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1. Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial

Author

May, Andreas, Seitzer, Peter, Schmidt, Roland, Keta, Dritan, Janke, Viktoria, Schläger, Christian, André, Elisabeth, Brandt, Niels, Schön, Alexandra, Zollner, Alfred, Freyer, Luisa, Hamm, Wolfgang, Beil, Johannes, Strüven, Anna Katharina, Loew, Anja, Fichtner, Stephanie, Lange, Philipp, Krasniqi, Aresa, Grabmeier, Ulrich, Estner, Heidi, Bengel, Philipp, Lüthje, Lars, Kirova, Aleksandra, Fischer, Thomas, Bergau, Leonard, Herting, Jonas, Schlögl, Simon, Haarmann, Helge, Schlögl (Illes), Klaudia, Uecer, Ekrem, Sag, Sabine, Tafelmeier, Maria, Jungbauer, Carsten, Fredersdorf-Hahn, Sabine, Strack, Christina, Seither, Benedikt, Seegers, Joachim, Millenaar, Dominic, Wintrich, Jan, Fischer, Patrick, Buob, Axel, Razouk, Amjad, Demming, Thomas, Frank, Johanne, Kühl, Constantin, Ellendt, Ulrike, Sandrock, Sarah, Gänsbacher, Julia, Cupa, Janosch, Sinnecker, Daniel, Laugwitz, Karl-Ludwig, Steger, Alexander, Berkefeld, Anna, Schinke, Karin, Barthel, Petra, Dommasch, Michael, Amadei, Maiwand, Hindricks, Gerhard, Obradovic, Danilo, Döring, Michael, Bode, Kerstin, Hilbert, Sebastian, Löbe, Susanne, Knopp, Helge, König, Sebastian, John, Silke, Schöne, Katharina, Hartung, Philipp, Binner, Christian, Meyer-Zürn, Christine, Duckheim, Martin, Eick, Christian, Simpfle, Fabian, Schreieck, Jürgen, Mizera, Lars, Tscholl, Verena, Steinbeck, Lisa, Güc, Nadija, Schatz, Anne-Sophie, Attanasio, Philipp, Heuberger, Andrea, Roser, Mattias, Bellmann, Barbara, Nagel, Patrick, Biewener, Sebastian, Suhail, Saba, Juri, Benjamin, Meyer, Christian, Wiilems, Stephan, Jungen, Christiane, Schmitt, Susanne, Münkerer, Paula, Vogler, Julia, Kaiser, Lukas, Schäffer, Benjamin, Nies, Moritz, Tönnis, Tobias, Fluschnik, Nina, Grahn, Hanno, Waldeyer, Christoph, Kany, Shinwan, Sörensen, Nils Arne, Winkelmann, Simon, Akbulak, Özge, Gosau, Nils Arne, Würger, Tilman, Arnold, Natalie, Geßler, Nele, Jobs, Alexander, Münkler, Paula, Rausch, Stefan, Köster, Jelena, Brüggemann, Ben, Abdin, Amr, Wacker, Christian, Grotherr, Philipp, Fries, Bastian, Faust, Maximilian, Steuer, Stefanie, Swojanowsky, Patrick, Willems, Stephan, Portz, Nathaniel, Ujeyl, Amar, Krüger, Matthias, Gramlich, Robert, Köhler, Till, Sause, Armin, Nover, Ina, Ziakos, Athanasios-Panagiotis, Ciobanu, Veaceslav, Spelsberg, Norman, Siebermair, Johannes, Mahabadi, Amir-Abbas, Köhler, Miriam, Vonderlin, Nadine, Riesinger, Lisa, Abdiu, Edison, Bachmann, Anja, Frenzel, Marie, Hummel, Astrid, Lehnert, Kristin, Krüger, Anne, Busse, Franke, Napp, Andreas, Müller-Wieland, Dirk, Battermann, Simone, Lacour, Philipp, Trippel, Tobias, Beetz, Nick Lasse, Schleußner, Leonhard, Zach, Veronika, Rozados, Christina, Mudra, Harald, Staubach, Stephan, Illmann, Alexander, Joner, Michael, Bock, Matthias, Kolb, Christof, Koch, Tobias, Fröhlich, Rebecca, Lennerz, Carsten, Lenz, Tobias, Fuchs, Patrick, Freißmuth, Markus, Grebmer, Christian, Kuschyk, Jürgen, Kranert, Malte, Fastenrath, Fabian, Yücel, Gökhan, Rudic, Boris, Würfel, Sarah, Römer, Albrecht, Böhmer, Andreas, Honold, Jörg, Georgopoulos, Stamatis, Gleirscher, Lukas, Lederle, Susanne, Chaplygin, Artem, Pauschinger, Matthias, Brinker-Paschke, Andrea, Kropacek, Jana, Eckardt, Lars, Ellermann, Christian, Bode, Niklas, Reinke, Florian, Engelke, Hauke, Höllriegel, Robert, Woitek, Felix, Winzer, Ephraim, Ibrahim, Karim, Pflücke, Christian, Ende, Georg, Speiser, Uwe, Haußig, Stephan, Wachter, Rolf, Uhe, Tobias, Konrad, Torsten, Zitron, Edgar, Destani, Jeton, Fu, Fangyi, Al Said, Samer, Kaya, Ziya, Schgör, Wilfried, Senoner, Thomas, Bauer, Axel, Sappler, Nikolay, von Stülpnagel, Lukas, Klemm, Mathias, Schreinlechner, Michael, Wenner, Felix, Schier, Johannes, Al Tawil, Amani, Dolejsi, Theresa, Eiffener, Elodie, Bongarth, Christa, Stühlinger, Markus, Huemer, Martin, Gori, Tommaso, Wakili, Reza, Sahin, Riza, Schwinger, Robert, Lutz, Matthias, Luik, Armin, Gessler, Nele, Clemmensen, Peter, Linke, Axel, Maier, Lars S, Hinterseer, Martin, Busch, Mathias C, Blaschke, Florian, Sack, Stefan, Licka, Manuela, Tilz, Roland R, Ukena, Christian, Ehrlich, Joachim R, Zabel, Markus, Schmidt, Georg, Mansmann, Ulrich, Kääb, Stefan, Rizas, Konstantinos D, and Massberg, Steffen

Published
2022
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11. Clinical effectiveness of primary prevention implantable cardioverter-defibrillators: results of the EU-CERT-ICD controlled multicentre cohort study

Author

Zabel, Markus, Willems, Rik, Lubinski, Andrzej, Bauer, Axel, Brugada, Josep, Conen, David, Flevari, Panagiota, Hasenfuß, Gerd, Svetlosak, Martin, Huikuri, Heikki V, Malik, Marek, Pavlović, Nikola, Schmidt, Georg, Sritharan, Rajevaa, Schlögl, Simon, Szavits-Nossan, Janko, Traykov, Vassil, Tuinenburg, Anton E, Willich, Stefan N, Harden, Markus, Friede, Tim, Svendsen, Jesper Hastrup, Sticherling, Christian, Merkely, Béla, Perge, Peter, Sallo, Zoltan, Szeplaki, Gabor, Szegedi, Nandor, Nagy, Klaudia Vivien, Lüthje, Lars, Sritharan, R, Haarmann, Helge, Bergau, Leonard, Seegers, Joachim, Munoz- Exposito, Pascal, Tichelbäcker, Tobias, Kirova, Aleksandra, Hnatkova, Katerina, Vos, Marc A, Reinhold, Thomas, Vandenberk, Bert, Klinika, Magdalena, Rotkvić, L, Flevari, Panayota, Katsimardos, Andreas, Katsaras, Dimitrios, Hatala, Robert, Kuczejko, Tomasz, Hansen, Jim, Manola, Šime, Vinter, Ozren, Benko, Ivica, Tuinenburg, Anton, Sprenkeler, David, Smoczynska, A, Vos, M A, Meyer-Zürn, Christine, Eick, Christian, Arbelo, Elena, Kaliska, Gabriela, Martinek, Jozef, Dommasch, Michael, Steger, Alexander, Kääb, Stefan, Sinner, Moritz F, Rizas, Konstantinos D, Hamm, Wolfgang, Traykov, V, Cygankiewicz, Iwona, Ptaszyński, Pawel, Kaczmarek, K, Poddebska, I, Iovev, Svetoslav, Novotný, Tomáš, Kozak, Milan, Huikuri, Heikki, Kenttä, Tuomas, Pelli, Ari, Kasprzak, Jaroslaw D, Qavoq, Dariusz, Brusich, Sandro, Avdovic, Ervin, Klasan, Marina, Galuszka, Jan, Taborsky, Milos, Velchev, Vasil, Dissmann, Rüdiger, Shalganov, T, Guzik, P, Krauze, T, Bimmel, Dieter, Lieberz, Christiane, Ludwigsburg, Klinikum, Stefanow, Stefan, Rüb, Norman, Wolpert, Christian, Meier, Lars S, Behrens, Steffen, Jurisic, Zrinka, Braunschweig, Frieder, Blaschke, Florian, Pieske, Burkert, Bakotic, Zoran, Anic, Ante, Weiden, Klinikum, Schwinger, Robert H G, Platonov, Pyotr, Grönefeld, Gerian, Klingenheben, Thomas, and EU-CERT-ICD Study Investigators

Subjects
medicine.medical_specialty, medicine.medical_treatment, Implantable cardioverter-defibrillator, Risk factors, Mortality, Sudden cardiac death, 030204 cardiovascular system & hematology, Ventricular Function, Left, Cohort Studies, EU-CERT-ICD Study Investigators, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Internal medicine, medicine, Clinical endpoint, Humans, AcademicSubjects/MED00200, Prospective Studies, 030212 general & internal medicine, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, 1102 Cardiorespiratory Medicine and Haematology, Aged, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, Heart Failure, Ejection fraction, Ischemic cardiomyopathy, business.industry, Hazard ratio, Stroke Volume, 1103 Clinical Sciences, Dilated cardiomyopathy, medicine.disease, Confidence interval, Defibrillators, Implantable, 3. Good health, Europe, Primary Prevention, Death, Sudden, Cardiac, Treatment Outcome, Cardiovascular System & Hematology, Implantable cardioverter-defibrillator, Risk factors, Mortality, Sudden cardiac death, Cardiology and Cardiovascular Medicine, business, Cohort study
Abstract

Aims The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter-Defibrillators (EU-CERT-ICD), a prospective investigator-initiated, controlled cohort study, was conducted in 44 centres and 15 European countries. It aimed to assess current clinical effectiveness of primary prevention ICD therapy. Methods and results We recruited 2327 patients with ischaemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM) and guideline indications for prophylactic ICD implantation. Primary endpoint was all-cause mortality. Clinical characteristics, medications, resting, and 12-lead Holter electrocardiograms (ECGs) were documented at enrolment baseline. Baseline and follow-up (FU) data from 2247 patients were analysable, 1516 patients before first ICD implantation (ICD group) and 731 patients without ICD serving as controls. Multivariable models and propensity scoring for adjustment were used to compare the two groups for mortality. During mean FU of 2.4 ± 1.1 years, 342 deaths occurred (6.3%/years annualized mortality, 5.6%/years in the ICD group vs. 9.2%/years in controls), favouring ICD treatment [unadjusted hazard ratio (HR) 0.682, 95% confidence interval (CI) 0.537–0.865, P = 0.0016]. Multivariable mortality predictors included age, left ventricular ejection fraction (LVEF), New York Heart Association class Conclusion In contemporary ICM/DCM patients (LVEF ≤35%, narrow QRS), primary prophylactic ICD treatment was associated with a 27% lower mortality after adjustment. There appear to be patients with less survival advantage, such as older patients or diabetics.

Published
2020
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12. Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial

Author

Bauer, Axel, primary, Sappler, Nikolay, additional, von Stülpnagel, Lukas, additional, Klemm, Mathias, additional, Schreinlechner, Michael, additional, Wenner, Felix, additional, Schier, Johannes, additional, Al Tawil, Amani, additional, Dolejsi, Theresa, additional, Krasniqi, Aresa, additional, Eiffener, Elodie, additional, Bongarth, Christa, additional, Stühlinger, Markus, additional, Huemer, Martin, additional, Gori, Tommaso, additional, Wakili, Reza, additional, Sahin, Riza, additional, Schwinger, Robert, additional, Lutz, Matthias, additional, Luik, Armin, additional, Gessler, Nele, additional, Clemmensen, Peter, additional, Linke, Axel, additional, Maier, Lars S, additional, Hinterseer, Martin, additional, Busch, Mathias C, additional, Blaschke, Florian, additional, Sack, Stefan, additional, Lennerz, Carsten, additional, Licka, Manuela, additional, Tilz, Roland R, additional, Ukena, Christian, additional, Ehrlich, Joachim R, additional, Zabel, Markus, additional, Schmidt, Georg, additional, Mansmann, Ulrich, additional, Kääb, Stefan, additional, Rizas, Konstantinos D, additional, Massberg, Steffen, additional, May, Andreas, additional, Seitzer, Peter, additional, Schmidt, Roland, additional, Keta, Dritan, additional, Janke, Viktoria, additional, Schläger, Christian, additional, André, Elisabeth, additional, Brandt, Niels, additional, Schön, Alexandra, additional, Zollner, Alfred, additional, Freyer, Luisa, additional, Hamm, Wolfgang, additional, Beil, Johannes, additional, Strüven, Anna Katharina, additional, Loew, Anja, additional, Fichtner, Stephanie, additional, Lange, Philipp, additional, Grabmeier, Ulrich, additional, Estner, Heidi, additional, Bengel, Philipp, additional, Lüthje, Lars, additional, Kirova, Aleksandra, additional, Fischer, Thomas, additional, Bergau, Leonard, additional, Herting, Jonas, additional, Schlögl, Simon, additional, Haarmann, Helge, additional, Schlögl (Illes), Klaudia, additional, Uecer, Ekrem, additional, Sag, Sabine, additional, Tafelmeier, Maria, additional, Jungbauer, Carsten, additional, Fredersdorf-Hahn, Sabine, additional, Strack, Christina, additional, Seither, Benedikt, additional, Seegers, Joachim, additional, Millenaar, Dominic, additional, Wintrich, Jan, additional, Fischer, Patrick, additional, Buob, Axel, additional, Razouk, Amjad, additional, Demming, Thomas, additional, Frank, Johanne, additional, Kühl, Constantin, additional, Ellendt, Ulrike, additional, Sandrock, Sarah, additional, Gänsbacher, Julia, additional, Cupa, Janosch, additional, Sinnecker, Daniel, additional, Laugwitz, Karl-Ludwig, additional, Steger, Alexander, additional, Berkefeld, Anna, additional, Schinke, Karin, additional, Barthel, Petra, additional, Dommasch, Michael, additional, Amadei, Maiwand, additional, Hindricks, Gerhard, additional, Obradovic, Danilo, additional, Döring, Michael, additional, Bode, Kerstin, additional, Hilbert, Sebastian, additional, Löbe, Susanne, additional, Knopp, Helge, additional, König, Sebastian, additional, John, Silke, additional, Schöne, Katharina, additional, Hartung, Philipp, additional, Binner, Christian, additional, Meyer-Zürn, Christine, additional, Duckheim, Martin, additional, Eick, Christian, additional, Simpfle, Fabian, additional, Schreieck, Jürgen, additional, Mizera, Lars, additional, Tscholl, Verena, additional, Steinbeck, Lisa, additional, Güc, Nadija, additional, Schatz, Anne-Sophie, additional, Attanasio, Philipp, additional, Heuberger, Andrea, additional, Roser, Mattias, additional, Bellmann, Barbara, additional, Nagel, Patrick, additional, Biewener, Sebastian, additional, Suhail, Saba, additional, Juri, Benjamin, additional, Meyer, Christian, additional, Wiilems, Stephan, additional, Jungen, Christiane, additional, Schmitt, Susanne, additional, Münkerer, Paula, additional, Vogler, Julia, additional, Kaiser, Lukas, additional, Schäffer, Benjamin, additional, Nies, Moritz, additional, Tönnis, Tobias, additional, Fluschnik, Nina, additional, Grahn, Hanno, additional, Waldeyer, Christoph, additional, Kany, Shinwan, additional, Sörensen, Nils Arne, additional, Winkelmann, Simon, additional, Akbulak, Özge, additional, Gosau, Nils Arne, additional, Würger, Tilman, additional, Arnold, Natalie, additional, Geßler, Nele, additional, Jobs, Alexander, additional, Münkler, Paula, additional, Rausch, Stefan, additional, Köster, Jelena, additional, Brüggemann, Ben, additional, Abdin, Amr, additional, Wacker, Christian, additional, Grotherr, Philipp, additional, Fries, Bastian, additional, Faust, Maximilian, additional, Steuer, Stefanie, additional, Swojanowsky, Patrick, additional, Willems, Stephan, additional, Portz, Nathaniel, additional, Ujeyl, Amar, additional, Krüger, Matthias, additional, Gramlich, Robert, additional, Köhler, Till, additional, Sause, Armin, additional, Nover, Ina, additional, Ziakos, Athanasios-Panagiotis, additional, Ciobanu, Veaceslav, additional, Spelsberg, Norman, additional, Siebermair, Johannes, additional, Mahabadi, Amir-Abbas, additional, Köhler, Miriam, additional, Vonderlin, Nadine, additional, Riesinger, Lisa, additional, Abdiu, Edison, additional, Bachmann, Anja, additional, Frenzel, Marie, additional, Hummel, Astrid, additional, Lehnert, Kristin, additional, Krüger, Anne, additional, Busse, Franke, additional, Napp, Andreas, additional, Müller-Wieland, Dirk, additional, Battermann, Simone, additional, Lacour, Philipp, additional, Trippel, Tobias, additional, Beetz, Nick Lasse, additional, Schleußner, Leonhard, additional, Zach, Veronika, additional, Rozados, Christina, additional, Mudra, Harald, additional, Staubach, Stephan, additional, Illmann, Alexander, additional, Joner, Michael, additional, Bock, Matthias, additional, Kolb, Christof, additional, Koch, Tobias, additional, Fröhlich, Rebecca, additional, Lenz, Tobias, additional, Fuchs, Patrick, additional, Freißmuth, Markus, additional, Grebmer, Christian, additional, Kuschyk, Jürgen, additional, Kranert, Malte, additional, Fastenrath, Fabian, additional, Yücel, Gökhan, additional, Rudic, Boris, additional, Würfel, Sarah, additional, Römer, Albrecht, additional, Böhmer, Andreas, additional, Honold, Jörg, additional, Georgopoulos, Stamatis, additional, Gleirscher, Lukas, additional, Lederle, Susanne, additional, Chaplygin, Artem, additional, Pauschinger, Matthias, additional, Brinker-Paschke, Andrea, additional, Kropacek, Jana, additional, Eckardt, Lars, additional, Ellermann, Christian, additional, Bode, Niklas, additional, Reinke, Florian, additional, Engelke, Hauke, additional, Höllriegel, Robert, additional, Woitek, Felix, additional, Winzer, Ephraim, additional, Ibrahim, Karim, additional, Pflücke, Christian, additional, Ende, Georg, additional, Speiser, Uwe, additional, Haußig, Stephan, additional, Wachter, Rolf, additional, Uhe, Tobias, additional, Konrad, Torsten, additional, Zitron, Edgar, additional, Destani, Jeton, additional, Fu, Fangyi, additional, Al Said, Samer, additional, Kaya, Ziya, additional, Schgör, Wilfried, additional, and Senoner, Thomas, additional

Published
2022
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13. Sympathetic activity--associated periodic repolarization dynamics predict mortality following myocardial infarction

Author

Rizas, Konstantinos D., Nieminen, Tuomo, Barthel, Petra, Zurn, Christine S., Kahonen, Mika, Viik, Jari, Lehtimaki, Terho, Nikus, Kjell, Eick, Christian, Greiner, Tim O., Wendel, Hans P., Seizer, Peter, Schreieck, Jurgen, Gawaz, Meinrad, Schmidt, Georg, and Bauer, Axel

Subjects
Nervous system, Sympathetic -- Physiological aspects -- Research, Heart beat -- Research, Cardiac arrest -- Research, Health care industry
Abstract

Background. Enhanced sympathetic activity at the ventricular myocardium can destabilize repolarization, increasing the risk of death. Sympathetic activity is known to cluster in low-frequency bursts; therefore, we hypothesized that sympathetic activity induces periodic low-frequency changes of repolarization. We developed a technique to assess the sympathetic effect on repolarization and identified periodic components in the low-frequency spectral range (≤ 0.1 Hz), which we termed periodic repolarization dynamics (PRD). Methods. We investigated the physiological properties of PRD in multiple experimental studies, including a swine model of steady-state ventilation (n = 7) and human studies involving fixed atrial pacing (n = 10), passive head-up tilt testing (n = 11), low-intensity exercise testing (n = 11), and beta blockade (n = 10). We tested the prognostic power of PRD in 908 survivors of acute myocardial infarction (MI). Finally, we tested the predictive values of PRD and T-wave alternans (TWA) in 2,965 patients undergoing clinically indicated exercise testing. Results. PRD was not related to underlying respiratory activity (P < 0.001) or heart-rate variability (P = 0.002). Furthermore, PRD was enhanced by activation of the sympathetic nervous system, and pharmacological blockade of sympathetic nervous system activity suppressed PRD (P < 0.005 for both). Increased PRD was the strongest single risk predictor of 5-year total mortality (hazard ratio 4.75, 95% CI 2.94-7.66; P < 0.001) after acute MI. In patients undergoing exercise testing, the predictive value of PRD was strong and complementary to that of TWA. Conclusion. We have described and identified low-frequency rhythmic modulations of repolarization that are associated with sympathetic activity. Increased PRD can be used as a predictor of mortality in survivors of acute MI and patients undergoing exercise testing. Trial registration. ClinicalTrials.gov NCT00196274. Funding. This study was funded by Angewandte Klinische Forschung, University of Tubingen (252-1-0)., Introduction Sudden cardiac death (SCD) is the single most common cause of death in the industrialized world (1). A substantial proportion of SCD cases occur in patients after myocardial infarction [...]

Published
2014
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15. Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study

Author

Pelli, Ari, Junttila, M Juhani, Kenttä, Tuomas V, Schlögl, Simon, Zabel, Markus, Malik, Marek, Reichlin, Tobias, Willems, Rik, Vos, Marc A, Harden, Markus, Friede, Tim, Sticherling, Christian, Huikuri, Heikki V, Arbelo, Elena, Bauer, Axel, Braunschweig, Frieder, Brugada, Josep, Conen, David, Cygankiewicz, Iwona, Dommasch, Michael, Eick, Christian, Flevari, Panagiota, Galuszka, Jan, Hansen, Jim, Hatala, Robert, Hnatkova, Katerina, Junttila, Juhani M, Kääb, Stefan, Kaliska, Gabriela, Kasprzak, Jaroslaw D, Katsimardos, Andreas, Kozak, Milan, Kuczejko, Tomasz, Lubinski, Andrzej, Martinek, Jozef, Merkely, Béla, Novotný, Tomáš, Perge, Peter, Pieske, Burkert, Platonov, Pyotr, Ptaczyński, Pawel, Qavoq, Dariusz, Rotkvić, L, Sallo, Zoltan, Schmidt, Georg, Sinner, Moritz, Sritharan, Rajeeva, Stefanow, Stefan, Svendsen, Jesper Hastrup, Svetlosak, Martin, Szavits-Nossan, Janko, Taborsky, Milos, Tuinenburg, Anton, Vandenberk, Bert, Willich, Stefan N, Wolpert, Christian, Anic, Ante, Bakotic, Zoran, Behrens, Steffen, Bimmel, Dieter, Brusich, Sandro, Dissmann, Rüdiger, Grönefeld, Gerian, Guzik, Przemyzlav, Iovev, Svetoslav, Jurisic, Zrinka, Klingenheben, Thomas, Pavlović, Nikola, Seegers, Joachim, Schwinger, Robert H G, Shalganov, Tchavdar, Traykov, Vassil, Velchev, Vasil, and the EU-CERT-ICD Study Investigators

Subjects
QT interval, medicine.medical_specialty, medicine.medical_treatment, Population, 610 Medicine & health, Heart failure, Benefit, 030204 cardiovascular system & hematology, Implantable cardioverter-defibrillator, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Risk Factors, Physiology (medical), Internal medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Mortality, education, Pathological, education.field_of_study, Primary prevention, business.industry, Incidence (epidemiology), Hazard ratio, Arrhythmias, Cardiac, Appropriate shock, Electrocardiogram, Q wave, medicine.disease, Confidence interval, Defibrillators, Implantable, Primary Prevention, Death, Sudden, Cardiac, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Aim The association of standard 12-lead electrocardiogram (ECG) markers with benefits of the primary prophylactic implantable cardioverter-defibrillator (ICD) has not been determined in the contemporary era. We analysed traditional and novel ECG variables in a large prospective, controlled primary prophylactic ICD population to assess the predictive value of ECG in terms of ICD benefit. Methods and results Electrocardiograms from 1477 ICD patients and 700 control patients (EU-CERT-ICD; non-randomized, controlled, prospective multicentre study; ClinicalTrials.gov Identifier: NCT02064192), who met ICD implantation criteria but did not receive the device, were analysed. The primary outcome was all-cause mortality. In ICD patients, the co-primary outcome of first appropriate shock was used. Mean follow-up time was 2.4 ± 1.1 years to death and 2.3 ± 1.2 years to the first appropriate shock. Pathological Q waves were associated with decreased mortality in ICD patients [hazard ratio (HR) 0.54, 95% confidence interval (CI) 0.35–0.84; P Conclusion Pathological Q waves were a strong ECG predictor of ICD benefit in primary prophylactic ICD patients. Excess mortality among Q wave patients seems to be due to arrhythmic death which can be prevented by ICD.

Published
2021
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23. Association of Heart Rate Variability With Silent Brain Infarcts in Patients With Atrial Fibrillation

Author

Hämmerle, Peter, primary, Eick, Christian, additional, Poli, Sven, additional, Blum, Steffen, additional, Schlageter, Vincent, additional, Bauer, Axel, additional, Rizas, Konstantinos D., additional, Eken, Ceylan, additional, Coslovsky, Michael, additional, Aeschbacher, Stefanie, additional, Krisai, Philipp, additional, Meyre, Pascal, additional, Wuerfel, Jens, additional, Sinnecker, Tim, additional, Vesin, Jean-Marc, additional, Beer, Jürg H., additional, Moschovitis, Giorgio, additional, Bonati, Leo H., additional, Sticherling, Christian, additional, Conen, David, additional, Osswald, Stefan, additional, Kühne, Michael, additional, and Zuern, Christine S., additional

Published
2021
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24. Heart Rate Variability Triangular Index as a Predictor of Cardiovascular Mortality in Patients With Atrial Fibrillation

Author

Hämmerle, Peter, Eick, Christian, Blum, Steffen, Schlageter, Vincent, Bauer, Axel, Rizas, Konstantinos D., Eken, Ceylan, Coslovsky, Michael, Aeschbacher, Stefanie, Krisai, Philipp, Meyre, Pascal, Vesin, Jean-Marc, Rodondi, Nicolas, Moutzouri, Elisavet, Beer, Jürg, Moschovitis, Giorgio, Kobza, Richard, Di Valentino, Marcello, Corino, Valentina D. A., Laureanti, Rita, Mainardi, Luca, Bonati, Leo H., Sticherling, Christian, Conen, David, Osswald, Stefan, Kühne, Michael, Zuern, Christine S., and Swiss‐AF Study Investigators

Abstract

Background Impaired heart rate variability (HRV) is associated with increased mortality in sinus rhythm. However, HRV has not been systematically assessed in patients with atrial fibrillation (AF). We hypothesized that parameters of HRV may be predictive of cardiovascular death in patients with AF. Methods and Results From the multicenter prospective Swiss-AF (Swiss Atrial Fibrillation) Cohort Study, we enrolled 1922 patients who were in sinus rhythm or AF. Resting ECG recordings of 5-minute duration were obtained at baseline. Standard parameters of HRV (HRV triangular index, SD of the normal-to-normal intervals, square root of the mean squared differences of successive normal-to-normal intervals and mean heart rate) were calculated. During follow-up, an end point committee adjudicated each cause of death. During a mean follow-up time of 2.6±1.0 years, 143 (7.4%) patients died; 92 deaths were attributable to cardiovascular reasons. In a Cox regression model including multiple covariates (age, sex, body mass index, smoking status, history of diabetes mellitus, history of hypertension, history of stroke/transient ischemic attack, history of myocardial infarction, antiarrhythmic drugs including β blockers, oral anticoagulation), a decreased HRV index ≤ median (14.29), but not other HRV parameters, was associated with an increase in the risk of cardiovascular death (hazard ratio, 1.7; 95% CI, 1.1-2.6;; P; =0.01) and all-cause death (hazard ratio, 1.42; 95% CI, 1.02-1.98;; P; =0.04). Conclusions The HRV index measured in a single 5-minute ECG recording in a cohort of patients with AF is an independent predictor of cardiovascular mortality. HRV analysis in patients with AF might be a valuable tool for further risk stratification to guide patient management. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02105844.

Published
2020

25. Heart Rate Variability Triangular Index as a Predictor of Cardiovascular Mortality in Patients With Atrial Fibrillation

Author

Haemmerle, Peter, Eick, Christian, Blum, Steffen, Schlageter, Vincent, Bauer, Axel, Rizas, Konstantinos D., Eken, Ceylan, Coslovsky, Michael, Aeschbacher, Stefanie, Krisai, Philipp, Meyre, Pascal, Vesin, Jean-Marc, Rodondi, Nicolas, Moutzouri, Elisavet, Beer, Juerg, Moschovitis, Giorgio, Kobza, Richard, Di Valentino, Marcello, Corino, Valentina D. A., Laureanti, Rita, Mainardi, Luca, Bonati, Leo H., Sticherling, Christian, Conen, David, Osswald, Stefan, Kuehne, Michael, Zuern, Christine S., and University of Zurich

Subjects
Male, onset, autonomic dysfunction, morbidity, ventricular response, 610 Medicine & health, morbidity/mortality, concealed conduction, Autonomic Nervous System, Risk Assessment, sudden cardiac death, 2705 Cardiology and Cardiovascular Medicine, 11459 Center for Molecular Cardiology, Electrocardiography, stomatognathic system, 360 Social problems & social services, Predictive Value of Tests, Risk Factors, Heart Rate, frequency-domain, Atrial Fibrillation, otorhinolaryngologic diseases, acute myocardial-infarction, Humans, prognostic value, Arrhythmia and Electrophysiology, Prospective Studies, risk, Original Research, Aged, heart rate variability, virus diseases, Reproducibility of Results, mortality, arrhythmic events, Cardiovascular Diseases, Electrocardiography, Ambulatory, 570 Life sciences, biology, Female, Mortality/Survival, circulatory and respiratory physiology
Abstract

Background Impaired heart rate variability (HRV) is associated with increased mortality in sinus rhythm. However, HRV has not been systematically assessed in patients with atrial fibrillation (AF). We hypothesized that parameters of HRV may be predictive of cardiovascular death in patients with AF. Methods and Results From the multicenter prospective Swiss-AF (Swiss Atrial Fibrillation) Cohort Study, we enrolled 1922 patients who were in sinus rhythm or AF. Resting ECG recordings of 5-minute duration were obtained at baseline. Standard parameters of HRV (HRV triangular index, SD of the normal-to-normal intervals, square root of the mean squared differences of successive normal-to-normal intervals and mean heart rate) were calculated. During follow-up, an end point committee adjudicated each cause of death. During a mean follow-up time of 2.61.0 years, 143 (7.4%) patients died; 92 deaths were attributable to cardiovascular reasons. In a Cox regression model including multiple covariates (age, sex, body mass index, smoking status, history of diabetes mellitus, history of hypertension, history of stroke/transient ischemic attack, history of myocardial infarction, antiarrhythmic drugs including beta blockers, oral anticoagulation), a decreased HRV index

Published
2020
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26. Appropriate Shocks and Mortality in Patients With Versus Without Diabetes With Prophylactic Implantable Cardioverter Defibrillators

Author

Junttila, M. Juhani, Pelli, Ari, Kenttä, Tuomas V., Friede, Tim, Willems, Rik, Bergau, Leonard, Malik, Marek, Vandenberk, Bert, Vos, Marc A., Schmidt, Georg, Merkely, Bela, Lubinski, Andrzej, Svetlosak, Martin, Braunschweig, Frieder, Harden, Markus, Zabel, Markus, Huikuri, Heikki V., Sticherling, Christian, Seegers, Joachim, Hasenfuß, Gerd, Munoz-Exposito, Pascal, Tichelbäcker, Tobias, Kirova, Aleksandra, Schlögl, Simon, Sritharan, Rajevaa, Jörß, Katharina, Macken, Jessica, Misdaq, Misbah, Rudolph, Kornelia, Bauer, Axel, Meyer-Zürn, Christine, Eick, Christian, rechts der Isar, Klinikum, Schmidt, Goerg, Müller, Alexander, Dommasch, Michael, Sinnecker, Daniel, Kääb, Stefan, Sinner, Moritz F., Dissmann, Rüdiger, Burmester, Ute, Behrens, Steffen, Gregor, Martina, Stefanow, Stefan, Rüb, Norman, Wolpert, Christian, Bimmel, Dieter, Lieberz, Christiane, Maier, Lars S., Schwinger, Robert H.G., Blaschke, Florian, Pieske, Burkert, Grönefeld, Gerian, Klein, Gunnar, Gardiwal, Ajmal, Szeplaki, Gabor, Perge, Peter, Szavits Nossan, Janko, Rotkvić, Luka, Pavlovic, Nikola, Manola, Sime, Vinter, Ozren, Benko, Ivica, Brusic, Sandro, Avdovic, Ervin, Klasan, Marina, Bakotic, Zoran, Anic, Ante, Jurisic, Zrinka, Kowalczyk, Emilia, Kucejko, Tomasz, Czechowska, Agnieszka, Wybor, Katarina, Cygankiewicz, Iwona, Ptaszyński, Pawel, Kasprzak, Jaroslaw, Qavoq, Dariusz, Guzik, Przemyslaw, Krauze, Tomasz, Sterlinski, Maciej, Hatala, Robert, Kaliska, Gabriela, Martinek, Jozef, Hastrup Svendsen, Jesper, Thamsborg, Karen, Hansen, Jim, Schloett-Hyldelund, Ida-Maria, Laage-Petersen, Julie, van Soest, Sofie, Flevari, Panayota, Katsaras, Dimitrios, Katsimardos, Andreas, Leftheriotis, Dionyssios, Papangelopoulou, Konstantinia, Varlamos, Charalambos, Traykov, Vassil, Velchev, Vasil, Iovev, Svetoslav, Shalganov, Tchavdar, Conen, David, Giesebart, Sarah, Novotny, Tomas, Kozak, Milan, Taborsky, Milos, Galuszka, Jan, Tuinenburg, Anton E., Wijers, Sofieke, Dunnink, Albert, Sprenkeler, David, Brugada, Josep, Arbelo, Elena, Trucco, Emilce, Vidorreta, Silvia, Kenttä, Tuomas, Huikuri, Pirkko, Koski, Päivi, Karlsson, Helena, Ersgaard, David, Platonov, Pyotr, Klingenheben, Thomas, and EU-CERT-ICD Investigators

Subjects
Male, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Ventricular Function, Left, DISEASE, Sudden cardiac death, Endocrinology, 0302 clinical medicine, Tachycardia, Medicine, FIBROSIS, Advanced and Specialised Nursing, 030212 general & internal medicine, Registries, 11 Medical and Health Sciences, RISK, Electroshock, OUTCOMES, Incidence (epidemiology), Incidence, Hazard ratio, ASSOCIATION, Middle Aged, Implantable cardioverter-defibrillator, 3. Good health, Defibrillators, Implantable, Diabetes and Metabolism, Primary Prevention, PRESERVED EJECTION FRACTION, Cardiology, Female, VENTRICULAR-FIBRILLATION, Life Sciences & Biomedicine, medicine.medical_specialty, 030209 endocrinology & metabolism, Lower risk, Sudden death, 03 medical and health sciences, Endocrinology & Metabolism, Diabetes mellitus, Internal medicine, Journal Article, Internal Medicine, Diabetes Mellitus, Humans, Aged, Retrospective Studies, Advanced and Specialized Nursing, Science & Technology, business.industry, Retrospective cohort study, medicine.disease, Death, Sudden, Cardiac, MYOCARDIAL-INFARCTION, ICD sudden death cardiomyopathy, business, SUDDEN CARDIAC DEATH, Diabetic Angiopathies, Follow-Up Studies
Abstract

OBJECTIVE Diabetes increases the risk of all-cause mortality and sudden cardiac death (SCD). The exact mechanisms leading to sudden death in diabetes are not well known. We compared the incidence of appropriate shocks and mortality in patients with versus without diabetes with a prophylactic implantable cardioverter defibrillator (ICD) included in the retrospective EU-CERT-ICD registry. RESEARCH DESIGN AND METHODS AND RESULTS A total of 3,535 patients from 12 European EU-CERT-ICD centers with a mean age of 63.7 ± 11.2 years (82% males) at the time of ICD implantation were included in the analysis. A total of 995 patients (28%) had a history of diabetes. All patients had an ICD implanted for primary SCD prevention. End points were appropriate shock and all-cause mortality. Mean follow-up time was 3.2 ± 2.3 years. Diabetes was associated with a lower risk of appropriate shocks (adjusted hazard ratio [HR] 0.77 [95% CI 0.62–0.96], P = 0.02). However, patients with diabetes had significantly higher mortality (adjusted HR 1.30 [95% CI 1.11–1.53], P = 0.001). CONCLUSIONS All-cause mortality is higher in patients with diabetes than in patients without diabetes with primary prophylactic ICDs. Subsequently, patients with diabetes have a lower incidence of appropriate ICD shocks, indicating that the excess mortality might not be caused primarily by ventricular tachyarrhythmias. These findings suggest a limitation of the potential of prophylactic ICD therapy to improve survival in patients with diabetes with impaired left ventricular function.

Published
2020

28. Mitral Valve Endocarditis due to Lactobacillus

Author

Groga-Bada, Patrick, Mueller, Iris I., Foschi, Federico, Gawaz, Meinrad, and Eick, Christian

Subjects
Article Subject, food and beverages
Abstract

Lactobacillus species are Gram-positive, facultative anaerobic, rod-shaped bacteria. They belong to the lactic acid bacteria group and are also known as a usual part of the normal flora of the gastrointestinal tract as well as of the urinary and genital tracts. They are an infrequent human pathogen but can induce several infections such as bacteremia and infectious endocarditis. We report the case of an 81-year-old woman with Lactobacillus bacteremia and mitral valve endocarditis as well as splenic abscesses.

Published
2018
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29. Prediction of mortality benefit based on periodic repolarisation dynamics in patients undergoing prophylactic implantation of a defibrillator: a prospective, controlled, multicentre cohort study

Author

Bauer, Axel, primary, Klemm, Mathias, additional, Rizas, Konstantinos D, additional, Hamm, Wolfgang, additional, von Stülpnagel, Lukas, additional, Dommasch, Michael, additional, Steger, Alexander, additional, Lubinski, Andrezej, additional, Flevari, Panagiota, additional, Harden, Markus, additional, Friede, Tim, additional, Kääb, Stefan, additional, Merkely, Bela, additional, Sticherling, Christian, additional, Willems, Rik, additional, Huikuri, Heikki, additional, Malik, Marek, additional, Schmidt, Georg, additional, Zabel, Markus, additional, Merkely, Béla, additional, Perge, Peter, additional, Sallo, Zoltan, additional, Szeplaki, Gabor, additional, Lüthje, Lars, additional, Schlögl, Simon, additional, Haarmann, Helge, additional, Bergau, Leonard, additional, Seegers, Joachim, additional, Hasenfuß, Gerd, additional, Munoz-Exposito, Pascal, additional, Tichelbäcker, Tobias, additional, Kirova, Aleksandra, additional, Hnatkova, Katerina, additional, Vos, Marc, additional, Willich, Stefan N., additional, Reinhold, Thomas, additional, Vandenberk, Bert, additional, Klinika, Magdalena, additional, Toplice, Krapinske, additional, Flevari, Panayota, additional, Katsimardos, Andreas, additional, Katsaras, Dimitrios, additional, Hatala, Robert, additional, Svetlosak, Martin, additional, Lubinski, Andrzej, additional, Kuczejko, Tomasz, additional, Hansen, Jim, additional, Conen, David, additional, Milosrdnice, Sestre, additional, Pavlović, Nikola, additional, Manola, Šime, additional, Vinter, Ozren, additional, Benko, Ivica, additional, Tuinenburg, Anton, additional, Bauer, Axel, additional, Meyer-Zürn, Christine, additional, Eick, Christian, additional, Hastrup, Jesper, additional, Brugada, Josep, additional, Arbelo, Elena, additional, Kaliska, Gabriela, additional, Martinek, Jozef, additional, Sinner, Moritz F., additional, Rizas, Konstantinos D., additional, Vdovin, Nikolay, additional, Cygankiewicz, Iwona, additional, Ptaszynski, Pawel, additional, Kaczmarek, Krzysztof, additional, Poddebska, Izabela, additional, Iovev, Svetoslav, additional, Novotný, Tomáš, additional, Kozak, Milan, additional, Kenttä, Tuomas, additional, Pelli, Ari, additional, Kasprzak, Jaroslaw D., additional, Qavoq, Dariusz, additional, Brusich, Sandro, additional, Avdovic, Ervin, additional, Klasan, Marina, additional, Galuszka, Jan, additional, Taborsky, Milos, additional, Velchev, Vasil, additional, Dissmann, Rüdiger, additional, Guzik, Przemysław, additional, Bimmel, Dieter, additional, Lieberz, Christiane, additional, Stefanow, Stefan, additional, Rüb, Norman, additional, Wolpert, Christian, additional, Maier, Lars S., additional, Behrens, Steffen, additional, Jurisic, Zrinka, additional, Braunschweig, Frieder, additional, Blaschke, Florian, additional, Pieske, Burkert, additional, Bakotic, Zoran, additional, Anic, Ante, additional, Schwinger, Robert H.G., additional, and Platonov, Pyotr, additional

Published
2019
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36. Automated Assessment of Cardiac Autonomic Function by Means of Deceleration Capacity from Noisy, Nonstationary ECG Signals: Validation Study

Author

Eick, Christian, Rizas, Konstantinos D., Zuern, Christine S., and Bauer, Axel

Subjects
Electrocardiography, Heart Rate, Deceleration, Humans, Heart, Signal Processing, Computer-Assisted, Original Articles, Artifacts, Autonomic Nervous System, Algorithms
Abstract

BACKGROUND: Assessment of heart rate variability by means of deceleration capacity (DC) provides a noninvasive probe of cardiac autonomic activity. However, clinical use of DC is limited by the need of manual review of the ECG signals to eliminate artifacts, noise, and nonstationarities. OBJECTIVE: To validate a novel approach to fully automatically assess DC from noisy, nonstationary signals METHODS: We analyzed 100 randomly selected ECG tracings recorded for 10 minutes by routine monitor devices (GE DASH 4000, sample size 100 Hz) in a medical emergency department. We used a novel automated R‐peak detection algorithm, which is mainly based on a Shannon energy envelope estimator and a Hilbert transformation. We transformed the automatically generated RR interval time series by phase‐rectified signal averaging (PRSA) to assess DC of heart rate (DC(auto)). DC(auto) was compared to DC(manual), which was obtained from the same manually preprocessed ECG signals. RESULTS: DC(auto) and DC(manual) showed good correlation and agreement, particularly if a low‐pass filter was implemented into the PRSA algorithm. Correlation coefficient between DC(auto) and DC(manual) was 0.983 (P < 0.0001). Average difference between DC(auto) and DC(manual) was ‒0.23±0.49 ms with limits of agreement ranging from ‒1.19 to 0.73 ms. Significantly lower correlations were observed when a different R‐peak detection algorithm or conventional heart rate variability (HRV) measures were tested. CONCLUSIONS: DC can be fully automatically assessed from noisy, nonstationary ECG signals.

Published
2013

37. Bedside autonomic risk stratification after myocardial infarction by means of short-term deceleration capacity of heart rate.

Author

Rizas, Konstantinos D., Eick, Christian, Doller, Angela J., Hamm, Wolfgang, von Stuelpnagel, Lukas, Zuern, Christine S., Barthel, Petra, Schmidt, Georg, and Bauer, Axel

Abstract

Aims Twenty-four-hour deceleration capacity (DC24h) of heart rate is a strong predictor of mortality after myocardial infarction (MI). Assessment of DC from short-term recordings (DCst) would be of practical use in everyday clinical practice but its predictive value is unknown. Here, we test the usefulness of DCst for autonomic bedside risk stratification after MI. Methods and results We included 908 patients after acute MI enrolled in Munich and 478 patients with acute (n  = 232) and chronic MI (n  = 246) enrolled in Tuebingen, both in Germany. We assessed DCst from high-resolution resting electrocardiogram (ECG) recordings (<30 min) performed under standardized conditions in supine position. In the Munich cohort, we also assessed DC24h from 24-h Holter recordings. Deceleration capacity was dichotomized at the established cut-off value of ≤ 2.5 ms. Primary endpoint was 3-year mortality. Secondary endpoint was 3-year cardiovascular mortality. In addition to DC, multivariable analyses included the Global Registry of Acute Coronary Events score >140 and left ventricular ejection fraction ≤ 35%. During follow-up, 48 (5.3%) and 48 (10.0%) patients died in the Munich and Tuebingen cohorts, respectively. On multivariable analyses, DCst ≤ 2.5 ms was the strongest predictor of mortality, yielding hazard ratios of 5.04 (2.68–9.49; P  < 0.001) and 3.19 (1.70–6.02; P  < 0.001) in the Munich and Tuebingen cohorts, respectively. Deceleration capacity assessed from short-term recordings ≤ 2.5 ms was also an independent predictor of cardiovascular mortality in both cohorts. Implementation of DCst ≤ 2.5 ms into the multivariable models led to a significant increase of C-statistics and integrated discrimination improvement score. Conclusion Deceleration capacity assessed from short-term recordings is a strong and independent predictor of mortality and cardiovascular mortality after MI, which is complementary to existing risk stratification strategies. [ABSTRACT FROM AUTHOR]

Published
2018
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40. Reply

Author

Zuern, Christine S., primary, Eick, Christian, additional, Rizas, Konstantinos D., additional, Bauer, Sarah, additional, Langer, Harald, additional, Gawaz, Meinrad, additional, and Bauer, Axel, additional

Published
2014
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41. Är nätverkssamhället här? En studie av diskursen inför två fusionssituationer åtskilda i tiden

Author

Eick, Christian and Nordvall, Thomas

Subjects
mergers&acquisitions, Business and economics, Hellgren, legitimacy, network society, institutions, societal change, Ekonomi, Volvo
Abstract

The claims that we have entered a new society, with a new typeof business logic and view on business relationships, are becoming more and more commonplace. In this context it seems appropriate to try and detect signals of change in societal behavior, possibly indicating a transition from one society to another. This essay deals with this very issue. By means of an analysis of the public discourses in 1993 and 1999 respectively, the authors try to establish evidence for or against such a societal shift. The analysis is focused on the discourse, as it was conveyed in the business press, surrounding two separate merger propositions, both including Volvo as one of the parties involved. The results indicate a societal change, albeit a moderate one. Also, no fundamental change in business logic could be detected. This would suggest that the hype around the New Economy might be just that, a hype.

Published
2001

42. On the threshold of the network society? A study of the public discourse prior to two merger situations separated in time

Author

Eick, Christian and Nordvall, Thomas

Subjects
mergers&acquisitions, Business and economics, Hellgren, legitimacy, network society, institutions, societal change, Ekonomi, Volvo
Abstract

The claims that we have entered a new society, with a new typeof business logic and view on business relationships, are becoming more and more commonplace. In this context it seems appropriate to try and detect signals of change in societal behavior, possibly indicating a transition from one society to another. This essay deals with this very issue. By means of an analysis of the public discourses in 1993 and 1999 respectively, the authors try to establish evidence for or against such a societal shift. The analysis is focused on the discourse, as it was conveyed in the business press, surrounding two separate merger propositions, both including Volvo as one of the parties involved. The results indicate a societal change, albeit a moderate one. Also, no fundamental change in business logic could be detected. This would suggest that the hype around the New Economy might be just that, a hype.

Published
2001

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