Publications by authors named "Karvonen J"

Background: Left bundle branch area pacing (LBBAP) has gained increased adoption globally with the use of both lumenless leads (LLLs) and stylet-driven leads (SDLs). As these leads have been developed for conventional endocardial pacing sites, concerns remain regarding the lead integrity with LBBAP.

Objectives: This study evaluates lead integrity of pacing leads used for LBBAP in a large, real-world cohort of patients with LBBAP.

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  • A 74-year-old male with Kartagener's syndrome and permanent atrial fibrillation underwent successful cardiac resynchronization therapy (CRT) and atrioventricular node (AVN) ablation using remote magnetic navigation (RMN) through peripheral access.
  • The patient had severe heart failure, a low ejection fraction of 30%, and significant complications from a left bundle branch block, leading to unsuccessful bi-ventricular pacing prior to the procedure.
  • Post-ablation, the patient's bi-ventricular pacing efficiency improved to 100%, and there were notable improvements in both cardiac function and overall symptoms, highlighting the effectiveness of RMN-guided techniques in treating complex cardiac cases.
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  • The study aimed to develop a clinical scoring system to help doctors identify patients with suspected acute diverticulitis who might need further CT imaging to assess the severity of their condition.
  • Researchers analyzed data from 513 patients diagnosed with CT-confirmed acute diverticulitis, finding key risk factors such as age, comorbidities, and certain lab results that increased the chances of complications.
  • The resulting Acute Diverticulitis Severity Score effectively differentiates between uncomplicated and complicated cases, allowing for more targeted use of imaging, which can lower healthcare costs and improve patient care.
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  • Chronotropic incompetence (CI) is a condition often seen in elderly patients with cardiac resynchronization therapy pacemakers, impacting their exercise performance.
  • This study followed older patients after CRT-P implantation, identifying CI in 75% of them and demonstrating the benefits of a rate-adaptive pacing mode using a minute ventilation sensor.
  • The results showed significant improvements in walking distance and heart rate response, indicating that optimized pacing can enhance exercise tolerance in these patients.
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  • The study examined the consistency of initial CT reports for acute diverticulitis (AD) and whether radiologist experience influenced the findings.
  • It analyzed reports from 562 AD patients, revealing that 5% of the reanalyses resulted in significantly different assessments that impacted patient management.
  • Ultimately, the research highlights the importance of having experienced consultant radiologists reassess CT reports, even though no major differences were found between reports from resident and consultant radiologists.
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Background: Edge-to-edge intervention is the most common trans-catheter procedure performed for isolated severe tricuspid regurgitation in high-surgical-risk patients. However, it creates an obstacle for future right ventricular (RV) procedures such as implantation of cardiac implantable electronic devices (CIEDs). Reports of the management of CIED implantation after tricuspid edge-to-edge therapy are scarce.

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Background And Objective: Colorectal cancer (CRC) can mimic acute diverticulitis and can thus be misdiagnosed. Therefore, colonic evaluation is recommended after an episode of acute diverticulitis. The aim of this study was to analyze the risk of CRC after computed tomography (CT) verified uncomplicated and complicated acute diverticulitis in short-term and, particularly, long-term follow-up to ensure the feasibility of the primary CT imaging in separating patients with uncomplicated and complicated acute diverticulitis.

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Background: Many algorithms have been developed to ensure the safety and accuracy of cardiac implantable electric devices (CIED). A specific algorithm designed to prevent pacemaker induced tachycardia (PMT) after a premature ventricular complex (PVC response) is available in all Abbott (former St. Jude Medical) CIED.

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Objectives: Cardiac implantable electronic device (CIED)-induced metal artefacts possibly significantly diminish the diagnostic value of magnetic resonance imaging (MRI), particularly cardiac MR (CMR). Right-sided generator implantation, wideband late-gadolinium enhancement (LGE) technique and raising the ipsilateral arm to the generator during CMR scanning may reduce the CIED-induced image artefacts. We assessed the impact of generator location and the arm-raised imaging position on the CIED-induced artefacts in CMR.

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Objective: This longitudinal study investigated the pathways from childhood socioemotional characteristics and cognitive skills to health behaviours in midlife. Participants in the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS) were followed from age 8 ( = 369) to age 50 ( = 271). Outcomes included physical activity, smoking, alcohol consumption and body mass index (BMI) assessed at ages 36, 42 and 50.

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Objectives: The European Society of Cardiology Guidelines on cardiac pacing from 2021 allow magnetic resonance imaging (MRI) in patients with cardiac implantable electronic devices (CIEDs) but do not recommend MRI in patients with epicardial pacing leads. The clinical dilemma remains whether performing an MRI in patients with CIED and epicardial leads is safe. We aimed to evaluate the safety of performing an MRI in patients with CIED and abandoned or functioning epicardial pacing leads.

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Background And Aims: Low anterior resection syndrome is common after anterior resection for rectal cancer. Its severity can be tested with the low anterior resection syndrome score. We have translated the low anterior resection syndrome score to Finnish, and the aim of this study is to validate the translation.

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Purpose: Laparoscopic incisional ventral hernia repair (LIVHR) is often followed by seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence, chronic pain and poor quality of life (QoL). We aimed to evaluate whether LIVHR combined with defect closure (hybrid) follows as a diminished seroma formation and thereby has a lower rate of hernia recurrence and chronic pain compared to standard LIVHR.

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Purpose: The seroma rate following laparoscopic incisional ventral hernia repair (LIVHR) is up to 78%. LIVHR is connected to a relatively rare but dangerous complication, enterotomy, especially in cases with complex adhesiolysis. Closure of the fascial defect and extirpation of the hernia sack may reduce the risk of seromas and other hernia-site events.

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Purpose: To analyze the results of abdominoperineal excisions (APE) for locally advanced rectal cancer at our institution before and after the adoption of extralevator abdominoperineal excision (ELAPE) with a special reference to long-term survival.

Methods: A retrospective cohort study conducted in a tertiary referral center. All consecutive patients operated for locally advanced (TNM classification T3-4) rectal cancer with APE in 2004-2009 were compared to patients with similar tumors operated with ELAPE in 2009-2016.

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Physical symptoms often occur in the absence of physical illness. This is termed somatization when the symptoms are caused by psychic factors. When abundant symptoms affect the functional capacity and cause subjective harm and seeking healthcare services, a psychic disorder may be in question.

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Background: Patients with diabetes mellitus (DM) have a higher risk of sudden cardiac death. Factors associated with the risk profiles of coronary artery disease (CAD) patients with DM are not well established. Heart rate turbulence (HRT) and T-wave alternans (TWA) are often used to predict arrhythmia events.

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Background: Symptomatic gallstone disease is considered an indication for cholecystectomy. A considerable proportion of patients may experience persistent symptoms after surgery. The purpose of the present study was to find out the rate of symptom persistence after elective laparoscopic cholecystectomy (LC) performed for symptomatic uncomplicated gallstone disease and, in particular, to clarify whether the recurrence rate differs according to the severity of preoperative symptoms.

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