Publications by authors named "Peter T Mortensen"
Aim: Left ventricular (LV) lead position at the latest mechanically activated non-scarred myocardial LV region confers improved response to cardiac resynchronization therapy (CRT). We conducted a double-blind, randomized controlled trial to evaluate the clinical benefit of multimodality imaging-guided LV lead placement in CRT.
Methods And Results: Patients were allocated (1:1) to imaging-guided LV lead placement using cardiac computed tomography (CT) venography, Technetium myocardial perfusion imaging, and speckle-tracking echocardiography radial strain to target the optimal coronary sinus (CS) branch closest to the non-scarred myocardial segment with latest mechanical activation (imaging group, n = 89) or to routine LV lead implantation in a posterolateral region with late electrical activation (control group, n = 93).
Article Synopsis
- Evidence-based heart failure (HF) medications are underused, but their optimization after cardiac resynchronization therapy (CRT) can improve patient outcomes.
- In a study of 826 patients who received CRT, medication doses increased significantly after 6 months, with high long-term adherence rates of 95% for beta-blockers and 94% for ACE inhibitors/ARBs.
- Higher doses of these medications were linked to better survival rates, showing that effective management of HF is feasible following CRT implantation.
Adding the implantable cardioverter-defibrillator to cardiac resynchronization therapy is associated with improved long-term survival in ischaemic, but not in non-ischaemic cardiomyopathy.
Europace
March 2016
Article Synopsis
- Cardiac resynchronization therapy (CRT) helps improve heart failure symptoms and survival, and the study investigates the additional benefits of adding an implantable cardioverter-defibrillator (ICD) for patients with heart failure.
- The study included 917 patients with heart failure from Aarhus University Hospital between 2000 and 2010, analyzing mortality data and the impact of ICD on survival.
- Results showed that patients with ischemic cardiomyopathy (ICM) had improved survival with ICD backup, while those with non-ischemic cardiomyopathy (NICM) did not show significant survival benefits.
Article Synopsis
- Patients without a history of atrial fibrillation (AF) who underwent cardiac resynchronization therapy (CRT) were studied to find the impact of early detected atrial high rate episodes (AHRE) on their health outcomes.
- The study found that 20% of the 394 patients had early AHREs, which significantly increased the risk of developing clinical AF and thromboembolic events during a follow-up period of about 4.6 years.
- However, the presence of early AHREs did not increase mortality risk, and only a minority of patients who experienced thromboembolic events had AHREs detected shortly before those events.
Background: In modern society, death has become 'forbidden' fed by the medical technology to conquer death. The technological paradigm is challenged by a social-liberal political ideology in postmodern Western societies. The question raised in this study was as follows: Which arguments, attitudes, values and paradoxes between modern and postmodern tendencies concerning treatment and care of older persons with an implantable cardioverter defibrillator appear in the literature?
Aims: The aim of this study was to describe and interpret how the field of tension concerning older persons with an implantable cardioverter defibrillator - especially end-of-life issues - has been expressed in the literature throughout the last decade.
Aims: To assess the long-term mortality and occurrence of post-ablation atrial fibrillation in patients undergoing a radiofrequency ablation for the Wolff-Parkinson-White (WPW) syndrome.
Methods And Results: A retrospective cohort study of patients (N = 362) subjected to radiofrequency ablation of the WPW syndrome at Aarhus University Hospital from 1990 to 2011. A comparison cohort (N = 3619) was generated from the Danish National Board of Health Central Population Registry.
Article Synopsis
- Fluoroscopy is commonly used to locate lead positions in cardiac resynchronization therapy (CRT), but its accuracy compared to cardiac CT is unclear.
- A study involving 59 patients showed that fluoroscopy accurately agreed with cardiac CT for left ventricular (LV) lead positions in only 35% of cases and for right ventricular (RV) leads in 22% of cases.
- The agreement of lead positions was poor with fluoroscopy (low kappa values) but excellent with cardiac CT, suggesting that cardiac CT should be used for precise lead placement in future CRT studies.
Article Synopsis
- The study aimed to compare the effects of long-term His or para-His pacing (HP) versus right ventricular septal pacing (RVSP) on left ventricular function in patients with atrioventricular block (AVB).
- After 12 months, LVEF was significantly lower in patients who received RVSP compared to those who underwent HP.
- The research concluded that HP better preserves LVEF and mechanical synchrony, suggesting it may be a more beneficial pacing method for patients with certain heart conditions.
Article Synopsis
- Cardiac resynchronization therapy (CRT) is commonly used to treat heart failure, but many patients do not respond effectively, with LV lead positioning being crucial for its success.
- The ImagingCRT study is a randomized trial testing whether using advanced imaging techniques for LV lead placement can improve patient outcomes, focusing on factors like mortality and heart failure hospitalizations.
- The study aims to address the ongoing challenge of CRT non-responders by potentially enhancing lead placement techniques, with results expected to inform future treatment approaches.
Article Synopsis
- The study aimed to compare left ventricular performance and mechanical synchrony in patients with high-grade atrioventricular block through three types of pacing: AAI, DDD-PHP, and DDD-RVS.
- Eleven patients were assessed using 3D echocardiograms and tissue Doppler imaging, revealing that DDD-RVS resulted in lower LVOT-VTI and reduced LVEF compared to AAI and DDD-PHP.
- The findings suggest that DDD-PHP is more effective in maintaining LV function and synchrony than DDD-RVS, especially in acute settings.
Article Synopsis
- The study aimed to compare the effects of biventricular (BIV) pacing with standard right ventricular (RV) pacing on left ventricular ejection fraction (LVEF) and left ventricular (LV) dyssynchrony in patients with high-grade atrioventricular block over three years.
- Results showed that while LVEF significantly decreased in the RV pacing group, it remained stable in the BIV pacing group.
- BIV pacing also prevented adverse LV remodelling and increased dyssynchrony observed in the RV group, although both groups did not show significant differences in clinical heart failure indicators.
Article Synopsis
- A left ventricular lead placed in the right spot, where the heart's mechanical activity is best, can improve outcomes for patients undergoing cardiac resynchronization therapy (CRT).
- The study used non-contrast MRI to identify the ideal lead location by measuring the heart's radial strain and avoiding areas with damage (transmural scar).
- Out of 16 patients, lead placement was adjusted in some cases based on MRI findings, indicating that imaging can influence the choice of vein for lead implantation in CRT.
Aims: Few studies have investigated the association between implantable cardioverter defibrillators (ICDs) and lead advisory notifications and patient-reported outcomes (PROs). We examined (i) whether the mode used to inform patients about a device advisory is associated with PROs, and (ii) whether patients with a lead subject to a device advisory report poorer PROs than non-advisory controls.
Methods And Results: Patients (n= 207) implanted with an ICD at Aarhus University Hospital, Denmark, with a Sprint Fidelis lead subject to an advisory and a non-advisory control group (n= 510), completed a set of standardized PRO measures.
His and para-His pacing in AV block: feasibility and electrocardiographic findings.
J Interv Card Electrophysiol
September 2011
Article Synopsis
- The study aimed to explore the use of His-bundle or para-His pacing in patients with severe atrioventricular (AV) block to improve heart function since right ventricular apical pacing can lead to poor outcomes.
- A total of 38 patients with specific heart conditions were documented, and the research focused on the effectiveness of new pacing techniques, achieving His-bundle pacing in some and para-His pacing in most cases over a 12-month period.
- The findings showed that 85% of patients could achieve stable pacing with improved electrical activity in the heart, suggesting these methods might be preferable alternatives to traditional pacing techniques.
Aims: Infection is a serious complication of pacemaker (PM) systems. Although the rate of infection has been debated, the figures are largely unknown. We therefore studied the incidence of PM infection and its associated risk factors in the Danish population.
View Article and Find Full Text PDFAims: The aim of this study was to examine health-care professionals attitudes towards implantable cardioverter-defibrillator (ICD) therapy and issues discussed with patients.
Methods And Results: Survey of 209 health-care professionals providing specialized treatment and care of ICD patients at the five implanting centres in Denmark. Questions pertained to gender, age, years of experience within the field, knowledge of the ongoing critical debate on ICD therapy, and personal experience with ICD treatment, and/or sudden cardiac arrest within family and/or friends.
Article Synopsis
- The study aimed to assess how the anatomical left ventricular pacing site (LV-PS) affects outcomes in cardiac resynchronization therapy (CRT) and overall mortality in patients.
- It involved 426 patients, categorized into three groups based on their LV-PS position, and analyzed their clinical and echocardiographic data before and after CRT implantation.
- While no direct relationship was established between LV-PS and CRT outcomes or mortality, preliminary findings suggest a potential impact on outcomes in specific patient subsets, such as non-ischaemic patients and those with left bundle branch block.
Background: The need for pacing support in typical ICD patients is unknown.
Objective: This study sought to determine whether atrial pacing with ventricular backup pacing is equivalent to ventricular backup pacing only in implantable cardioverter-defibrillator (ICD) patients.
Methods: We randomized 1,030 patients from 84 sites with indications for ICDs, with sinus rhythm, and without symptomatic bradycardia to atrial pacing with ventricular backup at 60 beats/min (518) or ventricular backup pacing at 40 beats/min (512).
Aims: The present study aims to identify the predictive value of electrocardiographic (ECG) patterns on long-term clinical and echocardiographic outcome in patients treated with cardiac resynchronization therapy (CRT).
Methods And Results: Clinical information including a standard 12-lead ECG was collected from patient files in consecutive patients treated with CRT from 1997 to 2007. Symptomatic response was defined as improvement in New York Heart Association class (> or =1) and echocardiographic response as improvement in left ventricular ejection fraction of > or =5% absolute.
Aims: To identify the predictive value of a presumed optimal left ventricular lead positions (LV-Ps) on the long-term clinical outcome in patients with cardiac resynchronization therapy (CRT).
Methods And Results: Clinical information was collected from patient files in consecutive patients treated with CRT from 1997 to 2007. A presumed optimal LV-Ps were defined as a position between 2 and 5 o'clock in the short-axis circumference and basal or mid-ventricular in the long axis.
Article Synopsis
- The study investigates how clustering of poor device acceptance and Type D personality affects anxiety and depression in Danish patients with implantable cardioverter defibrillators (ICDs).
- It includes a cohort of 557 patients and categorizes them into risk groups based on their psychosocial factors.
- Results show significantly higher anxiety and depression rates in patients with both poor device acceptance and Type D personality, highlighting the need for targeted clinical monitoring and intervention for these individuals.
Article Synopsis
- The study aimed to find the best interventricular (VV) timing for cardiac resynchronization therapy (CRT) using tissue Doppler imaging (TDI) and 2D echocardiography to potentially improve patient outcomes.
- Thirty patients underwent various echocardiographic evaluations before and after CRT, showing significant improvements in left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) class.
- TDI accurately predicted the optimum VV timing in 93% of cases, while 2D echocardiography was also effective, suggesting TDI may be the more precise method for assessing myocardial contraction delays before CRT implantation.
Background: Device acceptance may comprise one of the keys to identifying implantable cardioverter defibrillator (ICD) patients at risk for adverse health outcomes in clinical practice. We examined (1) the validity and reliability of the Florida Patient Acceptance Survey (FPAS) and (2) correlates of device acceptance in a large sample of Danish patients.
Methods: A cohort of consecutive patients (N = 566; 82.
Article Synopsis
- Cardiac resynchronization therapy (CRT) helps improve symptoms and survival in heart failure patients but long-term outcomes were previously uncertain.
- A study of 179 patients treated with CRT showed a notable mortality rate of 15% at one year and 53% at five years, with predictors of mortality including ischemic heart disease (IHD), lower left ventricular ejection fraction (LVEF), and lack of symptom improvement.
- After five years, most patients maintained clinical benefits, and those without IHD demonstrated significant improvements in LVEF over time.
Aims: To identify correlates of impaired quality of life (QOL), anxiety, and depression in patients with an implantable cardioverter-defibrillator (ICD).
Methods And Results: Surviving patients (n = 610) who received an ICD in our institution since 1989 completed the Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale. Mean age was 62.