Publications by authors named "Ward P J Jansen"
Inappropriate Therapy and Shock Rates Between the Subcutaneous and Transvenous Implantable Cardiac Defibrillator: A Secondary Analysis of the PRAETORIAN Trial.
Circ Arrhythm Electrophysiol
December 2024
Article Synopsis
- 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
Article Synopsis
- 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.
Article Synopsis
- The subcutaneous implantable cardioverter-defibrillator (S-ICD) was designed to reduce complications linked to traditional transvenous ICD (TV-ICD) therapy, such as lead issues and infections.
- The PRAETORIAN trial, which included 849 patients, found that while both devices had complications, the S-ICD group experienced fewer lead-related issues and systemic infections compared to the TV-ICD group.
- The trial results indicate that complications from the TV-ICD were more severe, often requiring invasive procedures, highlighting the S-ICD as a safer alternative for patients needing ICD therapy.
This was a head-to-head comparative study on different electrocardiogram (ECG)-based smartwatches and devices for atrial fibrillation detection. We prospectively included 220 patients scheduled for electrical cardioversion and recorded ECGs with 3 different devices (Withings Move ECG, Apple Watch 5, Kardia Mobile 6-leads) as well as the standard 12-lead ECG (gold standard), both before and after cardioversion. All atrial fibrillation detection algorithms had high accuracy (sensitivity and specificity: 91-99%) but were hampered by uninterpretable recordings (20-24%).
View Article and Find Full Text PDFEfficacy and Safety of Appropriate Shocks and Antitachycardia Pacing in Transvenous and Subcutaneous Implantable Defibrillators: Analysis of All Appropriate Therapy in the PRAETORIAN Trial.
Circulation
February 2022
Article Synopsis
- The PRAETORIAN trial compared the effectiveness of subcutaneous implantable cardioverter defibrillators (S-ICD) and transvenous implantable cardioverter defibrillators (TV-ICD), showing that S-ICD was noninferior in terms of inappropriate shocks and complications.
- A secondary analysis examined whether antitachycardia pacing in TV-ICD reduced appropriate shocks, particularly for patients with serious ventricular arrhythmias.
- Results indicated that S-ICD patients received appropriate therapy slightly more often than TV-ICD patients, but overall shock rates were comparable, with S-ICD demonstrating high shock efficacy.
Aims: Within the TeleCheck-AF project, numerous centres in Europe used on-demand photoplethysmography (PPG) technology to remotely assess heart rate and rhythm in conjunction with teleconsultations. Based on the TeleCheck-AF investigator experiences, we aimed to develop an educational structured stepwise practical guide on how to interpret PPG signals and to introduce typical clinical scenarios how on-demand PPG was used.
Methods And Results: During an online conference, the structured stepwise practical guide on how to interpret PPG signals was discussed and further refined during an internal review process.
Aims: TeleCheck-AF is a multicentre international project initiated to maintain care delivery for patients with atrial fibrillation (AF) during COVID-19 through teleconsultations supported by an on-demand photoplethysmography-based heart rate and rhythm monitoring app (FibriCheck®). We describe the characteristics, inclusion rates, and experiences from participating centres according the TeleCheck-AF infrastructure as well as characteristics and experiences from recruited patients.
Methods And Results: Three surveys exploring centre characteristics (n = 25), centre experiences (n = 23), and patient experiences (n = 826) were completed.