Publications by authors named "Thomas M Melchior"

Aims: Modern clinical management of patients with an implantable cardioverter defibrillator (ICD) largely consists of remote device monitoring, although a subset is at risk of mental health issues post-implantation. We compared a 12-month web-based intervention consisting of goal setting, monitoring of patients' mental health-with a psychological intervention if needed-psychoeducational support from a nurse, and an online patient forum, with usual care on participants' device acceptance 12 months after implantation.

Methods And Results: This national, multi-site, two-arm, non-blinded, randomized, controlled, superiority trial enrolled 478 first-time ICD recipients from all 6 implantation centres in Denmark.

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Background And Aim: There are a paucity of studies investigating workforce affiliation in connection with first-time implantable cardioverter defibrillator (ICD)-implantation. This study explored workforce affiliation and risk markers associated with not returning to work in patients with ICDs.

Methods: Using the nationwide Danish registers, patients with a first-time ICD-implantation between 2007 and 2017 and of working age (30-65 years) were identified.

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Background: SARS-CoV-2 may trigger both vasculitis and arrhythmias as part of a multisystem inflammatory syndrome described in children as well as in adults following COVID-19 infection with only minor respiratory symptoms. The syndrome denotes a severe dysfunction of one or more extra-pulmonary organ systems, with symptom onset approximately 2-5 weeks after the COVID-19 infection. In the present case, a seemingly intractable ventricular tachycardia preceded by SARS-CoV2 infection was only managed following the diagnosis and management of aortitis.

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Article Synopsis
  • A nationwide survey in Denmark assessed the awareness and adherence to driving restrictions among patients who received implantable cardioverter defibrillators (ICDs) between 2013 and 2016.
  • The study found that a significant number of respondents (between 28% and 58% depending on their situation) were unaware of the driving restrictions and over one-third resumed driving during prohibited periods.
  • Despite this, only 0.2% reported experiencing an ICD shock while driving, with a very low estimated risk of harm (0.0002% per person-year).
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Aims: Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications.

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Article Synopsis
  • The Danish Study (DANISH) aimed to evaluate the impact of implantable cardioverter-defibrillators (ICD) on health-related quality of life (HRQoL) in patients with non-ischaemic systolic heart failure, despite finding no overall effect on mortality.
  • In the study, 1116 patients were randomly assigned to receive either ICD implantation or standard care, with HRQoL assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) over 8 months.
  • Results indicated that there were no significant differences in HRQoL improvements between the ICD group and the control group, suggesting that ICD implantation did not enhance quality of life for these patients.
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Background: In Denmark and other countries, there has been a shift in the management of patients with an implantable cardioverter defibrillator (ICD) with remote device monitoring largely replacing in-hospital visits. Less patient-nurse and patient-physician interaction may lead to gaps in patients' quality of care and impede patients' adaptation to living successfully with the ICD. A comprehensive eHealth intervention that include goal-setting, monitoring of symptoms of depression, anxiety, and quality of life, psychological treatment, information provision, supportive tools, online dialogues with nursing staff and access to an online community network, may help fill these gaps and be particularly beneficial to patients who suffer from anxiety and depression.

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