Publications by authors named "Kron J"

Current online hemodiafiltration devices can be used to determine the absolute blood volume in clinical practice using the dialysate bolus method. Most of publications on this method have focused on preventing intradialytic complications. The influence of absolute blood volume on long-term prognosis has not been reported yet.

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Article Synopsis
  • Conduction system pacing (CSP) is being explored as a better option than traditional right ventricular (RV) pacing, but previous studies have been limited.
  • This large study analyzed Medicare data to compare outcomes between patients using CSP and those with dual-chamber (DC) RV pacing, separating CSP patients into two groups: left bundle branch area pacing (LBBAP) and His bundle pacing (HBP).
  • Results showed that CSP patients had significantly lower rates of heart failure hospitalizations and all-cause mortality compared to DC RV patients, with LBBAP patients experiencing fewer complications than HBP patients.
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Background: The rate and the duration of ultrafiltration (UF) are considered the most important factors to affect vascular refilling. The aim of the study was to investigate whether a UF profile could improve the vascular refilling.

Methods: Dialysis was delivered by a machine providing feedback control of ultrafiltration rates.

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Absolute blood volume can be calculated from the increase in relative blood volume after an infusion of a well-defined volume bolus of ultrapure dialysate into the extracorporeal circulation. Several working groups have applied this method in research and clinical practice. A critical analysis of differing blood volume data between working groups revealed methodologic problems of the measurement procedure and some important technical aspects.

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  • The study investigates the impact of periprocedural myocardial injury (PMI) on clinical outcomes in patients undergoing Left Bundle Branch Area Pacing (LBBAP), finding that PMI is common and might worsen outcomes.
  • Among 130 patients, 55% experienced PMI, with those showing significant increases in troponin levels (above four times the normal threshold) facing higher hospitalization rates, particularly for acute coronary syndrome.
  • Factors like multiple lead reposition attempts and specific lead types were linked to a greater risk of experiencing PMI during the procedure.
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Aims: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) have become established in preventing sudden cardiac death, with some advantages over transvenous defibrillator systems, including a lower incidence of lead failures. Despite technological advancements, S-ICD carriers may suffer from significant complications, such as premature battery depletion (PBD), that led to an advisory for nearly 40 000 patients. This multicentre study evaluated the incidence of PBD in a large set of S-ICD patients.

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Aims: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) offer potentially distinct advantages over transvenous defibrillator systems. Recent randomized trials showed significantly lower lead failure rates than transvenous ICD. Still, S-ICDs remain associated with the risk of inappropriate shocks (IAS).

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Takotsubo syndrome (TTS) is a reversible form of acute myocardial injury due to a neurocardiogenic mechanism associated with a relevant risk for life-threatening ventricular arrhythmias, occurring in up to 25% of all patients and including both ventricular arrhythmias (especially) in the context of QT prolongation and atrial tachy- or bradyarrhythmias. The pathogenetic mechanisms of TTS-related arrhythmic complications are not completely understood, and there are no randomized clinical trials addressing the pharmacologic and nonpharmacologic management in this specific setting. In this narrative review, the authors provide an overview of the pathogenesis and the therapeutic management of arrhythmic complications in patients with TTS, along with the future perspectives and the remaining knowledge gaps in this field.

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Background: An exuberant and dysregulated inflammatory response contributes to the development and progression of cardiovascular diseases (CVDs).

Methods: This narrative review includes original articles and reviews published over the past 20 years and found through PubMed. The following search terms (or combination of terms) were considered: "acute pericarditis," "recurrent pericarditis," "myocarditis," "cardiac sarcoidosis," "atherosclerosis," "acute myocardial infarction," "inflammation," "NLRP3 inflammasome," "Interleukin-1" and "treatment.

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Heart failure (HF) is a complex syndrome that remains a leading cause of morbidity and mortality worldwide. Abundant evidence suggests inflammation plays a key role in the development and perpetuation of HF, but there are currently no anti-inflammatory treatments approved for use in HF. Interleukin-1, the prototypical proinflammatory cytokine, has been implicated in adverse cardiac remodeling and left ventricular dysfunction.

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Article Synopsis
  • Cardiac physiologic pacing (CPP) includes techniques like cardiac resynchronization therapy (CRT) and conduction system pacing (CSP) aimed at reducing heart failure in patients with issues in heart rhythm.
  • The clinical guideline outlines recommendations for when to use CRT in heart failure patients, how to select suitable candidates, and key steps for pre-procedure preparation and ongoing care.
  • It also highlights areas where more research is needed to improve understanding and application of these pacing therapies, especially for children.
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The ratio of blood volume to extracellular volume is approximately one to three under physiological conditions and also in stable chronic hemodialysis patients. Recently, it was found that this ratio remains unchanged during hemodialysis despite ultrafiltration. This would signify that the higher the ratio, the lower the refilling and vice versa.

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Sleep is essential for human well-being, yet the quality and quantity of sleep reduce as age advances. Older persons (>65 years old) are more at risk of disorders accompanied and/or exacerbated by poor sleep. Furthermore, evidence supports a bidirectional relationship between disrupted sleep and Alzheimer's disease (AD) or related dementias.

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Cardiac sarcoidosis (CS) is a potentially serious form of infiltrative cardiomyopathy. Despite scarce evidence, immunosuppressive treatment is generally recommended, but local routines may vary significantly. We sought to survey the clinical practices in the treatment of CS, with the aim that the results may suggest future research priorities.

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Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.

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Article Synopsis
  • A study evaluated the association of various cardiac sarcoidosis (CS) diagnostic criteria from different years (1993, 2006, 2014, and 2017) with negative health outcomes in patients.
  • Research involved analyzing data from a global cardiac sarcoidosis registry and identified adverse events like mortality and surgeries in 587 patients.
  • Results showed patients meeting the 1993 and 2006 criteria had significantly higher chances of experiencing adverse outcomes compared to those who didn't, while the 2014 and 2017 criteria did not show a significant correlation with these events.
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Nonischemic cardiomyopathies are a frequent occurrence. The understanding of the mechanism(s) and triggers of these cardiomyopathies have led to improvement and even recovery of left ventricular function. Although chronic right ventricular pacing-induced cardiomyopathy has been recognized for many years, left bundle branch block and pre-excitation have been recently identified as potential reversible causes of cardiomyopathy.

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Sarcoidosis is a multi-organ system inflammatory disease of unknown etiology that disproportionately affects women and black patients in the United States. In addition, woman and minority patients have worse outcomes. In 2015, sarcoidosis physicians in cardiology, pulmonary medicine and rheumatology joined forces to create a multidisciplinary sarcoidosis at Virginia Commonwealth University.

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