Publications by authors named "Stephanie Fichtner"

Article Synopsis
  • * 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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Introduction: Infection is a significant complication of cardiac implantable electronic device (CIED) therapy. The European TauroPace™ Registry investigates the safety and efficacy of TauroPace™ (TP), an antimicrobial solution containing taurolidine, designed to prevent CIED infections.

Methods: This multicenter study included patients undergoing CIED procedures at participating centers where TP was used as a disinfectant for external hardware surfaces and an antiseptic for irrigating surgical sites.

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Background: Current standards of ablation of premature ventricular complexes (PVC) combine modern hard- and software mapping and ablation features like multielectrode mapping catheters (MEC), contact force (CF) guided ablation catheters and pattern matching filters (PMF). Benefits of these individual tools were described for selected patients with PVC, but data on combination of these features in the real world setting is sparse.

Methods: Between 2015 and 2021 we retrospectively enrolled 172 consecutive patients undergoing PVC ablation in our center.

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Background: Implantable electronic cardiac devices (CIED) have emerged as an essential component in the treatment of cardiac arrhythmias and heart failure. Due to increased life expectancy, expanding indications and limited technical survival, an increasing number of revision procedures can be anticipated. Venous access site occlusion (VASO) is the main obstacle during revision surgery.

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Background: Treatment with wearable cardioverter defibrillators (WCD) is a non-invasive, transient therapy option for prevention of sudden cardiac death (SCD) in patients with temporary contraindications for implantation of a permanent cardioverter defibrillator. Due to the constant risk of fatal arrhythmias, compliance is the fundamental requirement for effectiveness of a WCD, but this might be hindered by the poor quality-of-life (QoL) during WCD therapy. In this retrospective single-center study, we examined if a standardized WCD training and adherence surveillance programme could enhance compliance and QoL.

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Background: The subcutaneous cardioverter defibrillator (S-ICD) has been shown to be a viable alternative to transvenous ICDs (TV-ICD) in all patients at risk of sudden cardiac death (SCD) but without pacing indication.

Aim: The aim of this study was to examine the impact of therapy with current S-ICD devices on quality of life (QoL) in comparison to patients with TV-ICD devices.

Methods: In our single-centre study, 52 consecutive patients with S-ICD and 52 matched patients with TV-ICD were analysed.

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Article Synopsis
  • * Effective survival depends on quick cardiopulmonary resuscitation and the use of external defibrillators for patients with shockable rhythms, but current response systems still show unsatisfactory outcomes.
  • * Recent studies, particularly the TTM2 trial, suggest that targeting lower body temperatures (33 °C) for post-resuscitation care does not improve neurological outcomes compared to maintaining normal body temperature (36 °C to 37.5 °C), indicating a need to revise current temperature management guidelines.
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Background: Symptoms caused by cardiac arrhythmia are common problems that lead to presentation to the emergency department. However, the prevalence of pathological heart rhythm in patients triaged for cardiac arrhythmia in the emergency department remains up to now unknown.

Methods And Results: In this retrospective study, patients triaged for cardiac arrhythmia admitted to the interdisciplinary emergency department of the Ludwig-Maximilians University Hospital in Munich within 1 year were included.

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Postmortal interrogation of cardiac implantable electrical devices (CIED) may contribute to the determination of time of death in forensic medicine. Recent studies aimed to improve estimation of time of death by combining findings from autopsy, CIED interrogation and patients´ medical history. CIED from deceased undergoing forensic autopsy were included, if time of death remained unclear after forensic assessment.

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The Impella device (Impella, Abiomed, Danvers, MA) is a percutaneous transvalvular microaxial flow pump that is currently used for (1) cardiogenic shock, (2) left ventricular unloading (combination of venoarterial extracorporeal membrane oxygenation and Impella concept), (3) high-risk percutaneous coronary interventions, (4) ablation of ventricular tachycardia, and (5) treatment of right ventricular failure. Impella-assisted forward blood flow increased mean arterial pressure and cardiac output, peripheral tissue perfusion, and coronary blood flow in observational studies and some randomized trials. However, because of the need for large-bore femoral access (14 F for the commonly used Impella CP device) and anticoagulation, the incidences of bleeding and ischemic complications are as much as 44% and 18%, respectively.

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Introduction: Catheter ablation is the treatment of choice for recurrent focal atrial tachycardia (FAT) as medical therapy is limited. Routinely, a three-dimensional mapping system is used. Whether or not optimized signal detection does improve ablation success rates has not yet been investigated.

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Conduction disorders with need for permanent pacemaker (PPM) implantation remain frequent complications after transcatheter aortic valve implantation (TAVI). Up to 22% of PPM after TAVI are implanted for new onset left bundle branch block (LBBB) and atrioventricular block (AVB) I. However, clinical benefit and predictors of ventricular pacing in TAVI patients receiving PPM for this indication remain unclear.

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Objectives: The heart rate score (HRS) serves as a device-based measure of impaired heart rate variability and is an independent predictor of death in patients with heart failure and a cardiac implantable electrical device. However, no data are available for predicting death from the HRS in patients with end stage heart failure and a left ventricular assist device.

Methods: From November 2011 to July 2018, a total of 56 patients with a pre-existing cardiac implantable electrical device underwent left ventricular assist device implantation at our 2 study sites.

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Purpose: This study was designed to evaluate the electromagnetic interference (EMI) effects and safety of the new security screening millimetre wave body scanners (MWBSs) for patients with rare cardiac implantable electronic devices (CIEDs).

Methods: We identified 73 patients with either entirely subcutaneous implantable cardioverter-defibrillators (S-ICD) or leadless pacemakers (LPM) attending routine device follow-up. CIED programming was optimised for the detection of EMI occurrence, and high-voltage therapy was disabled.

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic threat of public health during the last month causing more than 10 million infections and 500 000 deceased patients worldwide. Nevertheless, data about risk of infection for health care workers are sparse.

Methods: In a large primary care facility, 151 workers underwent SARS-CoV-2 immunoglobulin G (IgG) testing.

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Cardiac rhythm monitoring plays an integral role in the diagnosis and treatment of various conditions. Technological developments of recent years have partly increased the ease of use and the availability of cardiac rhythm monitoring. Yet, the multitude of options has also added confusion.

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Background: Leadless pacemaker implantation rates are increasing worldwide. Until now leadless pacemaker dislocation and extraction has been rarely reported.

Case Summary: An 83-year-old patient with cardiac amyloidosis, chronic atrial fibrillation, and complete heart block was implanted with a leadless pacemaker (Micra, Medtronic).

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