Publications by authors named "Stefan Kaab"

In contemporary healthcare, effective risk stratification in the general population is vital amidst rising chronic disease rates and an ageing demographic. Deceleration Capacity of the heart rate (DC), derived from 24-hour Holter electrocardiograms, holds promise in risk stratification for cardiac patients. However, the potential of short-term electrocardiograms of five minutes duration for population screening has not been fully explored.

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In the modern era, cardiologists managing patients and families with cardiomyopathies need to be familiar with every stage of the diagnostic pathway from clinical phenotyping to the prescription and interpretation of genetic tests. This clinical consensus statement from the ESC Council for Cardiovascular Genomics aims to promote the integration of genetic testing into routine cardiac care of patients with cardiomyopathies, as recommended in the 2023 ESC guidelines for cardiomyopathies. The document describes the types of genetic tests currently available and provides advice on their prescription and for counselling after the return of genetic findings, including the approach in patients and families with variants of unknown significance.

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  • Inappropriate therapy (IAT) is a significant issue associated with implantable cardiac defibrillator (ICD) therapy, particularly highlighted in early subcutaneous ICD (S-ICD) studies which showed high rates of inappropriate shocks (IAS).
  • The PRAETORIAN trial, an international study with 849 patients, found no major differences in IAT and IAS rates between S-ICD and transvenous ICD (TV-ICD) groups, as both groups had similar cumulative incidences.
  • Key predictors for IAT varied between the two groups, with TV-ICD patients experiencing IAT mainly from supraventricular tachycardias, while S-ICD patients faced issues from cardiac oversensing
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Background: The right ventricle to pulmonary artery coupling (RV-PAc) describes the right ventricle's ability to adjust to an increased afterload. In case of transthyretin amyloid cardiomyopathy (ATTR-CM), impaired RV-PAc can result from increased left ventricular diastolic stiffness due to fibril deposition.

Objectives: While RV-PAc is a validated prognostic parameter in pulmonary arterial hypertension (PAH), its prognostic relevance in ATTR-CM remains unknown.

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  • The S-ICD was created to eliminate lead-related issues found in the TV-ICD, as it is an external device that sits under the skin rather than using leads inside the body.
  • This analysis comes from the PRAETORIAN trial, where patients were randomly assigned to either S-ICD or TV-ICD and assessed for quality of life through various questionnaires at different stages.
  • Results showed no significant differences in physical and mental well-being between the groups, but patients who experienced a shock recently reported lower social functioning and emotional health compared to those who did not.
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  • * Results showed no deaths, significant discomfort, or severe device malfunctions post-MRI, with only two instances of minor atrial arrhythmia, both in patients with MR-conditional pacemakers.
  • * The findings support that MRI can be safely conducted in patients with CIEDs without adverse effects or changes in device performance, following proper protocols and monitoring.
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Objectives: Teaching of ECG interpretation frequently relies on visual schemas. However, subsequent student ECG interpretation skills are often poor. Expertise research shows that expert looking patterns frequently deviate from the steps taught in schema learning.

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Introduction: Lately, mavacamten emerged as a new therapeutic option for symptomatic patients with obstructive hypertrophic cardiomyopathy (oHCM). Clinical trials revealed reduction of serum biomarkers, and left ventricular outflow tract (LVOT) obstruction, as well as an improvement in clinical symptoms and exercise capacity. Nevertheless, clinical experience and manageability of patients in a real-world setting is still lacking.

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  • The study investigates the link between sports-related physical activity and heart issues in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), noting that there's a lack of standard guidelines for assessing activity levels.
  • Researchers conducted a retrospective analysis of 124 ARVC patients, finding that higher levels of cumulative physical activity, particularly from sports, correlated with increased risks of heart failure and serious heart rhythm problems.
  • The results suggest that continuous tracking of physical activity can help identify risk levels for ARVC patients, highlighting that while sports activity is a significant factor, non-sports-related activities did not show a strong correlation with worsening heart conditions.
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  • The study investigates the relationship between serum calcium levels and ventricular repolarization time, specifically the QT and JT intervals, which are important for heart health.
  • Researchers conducted large-scale genome-wide analyses to explore potential interactions between calcium levels and genetic variants associated with QT and JT intervals, using over 122,000 participants.
  • The results showed limited evidence for the hypothesized calcium interaction effects, suggesting that other factors, such as rare genetic variations or environmental influences, likely play a larger role in the unexplained heritability of QT and JT intervals.
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Background: COVID-19 remains a challenge to individual health and healthcare resources worldwide. Telemedical surveillance might minimise hospitalisation and direct patient-physician contacts. Yet, randomised clinical trials evaluating telemedical management of COVID-19 patients are lacking.

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Aims: Reduced left atrial PITX2 is associated with atrial cardiomyopathy and atrial fibrillation (AF). PITX2 is restricted to left atrial cardiomyocytes (aCMs) in the adult heart. The links between PITX2 deficiency, atrial cardiomyopathy, and AF are not fully understood.

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Aims: Atrial fibrillation (AF) is common in heart failure (HF) and negatively impacts outcomes. The role of ablation-based rhythm control in patients with AF and HF with preserved (HFpEF) or mildly reduced ejection fraction (HFmrEF) is not known. The CABA-HFPEF-DZHK27 (CAtheter-Based Ablation of atrial fibrillation compared to conventional treatment in patients with Heart Failure with Preserved Ejection Fraction) trial will determine whether early catheter ablation for AF can prevent adverse cardiovascular outcomes in patients with HFpEF or HFmrEF.

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Background: The heart-to-mediastinum ratio (H/M-Ratio) of iodo-metaiodobenzylguanidine (I-MIBG) represents state-of-the-art assessment for sympathetic dysfunction in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to evaluate quantitative reconstruction of I-MIBG uptake and to demonstrate its correlation with echocardiographic parameters.

Methods: Cardiac innervation was assessed in 23 patients diagnosed with definite ARVC or borderline ARVC and 12 patients with other cardiac disease presenting arrhythmia, using quantitative I-MIBG Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) imaging.

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Background And Aims: Atherosclerosis is the main cause of stroke and coronary heart disease (CHD), both leading mortality causes worldwide. Proteomics, as a high-throughput method, could provide helpful insights into the pathological mechanisms underlying atherosclerosis. In this study, we characterized the associations of plasma protein levels with CHD and with carotid intima-media thickness (CIMT), as a surrogate measure of atherosclerosis.

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  • Genome-wide association studies (GWAS) have successfully identified genes linked to telomere length, but previous research hadn't validated these findings until now.
  • In a large analysis involving over 211,000 people, the study discovered five new signals linked to telomere length and highlighted the importance of blood/immune cells in this area.
  • The researchers confirmed that the genes KBTBD6 and POP5 truly affect telomere length by demonstrating that manipulating these genes can lengthen telomeres and that their regulation is crucial for understanding telomere biology.
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Background: Periodic repolarization dynamics (PRD) is an electrocardiographic biomarker that captures repolarization instability in the low frequency spectrum and is believed to estimate the sympathetic effect on the ventricular myocardium. High PRD indicates an increased risk for postischemic sudden cardiac death (SCD). However, a direct link between PRD and proarrhythmogenic autonomic remodeling has not yet been shown.

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Aims: Embolic stroke of undetermined source (ESUS) accounts for up to 20% of ischemic strokes annually. Undetected atrial fibrillation (AF) is one important potential underlying cause. For AF, oral anticoagulation has evolved as the most preferable means of secondary stroke prevention.

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Aims: Recent trial data demonstrate beneficial effects of active rhythm management in patients with atrial fibrillation (AF) and support the concept that a low arrhythmia burden is associated with a low risk of AF-related complications. The aim of this document is to summarize the key outcomes of the 9th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA).

Methods And Results: Eighty-three international experts met in Münster for 2 days in September 2023.

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  • The study aimed to investigate the actual rates of in-hospital complications (like mortality, major bleeding, and stroke) from catheter ablation procedures for atrial fibrillation (AF), atrial flutter (AFL), and ventricular tachycardia (VT) in four German hospitals from 2005 to 2020.
  • A total of 43,031 ablations were analyzed, revealing an overall low complication rate of 1.4%, with variations by procedure type: 1.1% for AF, 1.0% for AFL, and 5.3% for VT, while the total complication rate increased over time.
  • The study concluded that serious complications from these procedures are low and the true in
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Background: Atrial fibrillation (AF) is the most common arrhythmia and is associated with considerable morbidity and mortality. Ischaemic heart failure (IHF) remains one of the most common causes of AF in clinical practice. However, ischaemia-mediated mechanisms leading to AF are still incompletely understood, and thus, current treatment approaches are limited.

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Early detection of atrial fibrillation (AF) enables initiation of anticoagulation and early rhythm control therapy to reduce stroke, cardiovascular death, and heart failure. In a cross-sectional, observational study, we aimed to identify a combination of circulating biomolecules reflecting different biological processes to detect prevalent AF in patients with cardiovascular conditions presenting to hospital. Twelve biomarkers identified by reviewing literature and patents were quantified on a high-precision, high-throughput platform in 1485 consecutive patients with cardiovascular conditions (median age 69 years [Q1, Q3 60, 78]; 60% male).

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  • This study compares the effects of saline and balanced crystalloid solutions for fluid resuscitation in patients with cardiogenic shock, focusing on 30-day mortality rates and complications such as the need for renal replacement therapy.
  • The results showed no significant difference in overall mortality between the two groups (43.1% for saline vs. 43.0% for balanced crystalloids), but saline was linked to a higher incidence of renal replacement therapy and greater catecholamine use.
  • Notably, for patients with out-of-hospital cardiac arrest experiencing severe shock (high lactate levels), saline showed better outcomes with lower mortality rates compared to balanced crystalloids, suggesting that treatment choice may depend on specific patient conditions.
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