Publications by authors named "Senges J"
Background: Catheter ablation is the primary treatment option for idiopathic ventricular tachycardia (VT). It plays a key role in acute therapy of electrical storm, treatment of VTs in patients with structural heart disease (SHD), and can reduce VT burden. Here we report on 10-year clinical outcomes following VT ablation from patients enrolled in the prospective German Ablation Registry.
View Article and Find Full Text PDFBackground And Objectives: Oral anticoagulation in patients with atrial fibrillation is crucial to prevent thrombus formation in the heart, a major cause of ischemic stroke. The appropriate dose of direct oral anticoagulants (DOAC) - either standard or reduced dose - must be chosen individually in accordance with defined patient characteristics. However, a significant proportion of patients receive inappropriately low DOAC doses (underdosing).
View Article and Find Full Text PDFBackground: Asymptomatic nonvalvular atrial fibrillation is often suspected in patients with cryptogenic stroke which constitute 20%-30% of ischemic strokes. Detection of atrial fibrillation (AF) and treatment with anticoagulation can reduce the risk of stroke. We sought to investigate the prevalence of asymptomatic atrial fibrillation (aAF) in patients with a history of stroke or an acute stroke on admission.
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- Atrial fibrillation (AF) significantly increases the risk of stroke, and identifying risk factors for strokes in AF patients remains complicated, suggesting that existing scoring systems don't capture all relevant details.
- In a study analyzing patients from the ARENA project, it was found that those with a history of cerebrovascular events (CVE) were generally older, had higher CHADS-VASc scores, and larger left atrial diameters compared to those without CVE.
- The prognosis for AF patients with CVE was notably worse; they had higher mortality rates and higher stroke occurrences within a year, indicating that factors like atrial remodeling and underlying heart disease may contribute to their increased risk.
Article Synopsis
- The study investigates the effects of resting heart rate (RHR) on patients with heart failure who received implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy-defibrillators (CRT-Ds), specifically examining RHRs above and below 70 bpm.
- A total of 1589 patients were analyzed, and results showed that one-year all-cause mortality and major cardiovascular events were similar between those with RHR ≤ 70 bpm and > 70 bpm.
- However, patients with RHR > 70 bpm had higher rates of all-cause hospital admissions, mainly due to non-cardiovascular events, indicating potential increased risks associated with a higher RHR.
: The surgical ablation (SA) of atrial fibrillation (AF) during cardiac surgery is performed in only 8-40% of patients. We performed a subgroup analysis of the 1-year follow-up from the German CArdioSurgEry Atrial Fibrillation (CASE-AF) registry to determine how preoperative sinus rhythm (SR) prior to SA affected the outcomes. : The CASE-AF registry enrolled AF patients scheduled for cardiac surgery with concomitant SA.
View Article and Find Full Text PDFOutcomes of surgical ablation for atrial fibrillation in on- versus off-pump coronary artery bypass grafting.
Interdiscip Cardiovasc Thorac Surg
September 2024
Objectives: A considerable number of patients undergoing coronary artery bypass grafting surgery suffer from atrial fibrillation and should be treated concomitantly. This manuscript evaluates the impact of on-pump versus off-pump bypass grafting on the applied lesion set and rhythm outcome.
Methods: Between January 2017 and April 2020, patients who underwent combined bypass grafting and surgical ablation for atrial fibrillation were consecutively enrolled in the German CArdioSurgEry Atrial Fibrillation registry (CASE-AF, 17 centres).
Background: Community-based interventions may promote awareness and adherence to atrial fibrillation (AF)-related therapies, potentially reducing adverse events. The ARENA project investigated the health status, therapies and events in AF patients in the Rhein-Neckar Region, Germany. The subproject "ARENA intervention" studied the effect of community-based interventions on AF-associated outcomes.
View Article and Find Full Text PDF: The number of young patients receiving ICDs or CRT-Ds has been increasing in recent decades and understanding the key characteristics of this special population is paramount to optimized patient care. : The DEVICE I+II registry prospectively enrolled patients undergoing ICD/CRT-D implantation or revision from 50 German centers between 2007 and 2014 Data on patient characteristics, procedural outcome, adverse events, and mortality during the initial stay and 1-year follow-up were collected. All patients under the age of 45 years were identified and included in a comparative analysis with the remaining population.
View Article and Find Full Text PDFEpicardial and endocardial surgical ablation of atrial fibrillation: outcomes from CASE-AF Registry.
Interdiscip Cardiovasc Thorac Surg
July 2024
Objectives: The German CArdioSurgEry Atrial Fibrillation Registry is a prospective, multicentric registry analysing outcomes of patients undergoing surgical ablation for atrial fibrillation as concomitant or stand-alone procedures. This data sub-analysis of the German CArdioSurgEry Atrial Fibrillation Registry aims to describe the in-hospital and 1-year outcomes after concomitant surgical ablation, based on 2 different ablation approaches, epicardial and endocardial surgical ablation.
Methods: Between January 2017 and April 2020, 17 German cardiosurgical units enrolled 763 consecutive patients after concomitant surgical ablation.
Article Synopsis
- The study evaluates the outcomes of surgical atrial ablation in high-risk patients (HRPs) compared to low-risk patients (LRPs), analyzing data from 1,000 patients in a multicenter registry.
- HRPs had more comorbidities, lower heart function, and underwent more complex surgeries, but there was no increased mortality directly linked to the ablation procedure.
- Both HRPs and LRPs had similar rates of postoperative sinus rhythm and long-term symptoms, with anticoagulation remaining prevalent among HRPs.
Article Synopsis
- Patients with a history of prior myocardial infarction (pMI) have worse outcomes compared to those without pMI when dealing with ischaemic heart failure with reduced ejection fraction (HFrEF).
- In a study involving 2,075 patients, it was found that those with pMI experienced higher all-cause mortality, greater event rates for death or shock from an ICD, and a more significant decline in mobility and overall health status after one year.
- These findings suggest that patients with ischaemic HFrEF and a history of pMI are at a higher risk, indicating a need for more specialized care for this subgroup.
Article Synopsis
- The study analyzed catheter ablation success rates and complications in 591 patients with cardiac pacemakers compared to 7,393 patients without them, finding that patients with pacemakers were generally older and had more health issues.
- One-year mortality rates were higher in the pacemaker group (2.4%) versus the non-pacemaker group (1.3%), along with increased risks of re-hospitalization and combined cardiovascular events.
- Despite these increased risks, the rate of procedural success was high (98.8%) for those with pacemakers, and serious device-related complications were very low (0.4%).
Background: Atrial fibrillation (AF) is a cardiac arrhythmia frequently documented in patients requiring implantable cardioverter defibrillators (ICDs) and/or cardiac resynchronization therapy with defibrillator (CRT-D). Patients with diagnosed AF at the point of ICD or CRT-D implantation may have an impaired follow-up outcome.
Methods: The German DEVICE I-II registry is a nationwide prospective multicentre database of patients implanted with ICD and CRT-D with clinical follow-up data.
Article Synopsis
- Interventional left atrial appendage occlusion (LAAO) is effective for patients with nonvalvular atrial fibrillation (AF) who can't use long-term blood thinners, especially those with a history of stroke.
- A study from the LAARGE registry found that LAAO was similarly effective and safe for stroke patients compared to those without a stroke history, with high success rates and low complication rates in both groups.
- The results suggest that LAAO could be a viable option for secondary prevention in high-risk AF patients, showing no significant differences in risk of death or stroke between those with and without prior strokes.
Background: Current guidelines emphasize the diagnostic value of non-cardiac or possibly cardiac chest pain. The goal of this analysis was to determine whether German chest pain units (CPUs) adequately address conditions with "atypical" chest pain in existing diagnostic structures.
Method: A total of 11,734 patients from the German CPU registry were included.
Objectives: The CArdioSurgEry Atrial Fibrillation (CASE-AF) registry is a prospective, multicentre study for collecting and analysing real-world data of surgical atrial fibrillation (AF) treatment. This study aimed to evaluate outcomes of surgery for long-standing persistent AF at 1 year.
Methods: In total, 17 centres consecutively include all eligible patients with continuous AF lasting for ≥1 year.
Objective: Atrial fibrillation (AF) is associated with impaired health-related quality of life (HRQoL), an increased risk of morbidity, and mortality. Traditional AF-related outcomes (e.g.
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- - The study examined the prognostic value of inducible ventricular arrhythmia (VA) in patients with syncope who received defibrillators, comparing them to patients with prior heart issues needing secondary prevention.
- - Results showed that patients with syncope and inducible VA had fewer heart-related issues and better clinical outcomes after one year, including lower mortality and adverse events than those with a secondary preventive indication.
- - Importantly, while patients with syncope and inducible VA had favorable outcomes, their post-surgery complication rates were similar to those without syncope, highlighting the significance of VA inducibility in risk assessment.
Article Synopsis
- Interventional left atrial appendage occlusion (LAAO) is a treatment option that replaces long-term oral anticoagulation for patients with nonvalvular atrial fibrillation, particularly those with a high risk of bleeding.
- A study examined the impact of spontaneous echo contrast (SEC) on the risk of device-related thrombus (DRT) and thromboembolic events (TEs) in two groups of patients: those with SEC and those without it.
- The results showed that while procedural success was high in both SEC groups, DRT was only noted in the SEC- group and TEs were rare in both, suggesting that SEC presence might not significantly affect post-LAAO outcomes.
Background: Patients undergoing left atrial appendage (LAA) occlusion (LAAO) are multi-morbid, including mitral valve disease (MVD) which is associated with anatomic changes of the left atrium (LA). This study aims to identify how atrial myopathy in MVD influences outcomes in LAAO.
Methods: Atrial myopathy in MVD was defined as LA diameter > 45 mm (♀) and > 48 mm (♂) and existing MVD or history of surgical/interventional treatment.
Background: Pulmonary vein isolation (PVI) is recommended to treat paroxysmal and persistent atrial fibrillation (AF). This analysis aimed to assess the hospital efficiency of single-shot cryoballoon ablation (CBA) and point-by-point radiofrequency ablation (RFA).
Methods: The discrete event simulation used PVI procedure times from the FREEZE Cohort study to establish the electrophysiology (EP) lab occupancy time.
Background: Because of its antiarrhythmic potency and due to the lack of alternatives, amiodarone is often used for antiarrhythmic therapy in patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy-defibrillator systems. To date, robust data on the safety and clinical benefit of amiodarone therapy in these patients are missing.
Objective: The purpose of this study was to assess the periprocedural and postprocedural outcomes of combined therapy with beta-blockers plus amiodarone compared to treatment with single beta-blockers in the "real-life" cohort of ICD recipients of the German DEVICE registry.