T. Lavergne, J. Y. Le Heuzey, E. Mousseaux, A. Hersi, K. Alhabib, H. Alfaleh, K. Sulaiman, W. Almahmeed, J. Alsuwidi, H. Amin, A. Almotarreb, H. W. K. Pang, K. Michael, E. J. Pereira, P. W. Munt, M. F. Fitzpatrick, A. S. Revishvili, G. Simonyan, T. Dzhordzhikiya, O. Sopov, V. Kalinin, E. T. Locati, A. M. Vecchi, G. Cattafi, A. Sachero, M. Lunati, S. Sayah, A. Alizadeh, N. Nazari, M. Hekmat, M. Moradi, M. Zeighami, H. Ghanji, K. Suzuki, M. Takagi, K. Maeda, H. Tatsumi, P. Vieira, H. Reis, A. Toth, H. Vago, P. Takacs, E. Edes, A. Marki, G. Y. Balazs, K. Huttl, B. Merkely, F. Lainis, M. M. Buckley, E. J. Johns, C. M. Seifer, L. Daba, K. Liebrecht, W. Piwowarska, J. Toquero Ramos, E. Perez Pereira, C. Mitroi, V. Castro Urda, J. M. Fernandez Villanueva, A. Corona Figueroa, L. Hernandez Reina, I. Fernandez Lozano, A. Bartoletti, P. Bocconcelli, S. Giuli, R. Massa, C. Svetlich, G. Tarsi, F. Tronconi, E. Vitale, P. Stryjewski, M. Wegrzynowska, A. Lousinha, J. Labandeiro, E. Antunes, S. Silva, S. Alves, A. Timoteo, M. Oliveira, R. Cruz Ferreira, and J. Jedrzejczyk-Spaho

Subjects
medicine.medical_specialty, Voltage-dependent calcium channel, business.industry, medicine.drug_class, Umbilical artery, 030204 cardiovascular system & hematology, Cyclase, 3. Good health, Low testosterone levels, 03 medical and health sciences, 0302 clinical medicine, Bkca channel, Endocrinology, Physiology (medical), Internal medicine, medicine.artery, Natriuretic peptide, Medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Ionic Channels
Abstract

Inthelastdecadesseveralinvestigatorshavesuggestedtheassociationofandrogenswithhypertension. Recently, some studies have shown that the incidence of cardiovascular diseases is increased in men with low testosterone levels, suggesting a protective role of androgens. Hypertension is one of the mostcommonproblemsinpregnancythatcomplicates5-10 %ofpregnancies.Anincreaseofmorbidity wasobservedinbabiesfrompregnantwomenwithhypertension.However,thepathogenesisremains unclearandthislimitstheabilitytopreventandtreatthispathology.Thebeneficialeffectsofandrogens for vascular system are associated with their ability to cause vasorelaxation. Inhuman vessels, this non genomiceffectofandrogensappeartobeduetoactivationoflargeconductancecalcium-activatedpotassiumchannels(BKCa)andvoltagegatedpotassiumchannels(KV)whichisinducedbycGMPincrease andaconsequentactivationofcGMP-dependentproteinkinase(PKG).Ontheotherhand,thegenomic effects of androgens concerning ionic channels are almost unknown. Our previous studies suggested that androgens increase the expression of BKCa channels and decrease expression of L-type calcium channels (LTCC). The aim of this work was to analyze the genomic effects of androgens on theexpressionofotherproteinsinvolvedintheregulationofvascularcontractility,suchassolubleguanylate cyclase (sGC), the natriuretic peptide receptor-A (NPRA) and PKG. This study also aimed to compare the expression levels of these proteins in human umbilical artery (HUA) from normotensive andhypertensivepregnantwomen.ToachievethesegoalsrealtimePCRwasperformedusingsmooth

Published
2011
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5. Hot topics: CRT and ICD therapy

Author

F. Voss, T. Kleemann, C. Strunk-Mueller, G. Buja, B. J. Gordon, L. Hoskova, H. M. S. G. Veneto Region, M. Gasparini, G. Giannola, I. Malek, R. Sheppard, P. Jurkuvenas, F. Chiusso, G. Crossley, G. Zanotto, R. Corbisiero, M. Santini, R. Zahn, J. Senges, I. Niazi, A. F. Folino, R. Ricci, M. Strauss, D. Vaccari, A. G. Stuart, K. Seidl, M. Lunati, M. Biffi, B. Coutu, D. Meyer Zu Vilsendorf, C. Love, J. Baker, I. A. Fazal, S. Worley, D. Martin, D. Exner, M. Hochadel, J. M. Mccomb, M. Landolina, G. F. Tomassoni, F. Ammirati, K. Sedlacek, B. Ramza, J. Kautzner, K. M. Teo, G. Tomassoni, S. Valsecchi, E. Marras, C. J. Plummer, C. Stellbrink, W. Kranig, M. Bertaglia, and J. O. Schwab

Subjects
medicine.medical_specialty, Hot topics, business.industry, Physiology (medical), medicine, Medical physics, Cardiology and Cardiovascular Medicine, business, Icd therapy
Published
2011
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6. [Troubleshooting in Patients with Implanted Pacemaker and ICD].

Author

Meyer Zu Vilsendorf D, Hansky B, Baumann P, and Stellbrink C

Subjects
Equipment Failure, Humans, Defibrillators, Implantable adverse effects, Defibrillators, Implantable standards, Pacemaker, Artificial adverse effects, Pacemaker, Artificial standards
Abstract

Because of the growing number of implanted cardiac pacemakers and defibrillators and the ever-increasing complexity of these devices a fundamental knowledge of device malfunctions is of utmost importance even for the non-cardiology physician. Apart from hardware problems such as device infection, lead fracture or dislocation, basic knowledge of the pacemaker sensing and pacing algorithms is also necessary in order to judge the stimulation behavior in different clinical settings. With this respect, there are specific problems for antibradycardia and resynchronizing pacemakers as well as implantable defibrillators. This article gives an overview of the most common problems with cardiac pacemakers and defibrillators as well as the differential diagnostic and therapeutic management for the physician without specific training in arrhythmology., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Published
2018
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8. Endocardial radiofrequency ablation for hypertrophic obstructive cardiomyopathy: acute results and 6 months' follow-up in 19 patients.

Author

Lawrenz T, Borchert B, Leuner C, Bartelsmeier M, Reinhardt J, Strunk-Mueller C, Meyer Zu Vilsendorf D, Schloesser M, Beer G, Lieder F, Stellbrink C, and Kuhn H

Subjects
Aged, Aged, 80 and over, Cardiomyopathy, Hypertrophic physiopathology, Exercise Test methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Time Factors, Cardiomyopathy, Hypertrophic diagnosis, Cardiomyopathy, Hypertrophic therapy, Catheter Ablation methods, Endocardium physiology
Abstract

Objectives: The purpose of this study was to examine the efficacy and safety of endocardial radiofrequency ablation of septal hypertrophy (ERASH) for left ventricular outflow tract (LVOT) gradient reduction in hypertrophic obstructive cardiomyopathy (HOCM)., Background: Anatomic variability of the vessels supplying the obstructing septal bulge can limit the efficacy of transcoronary ablation of septal hypertrophy in HOCM. Previous studies showed that inducing a local contraction disorder without reducing septal mass results in effective gradient reduction. We examined an alternative endocardial approach to transcoronary ablation of septal hypertrophy by using ERASH., Methods: Nineteen patients with HOCM were enrolled; in 9 patients, the left ventricular septum was ablated, and in 10 patients, the right ventricular septum was ablated. Follow-up examinations (echocardiography, 6-min walk test, bicycle ergometry) were performed 3 days and 6 months after ERASH., Results: After 31.2 ± 10 radiofrequency pulses, a significant and sustained LVOT gradient reduction could be achieved (62% reduction of resting gradients and 60% reduction of provoked gradients, p = 0.0001). The 6-min walking distance increased significantly from 412.9 ± 129 m to 471.2 ± 139 m after 6 months, p = 0.019); and New York Heart Association functional class was improved from 3.0 ± 0.0 to 1.6 ± 0.7 (p = 0.0001). Complete atrioventricular block requiring permanent pacemaker implantation occurred in 4 patients (21%); 1 patient had cardiac tamponade., Conclusions: ERASH is a new therapeutic option in the treatment of HOCM, allowing significant and sustained reduction of the LVOT gradient as well as symptomatic improvement with acceptable safety by inducing a discrete septal contraction disorder. It may be suitable for patients not amenable to transcoronary ablation of septal hypertrophy or myectomy., (Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2011
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9. Resynchronization therapy optimization by intracardiac impedance.

Author

Bocchiardo M, Meyer zu Vilsendorf D, Militello C, Lippert M, Czygan G, Schauerte P, Gaita F, and Stellbrink C

Subjects
Aged, Bundle-Branch Block physiopathology, Cardiac Pacing, Artificial methods, Female, Humans, Male, Middle Aged, Pacemaker, Artificial, Prospective Studies, Stroke Volume physiology, Cardiac Resynchronization Therapy methods, Electric Impedance therapeutic use, Heart Failure therapy
Abstract

Aims: For successful cardiac resynchronization therapy (CRT), an optimization of left ventricular (LV) lead position and stimulation timing is required. The feasibility of optimizing LV lead position, atrioventricular delay (AVd), and interventricular delay (VVd) in CRT using intracardiac impedance measurement was evaluated., Methods and Results: Heart failure patients (n = 14, NYHA 13×III, 1×II, ejection fraction: 26 ± 6%, QRS: 165 ± 30 ms) were stimulated by AAI and biventricular (DDD-BiV) pacing in turn. Left ventricular lead site, AVd, and VVd were varied. An external pacemaker measured impedance, and a micromanometer catheter measured LV and aortic pressure. Left ventricular dP/dt(max), pulse pressure (PP), stroke volume (SV), end-systolic impedance (ESZ), and stroke impedance (SZ) were determined. Optimization results achieved by maximum increase in PP, SV, SZ, or ESZ were compared with the reference method (dP/dt(max) increase). Left ventricular lead site variation resulted in a mean optimal dP/dt(max) benefit of 18.2%. Lead site selection by SZ/PP/SV showed benefits of 17.4/17.9/17.2%, respectively. Atrioventricular delay optimization increased the optimal benefit to 22.1%, the methods ESZ/PP/SV achieved 20.1/20.8/19.4%. Interventricular delay optimization resulted in a benefit of 19.1/19.4/19.9% (SZ/PP/SV) with an optimum of 21.8%. The achieved benefit did not differ significantly between impedance, SV, and PP methods. A significant correlation between AVd values selected by dP/dt(max) and by the other methods was observed (r = 0.75/0.67/0.60 for ESZ/PP/SV)., Conclusion: The feasibility of optimizing LV lead site, AVd, and VVd by intracardiac impedance has been demonstrated for CRT patients with a similar performance as using SV and PP. Application of intracardiac impedance for automatic implant-based CRT optimization appears to be within reach.

Published
2010
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10. Intracardiac impedance monitors stroke volume in resynchronization therapy patients.

Author

Bocchiardo M, Meyer zu Vilsendorf D, Militello C, Lippert M, Czygan G, Gaita F, Schauerte P, and Stellbrink C

Subjects
Aged, Cardiography, Impedance instrumentation, Defibrillators, Implantable, Electrophysiologic Techniques, Cardiac instrumentation, Electrophysiologic Techniques, Cardiac methods, Female, Heart Rate physiology, Heart Ventricles physiopathology, Hemodynamics, Humans, Male, Middle Aged, Monitoring, Physiologic instrumentation, Prospective Studies, Cardiac Pacing, Artificial methods, Cardiography, Impedance methods, Heart Failure physiopathology, Heart Failure therapy, Monitoring, Physiologic methods, Stroke Volume physiology
Abstract

Aims: Monitoring of haemodynamic parameters or surrogate parameters of the left ventricle is especially important for patients under cardiac resynchronization therapy (CRT). Intracardiac impedance reflects left ventricular (LV) volume changes well in animal models. Since it is unknown whether this also holds in humans with heart failure (HF), we examined the correlation of LV intracardiac impedance with haemodynamic parameters in CRT patients for different positions of the LV lead., Methods and Results: In 14 HF patients with non-ischaemic cardiomyopathy (four female, age 70 +/- 6 years, NYHA 2.9 +/- 0.3, EF 26 +/- 6%), one or two suitable implantation sites for the LV lead were selected. Following atrial, right ventricular, and LV catheter positioning, a micro-manometer catheter was placed in the ascending aorta. Surface ECG, impedance, and aortic pressure were recorded during graded overdrive bi-ventricular pacing in DDD mode. The correlation between impedance and stroke volume (SV) or pulse pressure (PP) changes was compared for different LV lead positions. In total, 20 overdrive pacing tests were performed at six different LV lead positions. Strong correlations were found between stroke impedance (SZ) and SV (R = 0.82 +/- 0.16) as well as between SZ and PP (R = 0.81 +/- 0.16) without significant influence of LV lead position., Conclusion: In HF patients, a strong correlation between changes in intracardiac impedance and LV SV was found. Typical LV lead implant positions have been tested and all appear to be suitable for this method of LV volume monitoring.

Published
2010
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11. Predictors of complete heart block after transcoronary ablation of septal hypertrophy: results of a prospective electrophysiological investigation in 172 patients with hypertrophic obstructive cardiomyopathy.

Author

Lawrenz T, Lieder F, Bartelsmeier M, Leuner C, Borchert B, Meyer zu Vilsendorf D, Strunk-Mueller C, Reinhardt J, Feuchtl A, Stellbrink C, and Kuhn H

Subjects
Adult, Aged, Electrocardiography, Electrophysiologic Techniques, Cardiac, Female, Heart Block physiopathology, Heart Conduction System physiopathology, Humans, Hypertrophy, Male, Middle Aged, Pacemaker, Artificial, Prospective Studies, Risk Factors, Cardiomyopathy, Hypertrophic therapy, Catheter Ablation adverse effects, Heart Block epidemiology, Heart Septum pathology
Abstract

Objectives: This study analyzed changes in intracardiac conduction during transcoronary ablation of septal hypertrophy (TASH) to identify predictors for pacemaker dependency after TASH., Background: Transcoronary ablation of septal hypertrophy is an accepted therapeutic option in hypertrophic obstructive cardiomyopathy (HOCM). However, atrioventricular conduction disorders, requiring permanent pacemaker implantation, remain a major adverse effect., Methods: This study measured changes in intracardiac conduction in 172 consecutive patients during TASH by simultaneously recording electrophysiological parameters and correlated these parameters with the occurrence of complete heart block during continuous electrocardiographic monitoring for 8 days., Results: Intraprocedural complete heart block occurred in 36 patients (20.1%) and was associated with a pre-existing bundle branch block (p = 0.010) or advanced age (p = 0.023). All patients with delayed complete heart block during follow-up (n = 15, 8.7%), occurring 1 to 6 days after TASH, showed lack of retrograde atrioventricular nodal conduction after TASH (p = 0.018). None of the patients with intact retrograde conduction after TASH developed delayed complete heart block. Further risk factors for delayed block were advanced age, intraprocedural complete heart block, and prolonged QRS duration before or after TASH (p < 0.05 for all). Permanent pacemaker implantation was performed in 20 patients., Conclusions: Measurement of intracardiac conduction during TASH improves the safety of the procedure by enabling identification of patients who are at risk of complete heart block after TASH. The duration of prophylactic temporary pacemaker backup should be prolonged up to day 6 after TASH in patients at increased risk (patients with retrograde atrioventricular block and at least 1 additional risk factor).

Published
2007
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12. Transcoronary ablation of septal hypertrophy does not alter ICD intervention rates in high risk patients with hypertrophic obstructive cardiomyopathy.

Author

Lawrenz T, Obergassel L, Lieder F, Leuner C, Strunk-Mueller C, Meyer Zu Vilsendorf D, Beer G, and Kuhn H

Subjects
Aged, Cardiomyopathy, Hypertrophic therapy, Female, Heart Septum surgery, Humans, Male, Middle Aged, Treatment Outcome, Cardiomyopathy, Hypertrophic surgery, Catheter Ablation, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable
Abstract

Introduction: Transcoronary ablation of septal hypertrophy (TASH) is safe and effectively reduces the intraventricular gradient in patients with hypertrophic obstructive cardiomyopathy (HOCM). To analyze the potential of anti- and proarrhythmic effects of TASH, we studied the discharge rates of implanted cardioverter defibrillators (ICD) in patients with HOCM who are at a high risk for sudden cardiac death., Methods: ICD and TASH were performed in 15 patients. Indications for ICD-implantation were secondary prevention in nine patients after resuscitation from cardiac arrest with documented ventricular fibrillation (n = 7) or sustained ventricular tachycardia (n = 2) and primary prevention in 6 patients with a family history of sudden deaths, nonsustained ventricular tachycardia, and/or syncope. All the patients had severe symptoms due to HOCM (NYHA functional class = 2.9)., Results: During a mean follow-up time of 41 +/- 22.7 months following the TASH procedure, 4 patients had episodes of appropriate discharges (8% per year). The discharge rate in the secondary prevention group was 10% per year and 5% in the group with primary prophylactic implants. Three patients died during follow-up (one each of pulmonary embolism, stroke, and sudden death)., Conclusion: In conclusion, on the basis of ICD-discharge rates in HOCM-patients at high risk for sudden death, there is no evidence for an unfavorable arrhythmogenic effect of TASH. The efficacy of ICD treatment for the prevention of sudden cardiac death in HOCM could be confirmed, however, mortality is high in this cohort of hypertrophic cardiomyopathy patients.

Published
2005
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