Publications by authors named "Brachmann J"

Background: Catheter ablation is the primary treatment option for idiopathic ventricular tachycardia (VT). It plays a key role in acute therapy of electrical storm, treatment of VTs in patients with structural heart disease (SHD), and can reduce VT burden. Here we report on 10-year clinical outcomes following VT ablation from patients enrolled in the prospective German Ablation Registry.

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  • The study investigates the effects of resting heart rate (RHR) on patients with heart failure who received implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy-defibrillators (CRT-Ds), specifically examining RHRs above and below 70 bpm.
  • A total of 1589 patients were analyzed, and results showed that one-year all-cause mortality and major cardiovascular events were similar between those with RHR ≤ 70 bpm and > 70 bpm.
  • However, patients with RHR > 70 bpm had higher rates of all-cause hospital admissions, mainly due to non-cardiovascular events, indicating potential increased risks associated with a higher RHR.
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  • Catheter ablation for atrial fibrillation (AF) is widely researched, and this expert opinion aims to enhance future studies by applying lessons from past research and promoting consistency in methodologies.
  • The effectiveness of these studies can improve with clearly defined endpoints and a thorough understanding of emerging technologies, as well as a need to revisit some current research methods.
  • A panel of clinical experts has produced recommendations highlighting essential elements such as documenting clinical details, managing medications during trials, and assessing outcomes to aid in the standardization and quality of AF catheter ablation studies.
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Coronary artery disease (CAD) is a leading cause of death and disability in developed countries. While exercise testing is recommended for diagnosing stable angina pectoris, its limited sensitivity and specificity have been questioned. Myocardial strain is a promising predictor of significant CAD.

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  • - A randomized trial showed that adding delayed enhancement MRI-guided fibrosis ablation to pulmonary vein isolation (PVI) for treating atrial fibrillation (AF) didn’t improve outcomes, with similar recurrence rates between the two methods.
  • - The study analyzed how effectively lesions delivered during ablation covered fibrotic areas, finding that a much higher percentage of targeted fibrosis was successfully ablated using MRI guidance compared to PVI alone.
  • - While overall scar coverage didn’t significantly reduce AF recurrence, lower recurrence rates were noted in patients with less baseline fibrosis when fibrosis-targeted ablation was used, indicating variability in treatment effectiveness.
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: The number of young patients receiving ICDs or CRT-Ds has been increasing in recent decades and understanding the key characteristics of this special population is paramount to optimized patient care. : The DEVICE I+II registry prospectively enrolled patients undergoing ICD/CRT-D implantation or revision from 50 German centers between 2007 and 2014 Data on patient characteristics, procedural outcome, adverse events, and mortality during the initial stay and 1-year follow-up were collected. All patients under the age of 45 years were identified and included in a comparative analysis with the remaining population.

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The new building of the Hospital in Lichtenfels (Germany) was put into operation in mid-July 2018. Neither the medical personnel nor medical departments have been changed. We want to evaluate how 'safe' or 'insecure' the new hospital or department in the beginning might have been.

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Background: Catheter ablation is recognized as an effective treatment for atrial fibrillation (AF). Despite its effectiveness, significant sex-specific differences have been observed, which influence the outcomes of the procedure. This study explores these differences in a cohort of patients with persistent AF.

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Objectives: Cardiac arrhythmias predict poor outcome after myocardial infarction (MI). We studied if arrhythmia monitoring with an insertable cardiac monitor (ICM) can improve treatment and outcome.

Design: BIO|GUARD-MI was a randomized, international open-label study with blinded outcome assessment.

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Background: Catheter ablation of atrial fibrillation and atrial flutter is routinely performed in patients with implantable devices. The aim of the present study was to assess success rates and potential complications in a large registry cohort of patients with cardiac pacemakers.

Methods And Results: The German Ablation Registry is a nationwide, prospective registry with a 1-year follow-up investigating patients who underwent catheter ablation of supraventricular arrhythmias in 51 German centers.

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Background: Atrial fibrillation (AF) is a cardiac arrhythmia frequently documented in patients requiring implantable cardioverter defibrillators (ICDs) and/or cardiac resynchronization therapy with defibrillator (CRT-D). Patients with diagnosed AF at the point of ICD or CRT-D implantation may have an impaired follow-up outcome.

Methods: The German DEVICE I-II registry is a nationwide prospective multicentre database of patients implanted with ICD and CRT-D with clinical follow-up data.

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  • Interventional left atrial appendage occlusion (LAAO) is effective for patients with nonvalvular atrial fibrillation (AF) who can't use long-term blood thinners, especially those with a history of stroke.
  • A study from the LAARGE registry found that LAAO was similarly effective and safe for stroke patients compared to those without a stroke history, with high success rates and low complication rates in both groups.
  • The results suggest that LAAO could be a viable option for secondary prevention in high-risk AF patients, showing no significant differences in risk of death or stroke between those with and without prior strokes.
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Aims: Remote monitoring (RM) of thoracic impedance represents an early marker of pulmonary congestion in heart failure (HF). Chronic kidney disease (CKD) may promote fluid overload in HF patients. We investigated whether concomitant CKD affected the efficacy of impedance-based RM in the OptiLink HF trial.

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  • - The study examined the prognostic value of inducible ventricular arrhythmia (VA) in patients with syncope who received defibrillators, comparing them to patients with prior heart issues needing secondary prevention.
  • - Results showed that patients with syncope and inducible VA had fewer heart-related issues and better clinical outcomes after one year, including lower mortality and adverse events than those with a secondary preventive indication.
  • - Importantly, while patients with syncope and inducible VA had favorable outcomes, their post-surgery complication rates were similar to those without syncope, highlighting the significance of VA inducibility in risk assessment.
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Background: Atrial fibrillation (AF) is one of the most frequent causes of stroke. Several randomized trials have shown that prolonged monitoring increases the detection of AF, but the effect on reducing recurrent cardioembolism, ie, ischemic stroke and systemic embolism, remains unknown. We aim to evaluate whether a risk-adapted, intensified heart rhythm monitoring with consequent guideline conform treatment, which implies initiation of oral anticoagulation (OAC), leads to a reduction of recurrent cardioembolism.

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  • Interventional left atrial appendage occlusion (LAAO) is a treatment option that replaces long-term oral anticoagulation for patients with nonvalvular atrial fibrillation, particularly those with a high risk of bleeding.
  • A study examined the impact of spontaneous echo contrast (SEC) on the risk of device-related thrombus (DRT) and thromboembolic events (TEs) in two groups of patients: those with SEC and those without it.
  • The results showed that while procedural success was high in both SEC groups, DRT was only noted in the SEC- group and TEs were rare in both, suggesting that SEC presence might not significantly affect post-LAAO outcomes.
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Background: Because of its antiarrhythmic potency and due to the lack of alternatives, amiodarone is often used for antiarrhythmic therapy in patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy-defibrillator systems. To date, robust data on the safety and clinical benefit of amiodarone therapy in these patients are missing.

Objective: The purpose of this study was to assess the periprocedural and postprocedural outcomes of combined therapy with beta-blockers plus amiodarone compared to treatment with single beta-blockers in the "real-life" cohort of ICD recipients of the German DEVICE registry.

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Introduction: The 2019 European Society of Cardiology and European Atherosclerosis Society (2019 ESC/EAS) guidelines stress the importance of managing low-density lipoprotein cholesterol (LDL-C) after myocardial infarction (MI) to reduce the risk of cardiovascular events. Information on guideline implementation is limited. The aim of this survey was to describe current clinical practice regarding LDL-C management in the first year post-MI across Europe, improving understanding of the role of ESC/EAS guidelines on clinical practice.

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Importance: Ablation of persistent atrial fibrillation (AF) remains a challenge. Left atrial fibrosis plays an important role in the pathophysiology of AF and has been associated with poor procedural outcomes.

Objective: To investigate the efficacy and adverse events of targeting atrial fibrosis detected on magnetic resonance imaging (MRI) in reducing atrial arrhythmia recurrence in persistent AF.

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Background: This study aims to report on the clinical and patient-reported outcomes in patients undergoing atrial fibrillation (AF) ablation with moderate or severe complications.

Methods: The prospective, multicentre German Ablation Registry of patients undergoing catheter ablation was studied to compare outcomes of patients with moderate or severe complications (group I) and patients without or minor complications (group II).

Results: A total of 3865 patients (group I = 158, group II = 3707) were included in this analysis.

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Introduction: CAD (coronary artery disease) is a leading cause of death and disability in developed nations. Exercise testing is recommended as a first-line diagnostic test for patients with stable angina pectoris. In addition to myocardial strain, high-sensitivity CRP (hs-CRP) can predict the presence of significant coronary artery disease.

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  • Interventional left atrial appendage occlusion (LAAO) is a procedure used for patients with nonvalvular atrial fibrillation who cannot take standard blood thinners, and this study looks at its effects on patients with low versus high stroke risk.
  • The study included 638 patients divided into low-risk (CHA DS -VASc score ≤2) and high-risk (score >2) groups, finding that while implantation success was high, low-risk patients experienced more moderate complications despite having no major strokes or bleeds within a year.
  • The authors suggest that the need for LAAO in low-risk patients should be carefully evaluated to weigh potential benefits against risks.
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  • Vitamin K antagonists (VKAs) like warfarin are commonly used for long-term anticoagulant therapy in patients with conditions like atrial fibrillation, but they may promote cardiovascular calcification (CVC) due to their interference with vitamin K-dependent proteins.
  • This study compares the effects of rivaroxaban, a non-vitamin K oral anticoagulant (NOAC), to VKAs in terms of CVC progression in a randomized controlled trial with 192 patients over 2 years.
  • The primary outcome measures the change in coronary and aortic valve calcification through cardiac CT scans taken at 12 and 24 months after treatment initiation.
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