Publications by authors named "Jens B- Johansen"
Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature.
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- - The study investigated the higher risk of sinus node dysfunction (SND) that leads to pacemaker implantation and mortality among first-degree relatives of patients with pacemakers due to SND.
- - Data was collected from various Danish health registries, tracking over 6 million individuals from 1982 to 2022, and findings indicated that those with a family history of SND had a significantly higher risk (RR = 2.9) of requiring a pacemaker compared to the general population.
- - While overall mortality rates among these relatives were similar to the general population, there was a notable increase in mortality for those related to patients with early-onset SND (RR = 1.22), indicating a possible genetic
Article Synopsis
- This study looks at how well doctors can predict sudden cardiac death after someone has a heart attack using a measurement called left ventricular ejection fraction (LVEF).
- They combined information from over 140,000 heart attack patients to see if LVEF alone is good enough for deciding who should get a heart device called a defibrillator.
- The results showed that LVEF didn't do a great job at predicting sudden cardiac death, which means doctors need better ways to tell who is at risk.
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 evaluates the long-term performance and safety of the extravascular implantable cardioverter-defibrillator (EV ICD) after initial findings showed its effectiveness for 6 months.
- A total of 316 patients were enrolled, with a successful implant in 299 cases, experiencing various arrhythmic events that were effectively treated using antitachycardia pacing (ATP) and shocks.
- The results indicated high success rates for both ATP (77.1%) and shock therapy (100%), with low rates of complications and inappropriate shocks over the three-year study period.
Aim: To investigate associations between Body Image concerns (BICs) measured by the ICD Body Image Concerns Questionnaire (ICD-BICQ) and other Patient-Reported-Outcomes (PROs), in a cohort of patients with an Implantable Cardioverter Defibrillator (ICD).
Methods And Results: In a cross-sectional survey, we included patients >18 years implanted with a first-time ICD (VVI, DDD and CRT-D) who had lived with their ICD from 3-24 months. They completed the 39-item ICD-BICQ together with the Generalized Anxiety Disorder-scale, Patient Health-Questionnaire, Type D-Scale, Health Status-Questionnaire and the Florida Patient Acceptance-Survey.
Is interventional technique better than the traditional over-the-wire method for left ventricular lead implantation in cardiac resynchronization therapy?
Heart Rhythm O2
May 2024
Background: Interventional cardiac resynchronization therapy (I-CRT) for left ventricular lead (LVL) placement works as a supplement to traditional (over-the-wire) cardiac resynchronization therapy (T-CRT). It has been argued that I-CRT is a time-consuming and complicated procedure.
Objective: The purpose of this study was to investigate differences in procedure-related, perioperative, postoperative, and clinical endpoints between I-CRT and T-CRT.
Article Synopsis
- The Micra AV is a new type of transcatheter pacing system that achieves synchronous pacing by sensing mechanical contractions of the atrium, using advanced programming features like A3 and A4 windows.
- It’s essential for electrophysiologists to have in-depth knowledge of these programming parameters to enhance AV synchrony and address variability in patient outcomes.
- An expert panel of European electrophysiologists recommends specific programming approaches based on patient profiles, including evaluating atrial activity via echocardiography before implantation and customizing settings for optimal performance in different types of AV blocks.
Background And Aims: Prior reports have demonstrated a favourable safety and efficacy profile of the Micra leadless pacemaker over mid-term follow-up; however, long-term outcomes in real-world clinical practice remain unknown. Updated performance of the Micra VR leadless pacemaker through five years from the worldwide post-approval registry (PAR) was assessed.
Methods: All Micra PAR patients undergoing implant attempts were included.
Aims: Modern clinical management of patients with an implantable cardioverter defibrillator (ICD) largely consists of remote device monitoring, although a subset is at risk of mental health issues post-implantation. We compared a 12-month web-based intervention consisting of goal setting, monitoring of patients' mental health-with a psychological intervention if needed-psychoeducational support from a nurse, and an online patient forum, with usual care on participants' device acceptance 12 months after implantation.
Methods And Results: This national, multi-site, two-arm, non-blinded, randomized, controlled, superiority trial enrolled 478 first-time ICD recipients from all 6 implantation centres in Denmark.
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
- High atrial pacing rates have been linked to a higher risk of atrial fibrillation (AF), leading to a study evaluating whether reducing atrial pacing in sinus node dysfunction patients decreases AF episodes.
- In a randomized trial, 540 patients were assigned to either a higher (DDDR-60) or lower (DDD-40) atrial pacing rate, followed for 2 years to compare AF incidents.
- Results showed no significant difference in AF occurrence between the two groups, but the lower pacing group faced a higher risk of syncope or presyncope.
Article Synopsis
- The study evaluates the effectiveness and cost-efficiency of using an absorbable antibacterial envelope during cardiac device implantation to reduce infection rates in high-risk patients, contrasting it with traditional antibiotic treatments.
- Utilizing a decision-tree model and data from a Danish cohort study, it found that the antibacterial envelope resulted in a cost-effectiveness ratio of €12,022 per quality-adjusted life year (QALY), making it economically advantageous.
- The findings support its use in the Danish healthcare context and align with previous international studies, indicating potential for broader accessibility to this preventative technology in cardiac treatments.
Article Synopsis
- - The study examined the effectiveness of cardiac resynchronization therapy (CRT) among immigrants and non-immigrants in Denmark, focusing on heart failure-related hospitalizations and overall mortality from 2000 to 2017.
- - Results showed that both groups experienced similar improvements in hospitalizations after CRT, but there was no significant difference in five-year mortality rates overall, although Middle Eastern immigrants had higher mortality compared to non-immigrants.
- - The majority of deaths in both groups were due to cardiovascular issues, indicating that while CRT was effective for both populations, certain demographics may face increased risks post-therapy.
Does targeted positioning of the left ventricular pacing lead towards the latest local electrical activation in cardiac resynchronization therapy reduce the incidence of death or hospitalization for heart failure?
Am Heart J
September 2023
Background: Cardiac resynchronization therapy (CRT) improves symptoms, health-related quality of life and long-term survival in patients with systolic heart failure (HF) and shortens QRS duration. However, up to one third of patients attain no measurable clinical benefit from CRT. An important determinant of clinical response is optimal choice in left ventricular (LV) pacing site.
View Article and Find Full Text PDFObjective: The aim of this study was to explore cardiac nurses' experiences with a comprehensive web-based intervention for patients with an implantable cardioverter defibrillator.
Methods: We conducted an explorative qualitative study based on individual semi-structured interviews with 9 cardiac nurses from 5 Danish university hospitals.
Results: We found one overall theme: "Between traditional nursing and modern eHealth".
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.
Long-term risk of cardiovascular implantable electronic device reinterventions following external cardioversion of atrial fibrillation and flutter: A nationwide cohort study.
Heart Rhythm
September 2023
Article Synopsis
- External cardioversion (ECV) is a crucial procedure for managing atrial fibrillation and flutter in patients with or without cardiovascular implantable electronic devices (CIEDs), but long-term data on its effects on CIEDs are limited.
- This study aimed to evaluate the risk of needing CIED replacements or repairs after ECV in a nationwide cohort by examining data from the Danish Pacemaker and ICD Register and National Patient Registry from 2005 to 2021.
- Results showed that ECV-exposed patients had significantly higher rates of generator replacements (8.1% vs 5.2%) and lead interventions (5.6% vs 2.3%), indicating a greater risk associated with
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.
Patients with an implantable cardioverter defibrillator at risk of poorer psychological health during 24 months of follow-up (results from the Danish national DEFIB-WOMEN study).
Gen Hosp Psychiatry
January 2023
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.
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 PDFPurpose: Clinically significant pocket hematoma (CSH) is a common complication to cardiac implantable electronic device (CIED) surgery. We aimed to evaluate predictors of CSH after CIED surgery.
Methods: We performed a nationwide population-based prospective cohort study with systematic patient chart review of all Danish patients undergoing CIED surgery during a 12-month period.