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Article ; Online: From Bench to Bedside-Implementing the New ABC Approach for Atrial Fibrillation in an Emergency Department Setting.

Gupta, Sophie / Lutnik, Martin / Niederdöckl, Jan / Schnaubelt, Sebastian

International journal of environmental research and public health

2022 Volume 19, Issue 8

Abstract: Atrial fibrillation (AF) is a globally evolving medical challenge with, currently, 4% prevalence in the European Union's population [ ... ]. ...

Abstract	Atrial fibrillation (AF) is a globally evolving medical challenge with, currently, 4% prevalence in the European Union's population [...].
MeSH term(s)	Atrial Fibrillation/epidemiology ; Atrial Fibrillation/therapy ; Emergency Service, Hospital ; Humans ; Prevalence
Language	English
Publishing date	2022-04-15
Publishing country	Switzerland
Document type	Editorial ; Comment
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19084797
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Article ; Online: Immigration bias among medical students: a randomized controlled trial.

Grafeneder, Jürgen / Baewert, Andjela / Katz, Henri / Holzinger, Anita / Niederdoeckl, Jan / Roth, Dominik

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2023 Volume 30, Issue 6, Page(s) 417–423

Abstract: Background and importance: Racial bias is found in both physicians and medical students. Immigrants in many parts of the world face challenges similar to racial minorities. Identification of immigrants might however be more subtle than identification by ...

Abstract	Background and importance: Racial bias is found in both physicians and medical students. Immigrants in many parts of the world face challenges similar to racial minorities. Identification of immigrants might however be more subtle than identification by race, and currently, no data are available on a possible bias against the large minority group of migrants in Europe. Design: Randomized control trial. Settings and participants: Second-year medical students were randomized into four groups to watch a video of either a male or female patient with pain, with or without immigrant status. Intervention: Students were asked whether they would administer pain medication (primary outcome). Outcome measures and analysis: Immigrant status, patient's gender, student's gender, age, and language skills were covariates in a logistic regression model. Secondary outcomes included pain medication potency and the student's rating of the patient's pain intensity. Main results: We recruited 607 students [337 females (56%), 387 (64%) between 18 and 22 years old]. Analgesia was administered in 95% (n = 576). Immigrant status was not associated with the probability of receiving pain medication [95 vs. 95%, odds ratio (OR) 0.81, 95% confidence interval (CI) 0.39-1.70, P = 0.58]. Immigrants received high-potency analgesia less often (26 vs. 33%, OR 0.69, 95% CI 0.50-0.96, P = 0.03). Female students administered pain medication more frequently (96 vs. 93%, OR 2.29, 95% CI 1.05-5.02, P = 0.04), and rated the patients' pain higher (mean numeric rating scale 7.7, SD 0.9 vs. 7.4, SD 1.0, OR 1.36, 95% CI 1.16-1.60, P < 0.001). Conclusion: Medical students showed no immigration bias with regard to administering pain medication but were less likely to choose high-potency analgesia in immigrants. We also found a gender difference in pain management. These results demonstrate the importance of including knowledge about immigration bias in medical training.
MeSH term(s)	Humans ; Male ; Female ; Adolescent ; Young Adult ; Adult ; Emigration and Immigration ; Students, Medical ; Analgesia ; Pain ; Pain Management
Language	English
Publishing date	2023-08-25
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000001057
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Article ; Online: Excess short-term mortality in noncritical patients with atrial fibrillation presenting to the emergency department.

Niederdöckl, Jan / Schwameis, Michael / Herkner, Harald / Domanovits, Hans

Wiener klinische Wochenschrift

2021 Volume 133, Issue 15-16, Page(s) 802–805

Abstract: Background: Mortality data of non-critically ill patients presenting with symptomatic atrial fibrillation to an emergency department are scarce. We aimed to analyze the short-term mortality of these patients compared with that of the general Austrian ... ...

Abstract	Background: Mortality data of non-critically ill patients presenting with symptomatic atrial fibrillation to an emergency department are scarce. We aimed to analyze the short-term mortality of these patients compared with that of the general Austrian population. Design/methods: This study analyzed a consecutive series of non-critically ill adults presenting to the emergency department at the Medical University of Vienna between 2012 and 2016 with complaints related to atrial fibrillation. The study outcome was mortality during the observation period. Age-specific and sex-specific mortality rates per 100 person-years were calculated and compared with the mortality rates of the Austrian population during the same period. Results: In total, 1754 patients with atrial fibrillation (43.1% female) were included in the study. During a median follow-up of 25 months, 248 of these patients died. Observed mortality rates were 7.8 per 100 person-years for females (95% confidence interval, CI 6.6-9.5) and 5.9 per 100 person-years for males (95% CI 5.0-7.1). Age-adjusted and sex-adjusted mortality rates were 2.8 (95% CI 2.3-3.3) and 2.7 (95% CI 2.2-3.2) per 100 person-years, respectively. Mortality rates for the Austrian population were 1.1 per 100 person-years for both females and males. Corresponding standardized mortality ratios were 2.5 for females (95% CI 2.1-3.0) and 2.4 for males (95% CI 2.0-2.9). Conclusion: The short-term mortality of patients with symptomatic atrial fibrillation presenting to the emergency department was substantially higher compared with the general Austrian population.
MeSH term(s)	Adult ; Aged, 80 and over ; Atrial Fibrillation ; Austria ; Emergency Service, Hospital ; Female ; Humans ; Male
Language	English
Publishing date	2021-06-21
Publishing country	Austria
Document type	Journal Article
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-021-01895-y
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Article ; Online: Modern diagnostics in emergency medicine.

Niederdöckl, Jan / Buchtele, Nina / Schwameis, Michael / Domanovits, Hans

Wiener klinische Wochenschrift

2020 Volume 133, Issue 5-6, Page(s) 249–266

MeSH term(s)	Emergency Medical Services ; Emergency Medicine ; Emergency Service, Hospital ; Humans
Keywords	covid19
Language	English
Publishing date	2020-05-12
Publishing country	Austria
Document type	Journal Article
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-020-01657-2
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Article: Body Weight Counts-Cardioversion with Vernakalant or Ibutilide at the Emergency Department.

Lindmayr, Teresa / Schnaubelt, Sebastian / Sulzgruber, Patrick / Simon, Alexander / Niederdoeckl, Jan / Cacioppo, Filippo / Schuetz, Nikola / Domanovits, Hans / Spiel, Alexander Oskar

Journal of clinical medicine

2022 Volume 11, Issue 17

Abstract: Aim: Medication for the pharmacological cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) is applied either in a fixed dose or adapted to body weight. Individual body weight might be a relevant confounder for anti-arrhythmic treatment ... ...

Abstract	Aim: Medication for the pharmacological cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) is applied either in a fixed dose or adapted to body weight. Individual body weight might be a relevant confounder for anti-arrhythmic treatment success. Therefore, the aim of this study was to elucidate the impact of body weight on pharmacological cardioversion success, comparing weight adapted (Vernakalant) and fixed dose (Ibutilide) pharmacotherapeutic cardioversion regimes. Methods: Within this prospective observational trial, a total of 316 episodes of AF and AFL were enrolled. Patients were stratified in either a Vernakalant ( Results: Conversion to sinus rhythm was achieved in 76.3% of all cases. Of note, there was no difference comparing the Vernakalant and Ibutilide treatment arms (Vernakalant 76.2% vs. Ibutilide 76.3%; Conclusion: Both, the Vernakalant and Ibutilide treatment arms showed comparable rates of treatment success in pharmacotherapeutic cardioversion of AF and AFL. Of utmost importance, we observed that the fixed dose of Ibutilide-as compared to the weight-adapted dose of Vernakalant-showed a reduced treatment success with increasing body weight.
Language	English
Publishing date	2022-08-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11175061
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Article: Computed Tomography to Exclude Cardiac Thrombus in Atrial Fibrillation-An 11-Year Experience from an Academic Emergency Department.

Gupta, Sophie / Lutnik, Martin / Cacioppo, Filippo / Lindmayr, Teresa / Schuetz, Nikola / Tumnitz, Elvis / Friedl, Lena / Boegl, Magdalena / Schnaubelt, Sebastian / Domanovits, Hans / Spiel, Alexander / Toth, Daniel / Varga, Raoul / Raudner, Marcus / Herkner, Harald / Schwameis, Michael / Niederdoeckl, Jan

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 7

Abstract: Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present ... ...

Abstract	Background: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present our experiences with this modality in recent years. Methods: This registry-based observational study was performed at the Department of Emergency Medicine at the Medical University of Vienna, Austria. We studied all consecutive patients with AF and AFL who underwent CT between January 2012 and January 2023 to rule out LAAT before cardioversion to sinus rhythm was attempted. Follow-ups were conducted by telephone and electronic medical records. The main variables of interest were the rate of LAAT and ischemic stroke at follow-up. Results: A total of 234 patients (143 [61%] men; median age 68 years [IQR 57-76], median CHA Conclusion: LAAT was rare in patients admitted to the ED with AF and AFL who underwent cardiac CT prior to attempted cardioversion. At follow-up, no patient had suffered an ischemic stroke. Prospective studies need to show whether this strategy is suitable for the acute treatment of symptomatic AF in the emergency setting.
Language	English
Publishing date	2024-03-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14070699
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Article ; Online: Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department.

Cacioppo, Filippo / Reisenbauer, Denise / Herkner, Harald / Oppenauer, Julia / Schuetz, Nikola / Niederdoeckl, Jan / Schnaubelt, Sebastian / Gupta, Sophie / Lutnik, Martin / Simon, Alexander / Spiel, Alexander O / Buchtele, Nina / Domanovits, Hans / Laggner, Anton N / Schwameis, Michael

JAMA network open

2022 Volume 5, Issue 10, Page(s) e2237234

Abstract: Importance: Whether the simultaneous intravenous administration of potassium and magnesium is associated with the probability of spontaneous conversion to sinus rhythm (SCV) in the acute treatment of atrial fibrillation (AF) and atrial flutter (AFL) is ... ...

Abstract	Importance: Whether the simultaneous intravenous administration of potassium and magnesium is associated with the probability of spontaneous conversion to sinus rhythm (SCV) in the acute treatment of atrial fibrillation (AF) and atrial flutter (AFL) is unknown. Objective: To assess potassium and magnesium administration and SCV probability in AF and AFL in the emergency department. Design, setting, and participants: A registry-based cohort study was conducted in the Department of Emergency Medicine of the Medical University of Vienna, Austria. All consecutive patients with AF or AFL were screened between February 6, 2009, and February 16, 2020. Interventions: Intravenous administration of potassium, 24 mEq, and magnesium, 145.8 mg. Main outcomes and measures: The primary outcome was the probability of SCV during the patient's stay in the emergency department. Multivariable cluster-adjusted logistic regression was used to estimate the association between potassium and magnesium administration and the probability of SCV. Results: A total of 2546 episodes of nonpermanent AF (median patient age, 68 [IQR, 58-75] years, 1411 [55.4%] men) and 573 episodes of nonpermanent AFL (median patient age, 68 [IQR, 58-75] years; 332 [57.9%] men) were observed. In AF episodes, intravenous potassium and magnesium administration vs no administration was associated with increased odds of SCV (19.2% vs 10.4%; odds ratio [OR], 1.98; 95% CI, 1.53-2.57). In AFL episodes, in contrast, no association was noted for the probability of SCV with potassium and magnesium vs no administration (13.0% vs 12.5%; OR, 1.05; 95% CI, 0.65-1.69). Conclusions and relevance: The findings of this registry-based cohort study on intravenous administration of potassium and magnesium suggest an increased probability of SCV in nonpermanent AF, but not AFL, during a patients' stay in the emergency department.
MeSH term(s)	Male ; Humans ; Aged ; Female ; Atrial Flutter/drug therapy ; Atrial Flutter/epidemiology ; Atrial Flutter/complications ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/complications ; Magnesium ; Cohort Studies ; Treatment Outcome ; Emergency Service, Hospital ; Potassium
Chemical Substances	Magnesium (I38ZP9992A) ; Potassium (RWP5GA015D)
Language	English
Publishing date	2022-10-03
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.37234
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Article ; Online: Cardioversion of Post-Ablation Atrial Tachyarrhythmia with Ibutilide and Amiodarone: A Registry-Based Cohort Study.

Cacioppo, Filippo / Schwameis, Michael / Schuetz, Nikola / Oppenauer, Julia / Schnaubelt, Sebastian / Simon, Alexander / Lutnik, Martin / Gupta, Sophie / Roth, Dominik / Herkner, Harald / Spiel, Alexander Oskar / Laggner, Anton Norbert / Domanovits, Hans / Niederdoeckl, Jan

International journal of environmental research and public health

2022 Volume 19, Issue 11

Abstract: Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the ... ...

Abstract	Patients with recurrence of atrial tachyarrhythmia after catheter ablation for atrial fibrillation or atrial flutter constitute a rapidly growing cohort, but study-driven treatment recommendations are lacking. The present study aimed to compare the cardioversion success of ibutilide and amiodarone in patients with post-ablation atrial tachyarrhythmia. We included all episodes of post-ablation atrial tachyarrhythmia in patients treated with either intravenous ibutilide or amiodarone at an academic emergency department from 2010 to 2018. The primary endpoint was the conversion to sinus rhythm. The conversion rates were stratified by arrhythmia type, and multivariable cluster-adjusted logistic regression was used to estimate the effect of ibutilide and amiodarone on cardioversion success, given as the odds ratio (OR) with 95% confidence intervals (95% CI). In total, 109 episodes of 72 patients were analyzed. The conversion rates were 37/49 (76%) for ibutilide and 16/60 (27%) for amiodarone. Compared to amiodarone, ibutilide was associated with higher odds of conversion (multivariable cluster-adjusted OR 5.6, 95% CI 1.3-24.3). The cardioversion success of ibutilide was the highest in atrial flutter (crude OR 19.5, 95% CI 3.4-112.5) and focal atrial tachycardia (crude OR 8.3, 95% CI 1.5-47.2), but it was less pronounced in atrial fibrillation (crude OR 4.5, 95% CI 1.2-17.2). Randomized trials are warranted to confirm our findings.
MeSH term(s)	Amiodarone/therapeutic use ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/drug therapy ; Atrial Flutter/drug therapy ; Cohort Studies ; Electric Countershock ; Humans ; Registries ; Sulfonamides ; Tachycardia/drug therapy ; Treatment Outcome
Chemical Substances	Anti-Arrhythmia Agents ; Sulfonamides ; ibutilide (2436VX1U9B) ; Amiodarone (N3RQ532IUT)
Language	English
Publishing date	2022-05-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19116606
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Article ; Online: Topically administered purified clinoptilolite-tuff for the treatment of cutaneous wounds: A prospective, randomised phase I clinical trial.

Deinsberger, Julia / Marquart, Elias / Nizet, Stephane / Meisslitzer, Claudia / Tschegg, Cornelius / Uspenska, Kateryna / Gouya, Ghazaleh / Niederdöckl, Jan / Freissmuth, Michael / Wolzt, Michael / Weber, Benedikt

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society

2022 Volume 30, Issue 2, Page(s) 198–209

Abstract: In an ageing society, chronic ulcers pose an increasingly relevant healthcare issue associated with significant morbidity and an increasing financial burden. Hence, there is an unmet medical need for novel, cost-effective therapies that improve healing ... ...

Abstract	In an ageing society, chronic ulcers pose an increasingly relevant healthcare issue associated with significant morbidity and an increasing financial burden. Hence, there is an unmet medical need for novel, cost-effective therapies that improve healing of chronic cutaneous wounds. This prospective, randomised, open-label, phase I trial investigated the safety and tolerability of topically administered purified clinoptilolite-tuff (PCT), mainly consisting of the naturally occurring zeolite-mineral clinoptilolite, in artificial wounds in healthy male volunteers compared to the standard of care (SoC). We found that topically administered PCT was safe for therapeutic application in acute wounds in healthy male volunteers. No significant differences in wound healing or wound conditions were observed compared to SoC-treated wounds. However, we found a significantly higher proportion of CD68-positive cells and a significantly lower proportion of α-smooth muscle actin-positive cells in PCT-treated wounds. Scanning electron microscopy revealed PCT particles in the restored dermis in some cases. However, these did not impede wound healing or clinical symptoms. Hence, purified PCT could represent an attractive, cost-effective wound treatment promoting the process of healing.
MeSH term(s)	Humans ; Male ; Prospective Studies ; Soft Tissue Injuries ; Wound Healing/physiology ; Zeolites/pharmacology
Chemical Substances	clinoptilolite (12173-10-3) ; Zeolites (1318-02-1)
Language	English
Publishing date	2022-01-27
Publishing country	United States
Document type	Clinical Trial, Phase I ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1174873-4
ISSN	1524-475X ; 1067-1927
ISSN (online)	1524-475X
ISSN	1067-1927
DOI	10.1111/wrr.12991
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Article: Hyperkalemia: A persisting risk. A case report and update on current management.

Schnaubelt, Sebastian / Niederdoeckl, Jan / Schoergenhofer, Christian / Cacioppo, Filippo / Schuetz, Nikola / Spiel, Alexander O / Hecking, Manfred / Domanovits, Hans

Clinical case reports

2020 Volume 8, Issue 9, Page(s) 1748–1753

Abstract: We report a case of hemodynamic instability due to bradycardia on the basis of severe hyperkalemia. Diabetic ketoacidosis and acute kidney injury together with polypharmacy triggered the acute onset. Potentially life-threatening hyperkalemia is often ... ...

Abstract	We report a case of hemodynamic instability due to bradycardia on the basis of severe hyperkalemia. Diabetic ketoacidosis and acute kidney injury together with polypharmacy triggered the acute onset. Potentially life-threatening hyperkalemia is often induced by drug interactions. ECG features may be crucial for diagnosis, and treatment depends on setting and resources.
Language	English
Publishing date	2020-06-02
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.2974
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