Publications by authors named "Berit T Philbert"
Inappropriate Therapy and Shock Rates Between the Subcutaneous and Transvenous Implantable Cardiac Defibrillator: A Secondary Analysis of the PRAETORIAN Trial.
Louise R A Olde Nordkamp Shari Pepplinkhuizen Abdul Ghani Lucas V A Boersma Juergen Kuschyk Berit T Philbert
Circ Arrhythm Electrophysiol
December 2024
Article Synopsis
- Inappropriate therapy (IAT) is a significant issue associated with implantable cardiac defibrillator (ICD) therapy, particularly highlighted in early subcutaneous ICD (S-ICD) studies which showed high rates of inappropriate shocks (IAS).
- The PRAETORIAN trial, an international study with 849 patients, found no major differences in IAT and IAS rates between S-ICD and transvenous ICD (TV-ICD) groups, as both groups had similar cumulative incidences.
- Key predictors for IAT varied between the two groups, with TV-ICD patients experiencing IAT mainly from supraventricular tachycardias, while S-ICD patients faced issues from cardiac oversensing
Article Synopsis
- The S-ICD was created to eliminate lead-related issues found in the TV-ICD, as it is an external device that sits under the skin rather than using leads inside the body.
- This analysis comes from the PRAETORIAN trial, where patients were randomly assigned to either S-ICD or TV-ICD and assessed for quality of life through various questionnaires at different stages.
- Results showed no significant differences in physical and mental well-being between the groups, but patients who experienced a shock recently reported lower social functioning and emotional health compared to those who did not.
Article Synopsis
- Pericardial effusion is a serious condition that can happen after doctors put in heart devices, and it might lead to even worse problems like cardiac tamponade.
- Researchers studied data from over 55,000 patients in Denmark to find out what factors might increase the chances of this happening after getting heart devices like pacemakers.
- They found that certain things, like being female, having heart failure, or the number of leads in the device, can make it more likely to have a problem called procedural pericardial effusion, even though it's pretty rare.
Article Synopsis
- Decisions to implant an ICD in children are complex due to factors like their longer lifespan and higher risk of complications, but they often benefit the most from such devices.
- This study reviewed data from pediatric patients (≤ 15 years) in Denmark who received ICDs from 1982 to 2021, focusing on their demographics, complications, and mortality outcomes.
- Results showed no significant differences in outcomes between primary and secondary prevention ICDs, with a notable 41% complication rate and a 10-year appropriate therapy incidence of 70%, indicating that children have higher therapy and complication rates than adults.
Article Synopsis
- Bacteremia (SAB) is a serious condition that can lead to high rates of illness and death, especially in patients with cardiac implantable electronic devices (CIEDs), prompting researchers to study its incidence in first-time CIED carriers in Denmark over a 10-year period.
- The study involved 87,257 patients from a national registry who had their first CIED implanted from 2000 to 2020, with a focus on identifying the occurrence of SAB after the procedure and understanding risk factors that contribute to it.
- Results showed that 1.6% of patients developed SAB, with higher risks associated with specific device types and factors such as hemodialysis, previous SAB, liver disease, and demographic
Article Synopsis
- The study aimed to determine the relationship between changes in QRS duration (∆QRS) after cardiac resynchronization therapy (CRT) and mortality rates among patients with heart failure from the DANISH study.
- Researchers analyzed data from 572 patients and found that while there was a slight reduction in all-cause mortality associated with shorter QRS durations, this association vanished after adjusting for other factors.
- The conclusion indicated that in patients with non-ischemic cardiomyopathy, a reduction in QRS duration after CRT did not correlate with improved long-term survival.
Background And Aim: There are a paucity of studies investigating workforce affiliation in connection with first-time implantable cardioverter defibrillator (ICD)-implantation. This study explored workforce affiliation and risk markers associated with not returning to work in patients with ICDs.
Methods: Using the nationwide Danish registers, patients with a first-time ICD-implantation between 2007 and 2017 and of working age (30-65 years) were identified.
Article Synopsis
- The study investigates the relationship between Brugada syndrome (BrS) diagnosis and the development of new-onset depression or anxiety, as well as all-cause mortality among patients over a follow-up period of up to 5 years.
- Out of 223 patients identified with BrS, 15.7% developed new-onset depression or anxiety, with symptomatic patients showing a higher incidence compared to asymptomatic ones.
- The findings suggest that factors like symptomatic disease presentation and older age are significantly linked to an increased risk of developing mental health issues in BrS patients, although overall mortality rates were low.
Article Synopsis
- About one-third of patients diagnosed with Brugada syndrome (BrS) were treated with nonrecommended medications, with no significant change in prescription patterns observed post-diagnosis.
- Female patients, those with psychiatric diseases, and those with prior use of nonrecommended drugs were more likely to use these medications after diagnosis.
- No significant associations were found between nonrecommended drug use and outcomes like appropriate implantable cardioverter defibrillator therapy, mortality, or arrhythmic events during follow-up.
Article Synopsis
- Patients with nonischemic systolic heart failure face a higher risk of dangerous heart rhythms and sudden death, and identifying those who could benefit from implantable cardioverter-defibrillators (ICDs) is crucial.
- A study assessed right ventricular free wall strain (RV-FWS) through echocardiography in 445 patients, finding that 57% had RV dysfunction that could predict better outcomes from ICD implantation.
- Results showed that ICD implantation significantly lowered all-cause mortality in patients with RV dysfunction but not in those with normal right ventricular function, highlighting the importance of RV-FWS as a potential selection tool for ICD candidates.
Article Synopsis
- The study aimed to identify patients with implantable cardioverter defibrillators (ICDs) who are at risk for psychological distress, such as depression and anxiety, and the related risk factors.
- Researchers analyzed responses from 1,503 first-time ICD patients in Denmark over a two-year period, using questionnaires at multiple time points to track changes in distress levels.
- Results showed that while most patients with low distress remained stable, those with higher initial distress were likely to continue experiencing issues; factors like education level, age, and physical health were linked to better psychological outcomes, while previous psychological issues and lifestyle factors worsened distress levels.
Article Synopsis
- The study examined sex differences in concerns related to implantable cardioverter defibrillators (ICDs) among patients over 24 months after implantation.
- Results showed that female patients generally expressed more concerns than male patients at all assessment points, with a notable difference in average scores at the time of implantation.
- Both sexes experienced a decrease in concerns during the first 6 months, with baseline anxiety and depression influencing long-term ICD concerns differently for males and females.
Patients with non-ischemic systolic heart failure (HF) have increased risk of sudden cardiovascular death (SCD). The initiation and substrate for ventricular arrhythmias remains poorly understood. Our purpose was to describe the relationship between cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) and Holter recorded ventricular arrhythmic activity.
View Article and Find Full Text PDFAims: The present study aimed to determine the association between Type 2 diabetes mellitus (T2DM) and third-degree (complete) atrioventricular block.
Methods And Results: This nationwide nested case-control study included patients older than 18 years, diagnosed with third-degree atrioventricular block between 1 July 1995 and 31 December 2018. Data on medication, comorbidity, and outcomes were collected from Danish registries.
Aims: Cardiac implantable electronic device (CIED) infection is a severe complication to modern management of cardiac arrhythmias. The CIED type and the type of surgery are recognized as risk factors for CIED infections, but knowledge of patient-related risk factors is scarce. This study aimed to identify lifelong patient-related risk factors for CIED infections.
View Article and Find Full Text PDFArticle Synopsis
- The subcutaneous implantable cardioverter-defibrillator (S-ICD) was designed to reduce complications linked to traditional transvenous ICD (TV-ICD) therapy, such as lead issues and infections.
- The PRAETORIAN trial, which included 849 patients, found that while both devices had complications, the S-ICD group experienced fewer lead-related issues and systemic infections compared to the TV-ICD group.
- The trial results indicate that complications from the TV-ICD were more severe, often requiring invasive procedures, highlighting the S-ICD as a safer alternative for patients needing ICD therapy.
Article Synopsis
- The study investigates how periodic repolarization dynamics (PRD) can identify nonischemic cardiomyopathy patients who might benefit from getting a cardioverter-defibrillator (ICD) implanted as a preventive measure against sudden cardiac events.
- A post hoc analysis of the DANISH trial included patients with severe heart function issues (LVEF ≤35% and high NT-proBNP levels) to see how baseline PRD, measured using 24-hour Holter monitors, related to their mortality.
- Results showed that higher PRD was linked to higher mortality in patients not receiving ICDs, while there was no significant link in those with ICDs, suggesting that PRD could help target patients who would benefit most from ICD therapy
Clinician Preimplementation Perspectives of a Decision-Support Tool for the Prediction of Cardiac Arrhythmia Based on Machine Learning: Near-Live Feasibility and Qualitative Study.
Stina Matthiesen Søren Zöga Diederichsen Mikkel Klitzing Hartmann Hansen Christina Villumsen Mats Christian Højbjerg Lassen Berit T Philbert
JMIR Hum Factors
November 2021
Article Synopsis
- AI and machine learning show promise for enhancing clinical decision-making in cardiac diseases, but implementation in clinics faces sociotechnical challenges.
- A study examined a machine learning tool designed to predict ventricular tachycardia/fibrillation in patients with implantable cardiac defibrillators, focusing on its impact on clinical decision-making.
- Results indicated the tool could bolster confidence and support remote monitoring decisions, but was less effective with poor data quality and did not change clinical actions, highlighting the need for aligned expectations and trust in AI tools.*
Efficacy and Safety of Appropriate Shocks and Antitachycardia Pacing in Transvenous and Subcutaneous Implantable Defibrillators: Analysis of All Appropriate Therapy in the PRAETORIAN Trial.
Reinoud E Knops Willeke van der Stuijt Peter Paul H M Delnoy Lucas V A Boersma Juergen Kuschyk Berit T Philbert
Circulation
February 2022
Article Synopsis
- The PRAETORIAN trial compared the effectiveness of subcutaneous implantable cardioverter defibrillators (S-ICD) and transvenous implantable cardioverter defibrillators (TV-ICD), showing that S-ICD was noninferior in terms of inappropriate shocks and complications.
- A secondary analysis examined whether antitachycardia pacing in TV-ICD reduced appropriate shocks, particularly for patients with serious ventricular arrhythmias.
- Results indicated that S-ICD patients received appropriate therapy slightly more often than TV-ICD patients, but overall shock rates were comparable, with S-ICD demonstrating high shock efficacy.
Background: Implantable cardioverter-defibrillator (ICD) lead monitoring diagnostic alerts facilitate the diagnosis of structural lead failure.
Objective: The purpose of this study was to prospectively study the performance of Medtronic ICD lead monitoring alerts.
Methods: A prespecified ancillary substudy, World-Wide Randomized Antibiotic Envelope Infection Prevention Trial, was conducted in patients with an ICD with all available alerts enabled.
Article Synopsis
- A study examined the development of new anxiety and depression in patients with implantable cardioverter defibrillators (ICDs) over a 24-month period.
- Out of 1040 patients, 14.5% developed anxiety and 11.3% developed depression during the follow-up, indicating a significant mental health impact.
- Factors such as being over 60 years old and having higher initial anxiety or depression scores were linked to increased risks for developing these conditions, highlighting the need for regular mental health screenings in this population.
Objectives: This study sought to compare 2 ways of achieving cardiac resynchronization.
Background: Cardiac resynchronization therapy (CRT) in patients with symptomatic heart failure and left bundle branch block (LBBB) can be achieved with His-bundle pacing correcting the bundle branch block (His-CRT). The present study is the largest randomized study comparing His-CRT and biventricular pacing (BiV-CRT) to date.
Article Synopsis
- A nationwide survey in Denmark assessed the awareness and adherence to driving restrictions among patients who received implantable cardioverter defibrillators (ICDs) between 2013 and 2016.
- The study found that a significant number of respondents (between 28% and 58% depending on their situation) were unaware of the driving restrictions and over one-third resumed driving during prohibited periods.
- Despite this, only 0.2% reported experiencing an ICD shock while driving, with a very low estimated risk of harm (0.0002% per person-year).
Implantable cardioverter defibrillator (ICD) implantation in patients resuscitated from out-of-hospital cardiac arrest (OHCA) due to acute myocardial infarction (AMI) is controversial. Consecutive OHCA-survivors due to AMI from two Danish tertiary heart centers from 2007 to 2011 were included. Predictors of ICD-implantation, ICD-therapy and long-term survival (5 years) were investigated.
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