Publications by authors named "Peter S Hansen"

Article Synopsis
  • Pulsed field ablation (PFA) is a new method for treating atrial fibrillation (AF) that focuses on ablating heart tissue while minimizing harm to nearby structures.
  • In the MANIFEST-17K study, data from 106 centers involved 17,642 patients and showed no serious complications like esophageal damage, with only a 1% major complication rate.
  • The results suggest that PFA has a strong safety profile and may change how AF is treated, compared to traditional thermal ablation methods.
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Background: Landmark trials showed that invasive pressure measurement (Fractional Flow Reserve, FFR) was a better guide to coronary stenting than visual assessment. However, present-day interventionists have benefited from extensive research and personal experience of mapping anatomy to hemodynamics.

Aims: To determine if visual assessment of the angiogram performs as well as invasive measurement of coronary physiology.

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Chronic tricuspid regurgitation (TR) results in progressive right ventricular (RV) volume overload, followed by right-sided chamber dilatation, RV systolic dysfunction, and eventual low-output cardiac failure. Severe TR is associated with considerable morbidity and mortality, and yet until recently, patients in the late stage of their disease course had limited treatment options. Cognizant of the high mortality rates associated with surgical intervention, tricuspid valve (TV) transcatheter edge-to-edge repair (TEER) has emerged as a promising solution for patients with severe TR.

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Article Synopsis
  • The study aimed to validate the National Danish Ablation Database (NDAD) by comparing its data on patients who underwent ablation for atrial fibrillation against their medical records.
  • Researchers included 597 patients and assessed positive predictive values (PPV) and negative predictive values (NPV) across different categories, finding high agreement with both PPV and NPV exceeding 90%.
  • Results indicated that NDAD has strong validity, with data aligning well with medical records, although the low complication rates led to slightly less certainty in the PPV and NPV related to complications.
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Background: Treating known risk factors for coronary artery disease (CAD) has substantially reduced CAD morbidity and mortality. However, a significant burden of CAD remains unexplained. Immunoglobulin E sensitization to mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal) was recently associated with CAD in a small observational study.

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Article Synopsis
  • The study examined complications within 30 days of first-time catheter ablation for atrial fibrillation (AF) in patients aged ≥ 75 years compared to those aged 65-74 years.
  • No significant difference in the rate of complications, including cardiac issues and death, was found between the two age groups, indicating similar safety profiles.
  • Additionally, there was no notable difference in one-year AF relapse rates, suggesting that older patients do not face higher risks or reduced effectiveness from the procedure compared to younger patients.
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Background: Electrocardiogram (ECG) measured QRS duration has been shown to influence cardiovascular outcomes. However, there is paucity of data on whether ECG QRS duration is influenced by obesity and sex in large populations.

Methods: All ECGs performed by a pathology provider over a 2-year period were included.

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This case study is a rare example of cardiac hydatidosis in a high-income country, where a middle-aged man presented with a ruptured right ventricular cyst causing anaphylaxis, pulmonary emboli and dissemination of throughout the lung. He survived the cyst rupture and underwent cardiac surgery but had incomplete resection and experienced progressive cardiopulmonary hydatidosis despite antihelminthic therapy. As a result, he experienced an array of cardiopulmonary sequelae over his lifespan.

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Article Synopsis
  • Oral anticoagulation (OAC) is recommended for patients with atrial fibrillation (AF) and atrial flutter (AFL) who have higher CHADS-VASc scores, even after catheter ablation.
  • A study analyzed 2,409 patients who underwent cavo-tricuspid isthmus ablation (CTIA) for AFL, revealing that 30% of them discontinued OAC during a follow-up period of about 4 years.
  • Findings indicated younger patients with fewer health issues were more likely to stop OAC, but those who did face increased risks of mortality and stroke, especially correlated with older age and higher CHADS-VASc scores.
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Article Synopsis
  • Cavo tricuspid isthmus ablation (CTIA) is an effective treatment for typical atrial flutter (AFL), but many patients develop atrial fibrillation (AF) afterward.
  • A study analyzed data from 2409 patients in the Danish National Ablation Registry who underwent first-time CTIA between 2010 and 2016, following their outcomes until 2018.
  • Findings revealed that 10% of the patients needed a re-ablation for AFL and 13.5% underwent ablation for AF over an average follow-up of 4 years, with younger patients and those with fewer health issues being more likely to require additional procedures.
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Background: There is increasing recognition that heavy exertion can occasionally trigger an acute myocardial infarction (MI), although some uncertainties exist regarding the link. The primary aim of this study was to compare the relative risk (RR) of MI following vigorous exertion between those with confirmed coronary occlusion and those with a non-occluded culprit artery on acute angiography. Secondary aims were to determine if the risk of coronary occlusion is modified by the type of exercise (dynamic or isometric resistance), the frequency of regular exertion or whether the exertion was emotionally charged.

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Article Synopsis
  • Supraventricular ectopic complexes (SVEC) increase the risk of recurrent atrial fibrillation (AF), but their impact varies by age group, particularly in patients above and below 57 years old.
  • A study with 260 patients examined the effects of antiarrhythmic medication (AAD) and catheter ablation (CA), revealing that older patients (over 57) had a significantly higher rate of AF recurrence after CA compared to younger patients.
  • High SVEC burden within three months post-CA was linked to increased AF recurrence in older patients, whereas no age-related differences were seen in those treated with AAD.
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Introduction: This single-subject case report aims to describe and discuss a case of a patient with established C5 tetraplegia with acute coronary syndrome presenting with left upper quadrant pain and tenderness.

Case Presentation: A 65-year-old male with chronic C5 American Spinal Injury Association Impairment Scale (AIS) A tetraplegia presented to the emergency department with severe left upper quadrant pain radiating across the chest to the right upper limb with associated dyspnoea and diaphoresis. Prior to his emergency department admission, he had experienced progressive worsening of left upper quadrant pain and tenderness over several months.

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Article Synopsis
  • Identification and management of major cardiovascular risk factors (SMuRFs) have significantly improved heart health, but cardiovascular disease still leads globally in deaths.
  • A study analyzing STEMI patients from 2006 to 2014 showed that the number of patients without traditional risk factors (SMuRFless) increased from 11% to 27%.
  • The findings suggest that while the rates of high cholesterol and smoking decreased, there are many individuals whose heart conditions cannot be fully explained by known risk factors, signaling a need for further research into new causes and treatment methods.
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Article Synopsis
  • Supraventricular ectopic complexes (SVEC), linked to atrial fibrillation (AF), are more effectively suppressed by antiarrhythmic medications (AAD) compared to catheter ablation (CA) in long-term treatment.
  • In a study involving 260 patients, those on AAD had lower daily SVEC counts compared to those who underwent CA, particularly notable 24 months after treatment.
  • Patients with fewer SVEC exhibited reduced AF occurrences, with AAD showing more stable outcomes over time compared to the initial increase in SVEC burden seen after CA.
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Article Synopsis
  • The implantable cardioverter-defibrillator (ICD) is the primary treatment for preventing sudden cardiac death in patients with coronary artery disease and serious heart rhythm issues, and the Substrate Modification Study (SMS) looked at whether preemptively ablating heart tissue could reduce the recurrence of dangerous arrhythmias.
  • In a study of 111 patients, those who received catheter ablation in addition to ICD implantation showed a similar rate of first arrhythmia recurrence compared to those who only had the ICD, measured over an average follow-up of 2.3 years.
  • Although the SMS didn't achieve its main goal regarding first recurrence, it did find that catheter ablation led to fewer overall ICD interventions during the follow-up period.
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Background: Respiratory infection has been associated with an increased short-term risk of myocardial infarction (MI). However, previous studies have predominantly been conducted without angiographic confirmation of MI. The possibility can therefore not be excluded that raised troponin levels or electrocardiogram abnormalities that may be seen with respiratory infections are due to non-ischaemic causes.

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Article Synopsis
  • The study aimed to identify patients at risk of long-term atrial fibrillation (AF) recurrence after undergoing catheter ablation by analyzing post-procedural supraventricular ectopic complexes (SVEC).
  • 125 patients were monitored with Holter recordings for 7 days after the procedure, and their SVEC counts were categorized into quartiles to assess their correlation with AF recurrence.
  • Findings showed that higher SVEC counts significantly increased the risk of long-term AF recurrence, suggesting that measuring ectopy burden could help in deciding which patients may benefit from early re-intervention.
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Article Synopsis
  • - The MANTRA-PAF trial compared the effectiveness of radiofrequency catheter ablation (RFA) versus antiarrhythmic drug therapy (AAD) for treating paroxysmal atrial fibrillation (AF), measuring outcomes over a 5-year follow-up.
  • - Results showed that a higher percentage of patients in the RFA group remained free of AF (86% vs 71%) and symptomatic AF (94% vs 85%) compared to those receiving AAD, with significant differences in AF burden as well.
  • - Quality of life scores improved for both groups from baseline, but there were no significant differences between the RFA and AAD groups at the 5-year mark.
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Article Synopsis
  • The study aimed to evaluate the safety of catheter ablation for atrial fibrillation (AF) in patients using novel oral anticoagulants (NOAC) as part of a simple anticoagulation protocol.
  • A total of 234 patients on NOACs were included, with no major bleeding or thromboembolic complications observed during the procedure or follow-up, except for one minor case.
  • The findings suggest that temporarily stopping NOACs before the procedure, without the use of bridging therapy like low molecular weight heparin, is safe and well-tolerated for patients undergoing AF ablation.
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Transcatheter aortic valve implantation (TAVI) has been increasingly utilized for the treatment of severe symptomatic aortic stenosis in inoperable and high surgical risk patients. Recent advances in valve technology include repositionable scaffolds and smaller delivery systems, as well as improvement in periprocedural imaging. These advances have resulted in reduction of vascular complications, rates of paravalvular aortic regurgitation and periprocedural stroke and improved overall outcomes.

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Article Synopsis
  • The MANTRA-PAF study compares the effectiveness of radiofrequency catheter ablation (RFA) to antiarrhythmic drugs (AADs) for treating paroxysmal atrial fibrillation (PAF) as first-line therapy.
  • The results showed that, after 24 months, patients in the RFA group had significantly lower AF burden and a higher percentage of being free from AF compared to those using AADs and those who crossed over to other treatments.
  • Quality of life improved across all treatment groups with no significant differences in serious adverse events, suggesting that RFA could be a better first-line option for symptomatic PAF patients.
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Objectives: Assess the effect of aspiration thrombectomy on diagnosis and management of embolic acute myocardial infarction.

Background: Discrimination of embolic acute myocardial infarction from atherosclerotic plaque rupture/erosion prompts oral anticoagulation treatment of source of embolus, as well as avoiding unnecessary stenting and dual antiplatelet therapy. However, detection is difficult without aspiration.

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Article Synopsis
  • A study assessed Danish cardiologists' attitudes toward catheter ablation for atrial fibrillation (AF) using a nationwide survey, finding a significant response rate of 67.8%.
  • The results indicated that the majority of cardiologists anticipate AF recurrence post-ablation, with a more favorable view of the procedure correlated with the cardiologist's age and experience, especially for longstanding AF cases.
  • Overall, Danish cardiologists hold a generally positive stance towards catheter ablation for AF and are informed about appropriate patient information regarding the treatment options.
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