Principles of artificial intelligence and its application in cardiovascular medicine.

Artificial intelligence (AI) represents a rapidly developing field. Its use can improve diagnosis and therapy in many areas of medicine. Despite this enormous progress, many physicians perceive it as a black box and are skeptical about it.

Cardiac arrest related lung edema: examining the role of downtimes in transpulmonary thermodilution analysis.

Pulmonary edema and its association with low flow times has been observed in postcardiac arrest patients. However, diagnosis of distinct types of lung pathology is difficult.The aim of this study was to investigate pulmonary edema by transpulmonary thermodilution (TPTD) after out-of-hospital cardiac arrest (OHCA), and the correlation to downtimes.

Electrophysiology lab efficiency comparison between cryoballoon and point-by-point radiofrequency ablation: a German sub-analysis of the FREEZE Cohort study.

Background: Pulmonary vein isolation (PVI) is recommended to treat paroxysmal and persistent atrial fibrillation (AF). This analysis aimed to assess the hospital efficiency of single-shot cryoballoon ablation (CBA) and point-by-point radiofrequency ablation (RFA).

Methods: The discrete event simulation used PVI procedure times from the FREEZE Cohort study to establish the electrophysiology (EP) lab occupancy time.

A deep neural network using audio files for detection of aortic stenosis.

Background: Although aortic stenosis (AS) is the most common valvular heart disease in the western world, many affected patients remain undiagnosed. Auscultation is a readily available screening tool for AS. However, it requires a high level of professional expertise.

A spear to the heart-the accidental discovery of a giant cement embolism in the right heart: a case report.

Background: The incidence of recognized cardiopulmonary cement embolism in the context of percutaneous vertebroplasty varies between 0% and 23%. In most cases, only small fragments embolize in the pulmonary arteries or the right heart cavities. The latter can cause potential harm by right ventricular perforation.

Stroke due to Left Atrial Appendage Thrombus after Pulmonary Vein Isolation despite Novel Oral Anticoagulant: A Case Report.

In patients with atrial fibrillation, catheter ablation is suggested to reduce the mortality rate and is thus frequently performed. However, peri- and postprocedural thromboembolic complications as well as high recurrence rates of atrial fibrillation limit its advantages and require concomitant anticoagulation. With the advent of novel oral anticoagulants (NOACs), fixed dosing without routine laboratory monitoring became feasible.

Ablation Outcomes and Predictors of Mortality Following Catheter Ablation for Ventricular Tachycardia: Data From the German Multicenter Ablation Registry.

Background: Ventricular tachycardia (VT) causes significant morbidity and mortality. Implantable cardioverter-defibrillator shocks terminate VT but confer a significant morbidity and mortality risk. Therefore, VT ablation is increasingly common.

Acute and long-term outcome of focal atrial tachycardia ablation in the real world: results of the german ablation registry.

Introduction: Catheter ablation of focal atrial tachycardia (FAT) can be a challenging procedure and results have been rarely described. The purpose of this study was to determine the characteristics and results of FAT ablation in the large cohort of the German Ablation Registry.

Methods: The German Ablation Registry is a nationwide prospective multicenter database including 12566 patients who underwent an ablation procedure between 2007 and 2010.

Polymorphisms in the GNAS Gene as Predictors of Ventricular Tachyarrhythmias and Sudden Cardiac Death: Results From the DISCOVERY Trial and Oregon Sudden Unexpected Death Study.

Background: Population-based studies suggest that genetic factors contribute to sudden cardiac death (SCD).

Methods And Results: In the first part of the present study (Diagnostic Data Influence on Disease Management and Relation of Genetic Polymorphisms to Ventricular Tachy-arrhythmia in ICD Patients [DISCOVERY] trial) Cox regression was done to determine if 7 single-nucleotide polymorphisms (SNPs) in 3 genes coding G-protein subunits (GNB3, GNAQ, GNAS) were associated with ventricular tachyarrhythmia (VT) in 1145 patients receiving an implantable cardioverter-defibrillator (ICD). In the second part of the study, SNPs significantly associated with VT were further investigated in 1335 subjects from the Oregon SUDS, a community-based study analyzing causes of SCD.

Impact of lifestyle modification on left ventricular function and cardiopulmonary exercise capacity in patients with heart failure with normal ejection fraction and cardiometabolic syndrome: a prospective interventional study.

Background: Heart failure with normal left ventricular ejection fraction (HFNEF) accounts for about one third of all heart failure patients with considerable mortality. The metabolic syndrome (MS) is a risk factor for diastolic dysfunction and HFNEF. We hypothesized that modifying metabolic burden by exercise training and weight loss might improve left ventricular diastolic function, heart failure symptoms and rehospitalization rate.

Leadless pacing using induction technology: impact of pulse shape and geometric factors on pacing efficiency.

Aims: Leadless pacing can be done by transmitting energy by an alternating magnetic field from a subcutaneous transmitter unit (TU) to an endocardial receiver unit (RU). Safety and energy consumption are key issues that determine the clinical feasibility of this new technique. The aims of the study were (i) to evaluate the stimulation characteristics of the non-rectangular pacing pulses induced by the alternating magnetic field, (ii) to determine the extent and impact of RU movement caused by the beating heart, and (iii) to evaluate the influence of the relative position between TU and RU on pacing efficiency and energy consumption.

Iterative cardiac output measurement for optimizing cardiac resynchronization therapy: a randomized, blinded, crossover study.

Background: Many invasive and noninvasive methods have been proposed for guiding optimal programming of cardiac resynchronization therapy (CRT) devices. However, results are not satisfying. Preliminary results suggest that cardiac output (CO) measurements using inert gas rebreathing (IGR) might be an eligible method to tailor atrioventricular (AV) and ventriculo-ventricular (VV) programming.

Attenuation of post-shock increases in brain natriuretic Peptide with post shock overdrive pacing.

Background: Predischarge defibrillation threshold testing is often performed a few days after ICD implantation in order to validate defibrillation thresholds obtained at the time of implant. Ventricular fibrillation is induced with such testing and causes an increase in serum Brain Natriuretic Peptide (BNP) levels. BNP is an indicator for cardiac stress.

Polymorphisms associated with ventricular tachyarrhythmias: rationale, design, and endpoints of the 'diagnostic data influence on disease management and relation of genomics to ventricular tachyarrhythmias in implantable cardioverter/defibrillator patients (DISCOVERY)' study.

Implantable cardioverter-defibrillator (ICD) therapy is effective in primary and secondary prevention for patients who are at high risk of sudden cardiac death. However, the current risk stratification of patients who may benefit from this therapy is unsatisfactory. Single nucleotide polymorphisms (SNPs) are DNA sequence variations occurring when a single nucleotide in the genome differs among members of a species.

[Renal artery stenosis. Pathophysiology--diagnosis--therapy].

Renal artery stenosis (RAS) is both a common and progressive disease and its prevalence in patients > 65 years is 6.8%. In patients with known or suspected atherosclerosis undergoing coronary angiography, a frequency of even 11-23% is reported in the literature.

Leadless pacing of the heart using induction technology: a feasibility study.

Objectives: To develop a leadless pacemaker system based on induction technology and to investigate its feasibility and safety in the pig model.

Background: Despite tremendous technical advances during the last decades, cardiac pacing is still associated with a considerable rate of complications that can be primarily attributed to the leads.

Methods: The device consists of a transmitter unit implanted subcutaneously just above the heart and an endocardial receiver unit implanted in the apex of the right ventricle.

The prediction of ICD therapy in multicenter automatic defibrillator implantation trial (MADIT) II like patients: a retrospective analysis.

Objectives: MADIT II like patients have not been compared to patients without an electrophysiological study, patients in whom ventricular tachycardia or fibrillation were induced in an electrophysiological study (EPS) and patients without an inducibility in EPS in one study.

Background: The multicenter automatic defibrillator implantation trial (MADIT) II showed a benefit of ICD implantation in patients with ischemic heart disease.

Methods: We performed a retrospective analysis in 93 patients with an ischemic heart disease and an ejection fraction View Article and Find Full Text PDF

Effect of induced ventricular fibrillation and shock delivery on brain natriuretic peptide measured serially following a predischarge ICD test.

Objectives: Brain natriuretic peptide (BNP) was a marker for heart failure and cardiac wall tension. We analysed the trend of BNP after predischarge testing in order to get non-invasive details about the cardiac stress during predischarge testing.

Methods: 4-5 days after ICD implant we measured BNP, myoglobin, cardiac troponin I and creatine kinase in 20 patients before and 1, 5, 10, 20, 40, 60, 80, 100, 120 minutes and at the next day after predischarge testing.

Prediction of atrial fibrillation with atrial late potentials and pathological chemoreflexsensitivity.

Background: Atrial fibrillation (AF) is a very common arrhythmia that often causes the serious complication of a stroke.

Object: The aim was to evaluate the utility of pathological chemoreflexsensitivity (PCHRS) and atrial late potentials (ALP) to predict AF in follow-up.

Methods: We investigated a prospective study on the basis of our observation about a PCHRS and ALP in paroxysmal AF.

Online PC-based integration of digital intracoronary ultrasound images into angiographic images during cardiac catheterization.

In recent years, intravascular ultrasound (IVUS) has evolved as an important adjunct to angiography, providing insights that are significantly altering conventional paradigms in diagnosis and therapy. However, major drawbacks in the use of IVUS relied on the fact that a heavy console had to be moved from lab to lab, and extensive time for set up and image analysis. This additional time and the decrease in patients' through-put has not been applicable in clinical practice for many labs.

[Risk stratification of asymptomatic subjects using resting ECG and stress ECG].

The resting electrocardiogram (ECG) and stress ECG are established tests in the array of cardiovascular diagnostic modalities. In addition to their diagnostic value for structural heart disease and rhythm disorders, ECGs at rest or during stress also contain prognostically relevant information. Several ECG abnormalities, e.

Beta-blocker prophylaxis for atrial fibrillation after coronary artery bypass grafting in patients with sympathovagal imbalance.

Background: Atrial fibrillation (AF) is the most common arrhythmia after coronary bypass grafting (CABG) resulting in a prolonged hospital stay and higher costs. The withdrawal of beta-blocker and a sympathovagal imbalance were identified as risk factors for AF.

Methods: In our study we performed a measuring of standard deviation of all normal RR intervals (SDNN) among 142 consecutive patients with beta-blocker therapy before CABG in order to identify a collective who had an increased risk due to a withdrawal of beta-blocker medication.