Publications by authors named "Christian Jons"
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.
Background: The congenital heart disease (CHD) population is growing and aging. We aim to examine the impact by describing the temporal trend and causes of lifetime hospitalization burden among the CHD population.
Methods And Results: From the Danish National Patient Registry, 23 141 patients with CHD and their hospitalizations from 1977 to 2018 were identified, excluding patients with extracardiac malformation.
Article Synopsis
- - Adults with congenital heart disease (CHD) are surviving longer, but this leads to more complications, particularly arrhythmias, which have not been thoroughly studied long-term
- - A study of 45,820 Danish patients with CHD found that they have a significantly higher incidence of arrhythmias (2.6%) compared to matched controls (0.2%), with some heart conditions presenting even greater risks
- - Arrhythmias in CHD patients are linked to a higher risk of death (HR of 6.9), highlighting the need for ongoing monitoring and management of heart problems in this population
Article Synopsis
- The study aims to investigate the genetic factors associated with accessory atrioventricular pathways (APs) and related heart rhythm disorders using a genome-wide association study (GWAS).
- It involved analyzing genetic data from over 1,200,000 control individuals and 2,310 individuals with APs from multiple countries and various health databases.
- Key findings revealed three significant genetic variants linked to APs, particularly in specific genes (CCDC141 and SCN10A), with implications for understanding conditions like paroxysmal supraventricular tachycardia (PSVT).
Incidentally Induced Atrial Fibrillation During Programmed Electrical Stimulation in Patients With Depressed Left Ventricular Systolic Function After an Acute Myocardial Infarction.
Ann Noninvasive Electrocardiol
September 2024
Background: The aim of this study was to investigate the clinical implication of incidentally induced atrial fibrillation (AF) during programmed electrical stimulation (PES) in patients with left ventricular systolic dysfunction (≤40%) after an acute myocardial infarction (MI).
Methods: In this study, we included 231 patients from the Cardiac Arrhythmias and RIsk Stratification after Myocardial InfArction (CARISMA) study with left ventricular ejection fraction ≤40% and no prior history of AF. These patients underwent PES 6 weeks post-MI as part of the study protocol.
Background: Paroxysmal atrial fibrillation (pAF) occurs sporadically and can impair athletic performance. Gold standard for diagnosis is surface electrocardiography (ECG), however, this requires AF to be sustained. Implantable loop recorders (ILRs) are routinely used for AF detection in human medicine.
View Article and Find Full Text PDFObjectives: 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.
Article Synopsis
- Pre-eclampsia (PE) affects about 4-5% of pregnancies globally and is linked to higher risks of arrhythmias, although studies on this connection are limited.
- An observational cohort study in Denmark analyzed 523,271 first-time mothers, showing that those with PE had a higher incidence of various arrhythmias over a median follow-up of 10.1 years.
- The results indicate that women with PE face a significant long-term increase in arrhythmias, suggesting a need for better cardiovascular risk assessment and preventive measures for this group.
Article Synopsis
- Pediatric patients with ventricular pre-excitation or asymptomatic Wolff-Parkinson-White (WPW) syndrome face an increased risk of developing serious heart issues like atrial fibrillation and sudden cardiac death (SCD).
- Many of these patients may only show symptoms after experiencing a life-threatening event, highlighting the need for careful risk assessment.
- The review suggests that invasive testing and catheter ablation are effective strategies for managing these patients, with catheter ablation showing high success rates and low complication risks.
Background: Robust data on changes in pulmonary valve replacement (PVR) procedural volume and predictors of bioprosthetic pulmonary valve (BPV) durability in patients with tetralogy of Fallot (TOF) are scarce.
Objectives: This study sought to assess temporal trends in PVR procedural volume and BPV durability in a nationwide, retrospective TOF cohort.
Methods: Data were obtained from patient records.
ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy: The change of the paradigm.
Ann Noninvasive Electrocardiol
January 2024
Article Synopsis
- The diagnosis of left ventricular hypertrophy (LVH) through ECG primarily relies on measuring the QRS voltage, but this method often lacks sensitivity.
- A new approach emphasizes the understanding of electrical properties of the heart muscle and factors influencing QRS voltage beyond just size, including both spatial and non-spatial determinants.
- This perspective reveals a wide variety of QRS patterns in LVH patients, indicating that a normal QRS complex can still exist despite underlying complications, and highlights the importance of interpreting these changes for assessing cardiovascular risk.
Introduction: Prediction of recurrent ventricular arrhythmia (VA) in survivors of an out-of-hospital cardiac arrest (OHCA) is important, but currently difficult. Risk of recurrence may be related to presence of myocardial scarring assessed with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Our study aims to characterize myocardial scarring as defined by LGE-CMR in survivors of a VA-OHCA and investigate its potential role in the risk of new VA events.
View Article and Find Full Text PDFArticle Synopsis
- The diagnosis of Left Ventricular Hypertrophy (LVH) using ECG mainly relies on measuring the increased amplitude of the QRS complex in specific leads.
- The traditional understanding suggests that a larger left ventricular mass produces a stronger electrical field, leading to heightened QRS forces and amplitudes.
- However, studies show that only a small percentage of LVH patients actually exhibit this increased QRS amplitude, indicating that the current voltage criteria have low sensitivity, prompting a discussion on potential reasons and the introduction of a new diagnostic approach.
Global constructive work is associated with ventricular arrhythmias after cardiac resynchronization therapy.
Eur Heart J Cardiovasc Imaging
December 2023
Aims: Non-invasive left ventricular (LV) pressure-strain loops provide a novel method for quantifying myocardial work by incorporating LV pressure in measurements of myocardial deformation. Early studies suggest that myocardial work parameters such as global constructive work (GCW) could be useful and reliable in arrhythmia prediction, particularly in patients undergoing cardiac resynchronization therapy (CRT). The aim of this study was to evaluate whether the magnitude of GCW was associated with the occurrence of ventricular arrhythmias in patients after CRT.
View Article and Find Full Text PDFThe effect of increased plasma potassium on myocardial function; a randomized POTCAST substudy.
Int J Cardiovasc Imaging
November 2023
Plasma potassium (p-K) in the high-normal range has been suggested to reduce risk of cardiovascular arrythmias and mortality through electrophysiological and mechanical effects on the myocardium. In this study, it was to investigated if increasing p-K to high-normal levels improves systolic- and diastolic myocardial function in patients with low-normal to moderately reduced left ventricular ejection fraction (LVEF). The study included 50 patients (mean age 58 years (SD 14), 81% men), with a mean p-K 3.
View Article and Find Full Text PDFObjective: Hypokalemia is associated with increased risk of arrhythmias and it is recommended to monitor plasma potassium (p-K) regularly in at-risk patients with cardiovascular diseases. It is poorly understood if administration of potassium supplements and mineralocorticoid receptor antagonists (MRA) aimed at increasing p-K also increases intracellular potassium.
Methods: Adults aged≥18 years with an implantable cardioverter defibrillator (ICD) were randomized (1:1) to a control group or to an intervention that included guidance on potassium rich diets, potassium supplements, and MRA to increase p-K to target levels of 4.
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
- This study investigates the link between reduced systolic function in the inferior left ventricle and the risk of malignant arrhythmias in patients with non-ischemic heart failure.
- Researchers used 2D-speckle-tracking echocardiography to analyze regional strains in the hearts of 401 patients with a left ventricular ejection fraction (LVEF) below 35%.
- The findings indicate that lower strain in the inferior wall of the left ventricle significantly increases the risk of serious heart events, including sudden cardiac death, by 2.5 times, while strain in other regions showed no independent association.
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.
Objectives: To assess temporal changes in the surgical management of patients with tetralogy of Fallot including the timing of interventions, surgical techniques, reinterventions and survival in a nationwide cohort.
Methods: Patients with tetralogy of Fallot in Denmark were divided into 3 eras based on their year of birth: early (1977-1991), intermediate (1992-2006) and late (2007-2021).
Results: The cohort consisted of 745 patients.
Article Synopsis
- The study aimed to assess whether specific characteristics of ischaemic scars (scar core mass, border zone mass, and border zone channels) could predict the risk of ventricular arrhythmia (VA) in patients who experienced ST-segment elevation myocardial infarction (STEMI).
- A total of 843 STEMI patients underwent cardiac magnetic resonance imaging after 3 months, with 21 developing VA events during 100 months of follow-up; they were compared to 105 matched controls.
- Results showed that cases with VA had significantly higher border zone mass and a greater presence of border zone channels, indicating that these factors are strong indicators for predicting VA in STEMI patients.
Aims: Emerging data show that complete revascularization (CR) reduces cardiovascular death and recurrent myocardial infarction in ST-segment elevation myocardial infarction (STEMI). However, the influence of revascularization status on development of arrhythmia in the long-term post-STEMI phase is poorly described. We hypothesized that incomplete revascularization (ICR) compared with CR in STEMI is associated with an increased long-term risk of new-onset arrhythmia.
View Article and Find Full Text PDFArticle Synopsis
- The study investigated the incidence of thyroid dysfunction in patients starting amiodarone treatment, particularly focusing on those with and without heart failure (HF).
- Approximately 5% of patients developed thyroid issues within the first year, with a slightly higher occurrence in those with HF.
- A clear dose-response relationship was found, indicating that higher cumulative doses of amiodarone increased the risk of thyroid dysfunction over the next five years.
Article Synopsis
- The study aimed to evaluate the risk of developing malignant arrhythmias, specifically torsades de pointes (TdP), related to certain drugs in patients who experienced out-of-hospital cardiac arrest (OHCA).
- Researchers analyzed data from the Danish Cardiac Arrest Registry, focusing on patients 18 and older with a cardiac origin OHCA between 2001 and 2014, determining the prevalence and impact of TdP risk drug usage on patient outcomes.
- Findings showed that 37% of patients were treated with TdP risk drugs shortly before OHCA, which correlated with a decreased likelihood of experiencing a shockable rhythm and achieving return of spontaneous circulation (ROSC), although these patients tended to be older and more comorbid
Background: Low plasma potassium (p-K) is associated with increased risk of malignant arrhythmia and observational studies indicate protective effects of p-K in the upper reference level. However, randomized clinical studies are needed to document whether actively increasing p-K to high-normal levels is possible and safe and improves cardiovascular outcomes.
Objective: To investigate if increased p-K reduces the risk of malignant arrhythmia and all-cause death in high-risk patients with a cardiovascular disease treated with an implantable cardioverter defibrillator (ICD) for primary or secondary preventive causes.