Publications by authors named "Baalman S"

Article Synopsis
  • - Atrial fibrosis is a key factor in the development and persistence of atrial fibrillation (AF), but treating it is difficult due to the complex activity of atrial fibroblasts.
  • - The study discovered that primary cilia play a crucial role in regulating the fibrotic response of atrial fibroblasts in AF, showing fewer ciliated fibroblasts in AF patients compared to those without AF.
  • - Restoring or elongating primary cilia can potentially prevent the expression of fibrosis-related genes in AF patients, presenting a promising therapeutic strategy for managing atrial fibrosis.
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Article Synopsis
  • * The research focuses on the role of circulating proteins, particularly adipokines and other inflammatory proteins from adipose tissue, in both existing and newly diagnosed cases of AF.
  • * Findings indicate that inflammatory proteins from fat tissue are often elevated in people with AF and obesity, while common adipokines show little connection to AF occurrence.
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  • The study evaluates the relationship between left atrial (LA) strain parameters measured by transthoracic echocardiography and the recurrence of atrial fibrillation (AF) after thoracoscopic surgical ablation in patients who are either in sinus rhythm (SR) or experiencing AF at the start.
  • It included 204 patients who underwent a specific surgical procedure and had their LA strain and mechanical dispersion assessed before surgery, discovering that those who experienced AF recurrence had significantly lower strain values.
  • The research indicates that lower LA strain in the reservoir phase before surgery is a strong predictor of AF recurrence, suggesting that assessing LA strain could improve patient selection for surgical interventions.
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Thoracoscopic surgical ablation (SA) for atrial fibrillation (AF) has shown to be an effective treatment to restore sinus rhythm in patients with advanced AF. Identifying patients who will not benefit from this procedure would be valuable to improve personalized AF therapy. Machine learning (ML) techniques may assist in the improvement of clinical prediction models for patient selection.

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Background: To which extent atrial remodeling occurs before atrial fibrillation (AF) is unknown.

Objective: The PREventive left atrial appenDage resection for the predICtion of fuTure Atrial Fibrillation (PREDICT-AF) study investigated such subclinical remodeling, which may be used for risk stratification and AF prevention.

Methods: Patients (N = 150) without a history of AF with a CHADS-VASc score of ≥2 at an increased risk of developing AF were included.

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Despite our expanding knowledge about the mechanism underlying atrial fibrillation (AF), the interplay between the biological events underlying AF remains incompletely understood. This study aimed to identify the functionally enriched gene-sets in AF and capture their interconnection via pivotal factors, that may drive or be driven by AF. Global abundance of the proteins in the left atrium of AF patients compared to control patients (n = 3/group), and the functionally enriched biological processes in AF were determined by mass-spectrometry and gene set enrichment analysis, respectively.

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Aims: To guarantee uninterrupted function of the subcutaneous implantable cardioverter-defibrillator (S-ICD), the pulse generator needs to be surgically replaced before the battery is depleted. The risks related to this replacement substantially impact long-term outcome for S-ICD recipients, as the majority will undergo one or several of these procedures in their lifetime. We aim to describe the procedural characteristics of the replacement procedure and to provide an insight in the complications associated with these replacements.

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Background: Phospholamban (PLN) p.Arg14del mutation carriers are known to develop dilated and/or arrhythmogenic cardiomyopathy, and typical electrocardiographic (ECG) features have been identified for diagnosis. Machine learning is a powerful tool used in ECG analysis and has shown to outperform cardiologists.

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Introduction: The two-incision implantation technique of the subcutaneous implantable cardioverter-defibrillator (S-ICD) was introduced as an alternative to the standard three-incision approach by omitting the superior parasternal incision. Thereby, complications may be prevented. Short-term follow-up demonstrated the safety and efficacy of the two-incision technique.

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Introduction: The third-generation subcutaneous implantable cardioverter-defibrillator (S-ICD) (EMBLEM™ A219, Boston Scientific) contains a new diagnostic tool to detect atrial fibrillation (AF) in S-ICD patients, without the use of an intracardiac lead. This is the first study to evaluate the performance of the S-ICD AF monitor (AFM).

Methods: The AFM algorithm analyzes a subcutaneous signal for the presence of AF, similar to the signals collected by implantable and wearable diagnostic devices.

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Background: The subcutaneous implantable cardioverter-defibrillator (S-ICD) consists of a large generator and is implanted near the left breast. This might lead to discomfort and problems with self-perception and sexuality, especially in the female population. We aimed to assess the issues that female S-ICD patients experience and to provide practical guidance for cardiologists and implanters on minimizing these issues.

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Article Synopsis
  • A deep learning model was developed to improve the detection of atrial fibrillation (AF) by focusing on specific features of ECG readings, helping to clarify the model's decision-making process.
  • The model was trained on a dataset of 1,469 ECGs and achieved a high accuracy of 96% and an F1 score of 94%, with the QRS complex being the key feature for distinguishing AF from sinus rhythm (SR).
  • The visualization techniques used in the model could provide valuable insights for clinicians, enhancing their understanding of which ECG characteristics are most significant in identifying AF.
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Background: Since the introduction of the subcutaneous implantable-defibrillator (S-ICD) knowledge of factors elevating the defibrillation threshold (DFT), have increased. Optimal device positioning most likely results in a decrease in DFT. The PRAETORIAN score is a tool to systematically evaluate S-ICD implant position and predict conversion success by estimating the DFT on a chest X-ray.

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In transvenous implantable cardioverter-defibrillator (TV-ICD) implants, routine defibrillation testing (DFT) does not improve shock efficacy or reduce arrhythmic death but patients are exposed to the risk of complications related to DFT. The conversion rate of DFT in subcutaneous ICD (S-ICD) is high and first shock efficacy is similar to TV-ICD efficacy rates. STUDY DESIGN: The PRAETORIAN-DFT trial is an investigator-initiated, randomized, controlled, multicenter, prospective two-arm trial designed to demonstrate non-inferiority of omitting DFT in patients undergoing S-ICD implantation in which the S-ICD system components are optimally positioned.

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Background: Timely detection of atrial fibrillation (AF) in implantable cardioverter defibrillator (ICD) patients is clinically important for prevention of AF-related complications and inappropriate shocks. Patients with coronary artery disease (CAD) and a dual or triple chamber ICD show a high incidence of device-detected AF. Whether CAD patients with a single chamber ICD carry a similar risk for device-detected AF remains unknown.

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Background: Suboptimal positioning of the subcutaneous implantable cardioverter-defibrillator (S-ICD) increases the defibrillation threshold and risk of conversion failure.

Objective: Our objective is to develop a tool to evaluate the implant position and predict defibrillation success of the S-ICD: the PRAETORIAN score.

Methods: The PRAETORIAN score is based on clinical and computer modeling knowledge of determinants affecting the defibrillation threshold: subcoil fat, subgenerator fat, and anterior positioning of the S-ICD generator.

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Purpose Of Review: Clear guidelines on when to select a subcutaneous ICD (S-ICD) over a transvenous ICD (TV-ICD) are lacking. This review will provide an overview of the most recent clinical data on S-ICD and TV-ICD therapy by pooling comparison studies in order to aid clinical decision making.

Recent Findings: Pooling of observational-matched studies demonstrated an incidence rate ratio (IRR) for device-related complication of 0.

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Background: Monosodium glutamate (MSG), also referred to as Vetsin or E621, is a flavour enhancer frequently used in Asian cuisine and abundantly present in the famous Chinese dish Peking duck. MSG is notorious for triggering the onset of the so-called 'Chinese restaurant syndrome' (CRS), a complex of unpleasant symptoms, which might include flushing, sweating and the onset of atrial fibrillation (AF). This study aims to determine the effects of MSG on the occurrence of AF.

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Objective: The study purpose was to evaluate the associations between patient characteristics and the histologic remodeling scores of acellular dermal matrices (ADMs) biopsied from breast reconstruction sites in the first attempt to generate a multivariable risk prediction model of nonconstructive remodeling. It was hypothesized that host characteristics and surgical site assessments predict the degree of graft remodeling for ADMs used during breast reconstruction.

Methods: The ADMs were biopsied from the breast reconstruction sites of n = 62 patients during a subsequent breast procedure, stained with hematoxylin-eosin, and evaluated according to a semi-quantitative scoring system for remodeling characteristics (cell types, cell infiltration, extracellular matrix deposition, scaffold degradation, fibrous encapsulation, and neovascularization) and a mean composite score.

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Background: An acellular dermal matrix will typically incorporate, in time, with the overlying mastectomy skin flap. This remodeling process may be adversely impacted in patients who require chemotherapy and radiation, which influence neovascularization and cellular proliferation.

Methods: Multiple biopsy specimens were procured from 86 women (n = 94 breasts) undergoing exchange of a tissue expander for a breast implant.

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Purpose: The objective of this study was to evaluate the performance of acellular human dermis reinforcement during laparoscopic hiatal hernia repair.

Methods: A prospective non-randomized, single institution study enrolled patients undergoing laparoscopic hiatal hernia repair. Acellular human dermis, FlexHD (Musculoskeletal Transplant Foundation, Edison, NJ) or AlloDerm (LifeCell Inc.

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