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  1. Article: Impact of atrial fibrillation on 1-year outcome in patients with implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator: results from the German DEVICE Registry.

    Feickert, Sebastian / Ewertsen, Niels Christian / Köbe, Julia / Kleemann, Thomas / Jehle, Joachim / Senges, Jochen / Hochadel, Matthias / Andresen, Dietrich / Stellbrink, Christoph / Eckardt, Lars / Spitzer, Stefan / Brachmann, Johannes / Ince, Hüseyin / D'Ancona, Giuseppe

    Journal of thoracic disease

    2024  Volume 16, Issue 3, Page(s) 1825–1835

    Abstract: 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 ... ...

    Abstract 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. We analysed a 1-year follow up of implanted patients with AF and with sinus rhythm (SR).
    Results: A total of 4,929 ICD/CRT patients are included in the present analysis: 946 (19.2%) were in AF and 3,983 (80.8%) were SR at time of device implantation. AF patients had a significantly more comorbid profile including older age {72 [interquartile range (IQR), 66-77]
    Conclusions: Our clinical data on an extended cohort of contemporary patients confirm the significant impact of AF, and its associated comorbidities, upon mortality and major adverse events after implantation of ICD/CRT.
    Language English
    Publishing date 2024-03-27
    Publishing country China
    Document type Journal Article
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd-23-274
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Vorhofflimmern und Grenzen der oralen Antikoagulation – für wen eignen sich Vorhofohrokkluder?

    Feickert, Sebastian / Ewertsen, Niels Christian / D'Ancona, Giuseppe / Öner, Alper / Ince, Hüseyin / Ortak, Jasmin

    Der Internist

    2021  Volume 63, Issue 2, Page(s) 230–237

    Abstract: Background: Patients with atrial fibrillation are at a significantly increased risk of thromboembolic events, especially ischemic strokes. Oral anticoagulation reduces this risk, but cannot be used in some patients for various reasons and is associated ... ...

    Title translation Atrial fibrillation and the limits of oral anticoagulation: for whom are left atrial appendage occluders suitable?
    Abstract Background: Patients with atrial fibrillation are at a significantly increased risk of thromboembolic events, especially ischemic strokes. Oral anticoagulation reduces this risk, but cannot be used in some patients for various reasons and is associated with a relevantly increased risk of bleeding. As an alternative for prophylaxis of thromboembolic events in patients with atrial fibrillation, there are different options of left atrial appendage closure.
    Aim: This article explains the possibilities of interventional atrial occlusion as well as the suitable patient clientele using an overview of the currently available systems for atrial occlusion, a guideline for patient selection and a summary of the current scientific data.
    Conclusion and available scientific data: In carefully selected patients suffering from atrial fibrillation with relative or absolute contraindications for oral anticoagulation, interventional closure of the atrial appendage is a safe alternative for prophylaxis against thromboembolic events. The currently available scientific evidence from randomized controlled trials is sparse. Nevertheless, extensive amounts of registry study data suggest a benefit, while the results of several large randomized controlled trials are expected in the coming years.
    MeSH term(s) Anticoagulants/adverse effects ; Atrial Appendage/surgery ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Humans ; Stroke/etiology ; Stroke/prevention & control ; Thromboembolism/etiology ; Thromboembolism/prevention & control ; Treatment Outcome
    Chemical Substances Anticoagulants
    Language German
    Publishing date 2021-11-11
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2913-0
    ISSN 1432-1289 ; 0020-9554
    ISSN (online) 1432-1289
    ISSN 0020-9554
    DOI 10.1007/s00108-021-01206-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Book ; Online ; Thesis: Die Katheterablation von Vorhofflimmern

    Ewertsen, Niels Christian [Verfasser]

    wie wichtig ist ein dreidimensionales Mappingverfahren?

    2012  

    Author's details Niels Christian Ewertsen
    Keywords Medizin, Gesundheit ; Medicine, Health
    Subject code sg610
    Language German
    Publisher Medizinische Fakultät Charité - Universitätsmedizin Berlin
    Publishing place Berlin
    Document type Book ; Online ; Thesis
    Database Digital theses on the web

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  4. Article ; Online: Left Atrial Appendage Conduction Jump for Real-Time Evaluation of Conduction Block Over the Anterior Mitral Annulus Line.

    Huemer, Martin / Wutzler, Alexander / Parwani, Abdul Shokor / Attanasio, Philipp / Heiderfazel, Salman / Ewertsen, Niels Christian / Haverkamp, Wilhelm / Boldt, Leif-Hendrik

    Journal of cardiovascular electrophysiology

    2015  Volume 26, Issue 7, Page(s) 730–736

    Abstract: Introduction: Evaluation of conduction over a linear ablation lesion at the anterior mitral annulus can be time-consuming and difficult during ongoing radiofrequency application. The purpose of this study was to validate conduction time from the ... ...

    Abstract Introduction: Evaluation of conduction over a linear ablation lesion at the anterior mitral annulus can be time-consuming and difficult during ongoing radiofrequency application. The purpose of this study was to validate conduction time from the beginning of the p wave and from the coronary sinus ostium to the left atrial appendage (LAA) as a new method of conduction block surveillance.
    Methods: Conduction across the anterior mitral annulus line was evaluated using a total of 55 patients. We verified completeness of conduction block by standard techniques including differential pacing, double potential mapping and activation mapping. Those methods were compared to the new method of observing an abrupt prolongation of conduction time into the LAA as well as a conduction sequence change on a circular multipolar mapping catheter placed inside the LAA during sinus rhythm.
    Results: Bidirectional conduction block across the ablated line was achieved in 51 (92.7%) of the patients. Prior to ablation, mean conduction time across the line was 59 ± 21 milliseconds. This value increased to 163 ± 43 milliseconds after a successful ablation. An abrupt prolongation of conduction time into the LAA of at least 50 milliseconds was observed in all patients at the moment when a complete conduction block was achieved. Additionally, a change of conduction sequence recorded with the multi-electrode catheter placed in the LAA was observed in all of these patients.
    Conclusions: A sudden jump of p wave and coronary sinus ostium to LAA conduction time together with a change of conduction sequence recorded with a multi-electrode catheter placed inside the LAA during sinus rhythm is a simple and reliable approach for beat-to-beat surveillance of conduction block across the anterior mitral annulus during radiofrequency ablation.
    MeSH term(s) Action Potentials ; Adult ; Aged ; Algorithms ; Atrial Appendage/physiopathology ; Atrial Appendage/surgery ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Atrial Flutter/diagnosis ; Atrial Flutter/physiopathology ; Atrial Flutter/surgery ; Cardiac Catheterization/instrumentation ; Cardiac Catheters ; Cardiac Pacing, Artificial ; Catheter Ablation/instrumentation ; Electrophysiologic Techniques, Cardiac/instrumentation ; Equipment Design ; Female ; Heart Conduction System/physiopathology ; Heart Conduction System/surgery ; Humans ; Male ; Middle Aged ; Mitral Valve/physiopathology ; Mitral Valve/surgery ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Retrospective Studies ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2015-07
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Validation Studies
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.12670
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: First-line catheter ablation of paroxysmal atrial fibrillation: outcome of radiofrequency vs. cryoballoon pulmonary vein isolation.

    Straube, Florian / Dorwarth, Uwe / Ammar-Busch, Sonia / Peter, Timo / Noelker, Georg / Massa, Thomas / Kuniss, Malte / Ewertsen, Niels Christian / Chun, Kyoung Ryul Julian / Tebbenjohanns, Juergen / Tilz, Roland / Kuck, Karl Heinz / Ouarrak, Taoufik / Senges, Jochen / Hoffmann, Ellen

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2015  Volume 18, Issue 3, Page(s) 368–375

    Abstract: Aims: First-line ablation prior to antiarrhythmic drug (AAD) therapy is an option for symptomatic paroxysmal atrial fibrillation (PAF); however, the optimal ablation technique, radiofrequency (RF), or cryoballoon (CB) has to be determined.: Methods ... ...

    Abstract Aims: First-line ablation prior to antiarrhythmic drug (AAD) therapy is an option for symptomatic paroxysmal atrial fibrillation (PAF); however, the optimal ablation technique, radiofrequency (RF), or cryoballoon (CB) has to be determined.
    Methods and results: The FREEZE Cohort Study compares RF and CB ablation. Treatment-naïve patients were documented in the FREEZEplus Registry. Periprocedural data and outcome were analysed. From 2011 to 2014, a total of 373/4184 (8.9%) patients with PAF naïve to AAD were identified. Pulmonary vein isolation (PVI) was performed with RF (n = 180) or CB (n = 193). In the RF group, patients were older (65 vs. 61 years, P < 0.01) compared with the CB group. The procedure time was significantly shorter and radiation exposure higher in the CB group. Major adverse events occurred in 1.6% (CB) and 3.7% (RF) of patients (P = 0.22). AF/atrial tachycardia (AT) recurrence until discharge was 4.5% (RF) and 8.5% (CB, P = 0.2). Follow-up (FU) ≥12 months was available in 99 (RF) and 107 (CB) patients. After 1.4 years of FU, freedom from AF/atrial tachycardia (AT) was 61% (RF) and 71% (CB, P = 0.11). In the RF group, more patients underwent cardioversion, and a trend for more repeat ablations was observed. Persistent phrenic nerve palsy was observed in one patient treated by CB.
    Conclusion: First-line ablation for PAF is safe and effective with either RF or CB. The procedure was faster with the CB, but the radiation exposure was higher. Although there was a trend for more recurrences and complications in the RF group, a more favourable risk profile in patients undergoing CB ablation might have biased the results.
    Clinicaltrialsgov identifier: NCT01360008.
    MeSH term(s) Action Potentials ; Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Catheter Ablation/adverse effects ; Cryosurgery/adverse effects ; Europe ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Operative Time ; Prospective Studies ; Pulmonary Veins/physiopathology ; Pulmonary Veins/surgery ; Radiation Dosage ; Radiation Exposure ; Recurrence ; Registries ; Reoperation ; Risk Factors ; South Africa ; Time Factors ; Treatment Outcome ; United States
    Language English
    Publishing date 2015-10-25
    Publishing country England
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euv271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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