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111. Velocity encoded cardiovascular magnetic resonance to assess left atrial appendage emptying

Author

Muellerleile Kai, Sultan Arian, Groth Michael, Steven Daniel, Hoffmann Boris, Adam Gerhard, Lund Gunnar K, Rostock Thomas, and Willems Stephan

Subjects
Left atrial appendage, Atrial fibrillation, Stroke, Cardiovascular magnetic resonance, Transesophageal echocardiography., Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background The presence of impaired left atrial appendage (LAA) function identifies patients who are prone to thrombus formation in the LAA and therefore being at high risk for subsequent cardioembolic stroke. LAA function is typically assessed by measurements of LAA emptying velocities using transesophageal echocardiography (TEE) in clinical routine. This study aimed at evaluating the feasibility of assessing LAA emptying by velocity encoded (VENC) cardiovascular magnetic resonance (CMR). Methods This study included 30 patients with sinus rhythm (n = 18) or atrial fibrillation (n = 12). VENC-CMR velocity measurements were performed perpendicular to the orifice of the LAA. Peak velocities were measured of passive diastolic LAA emptying (e-wave) in all patients. Peak velocities of active, late-diastolic LAA emptying (a-wave) were assessed in patients with sinus rhythm. Correlation and agreement was analyzed between VENC-CMR and TEE measurements of e- and a-wave peak velocities. Results A significant correlation and good agreement was found between VENC-CMR and TEE measurements of maximal e-wave velocities (r = 0.61, P Conclusions The assessment of active and passive LAA emptying by VENC-CMR is feasible. Further evaluation is required of potential future clinical applications such as risk stratification for cardioembolic stroke.

Published
2012
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112. Predictors of successful complex catheter ablation for persistent atrial fibrillation despite failure of targeted procedural arrhythmia termination

Author

Spittler, Raphael, primary, Bahlke, Fabian, additional, Hoffmann, Boris A., additional, Theis, Cathrin, additional, Mollnau, Hanke, additional, Marx, Alexandra, additional, Ocete, Blanca Quesada, additional, Ilioska, Pamela, additional, Lange, Björn, additional, Konrad, Torsten, additional, and Rostock, Thomas, additional

Published
2019
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113. Long‐term efficacy and safety of radiofrequency catheter ablation of atrial fibrillation in patients with cardiac implantable electronic devices and transvenous leads

Author

Dinshaw, Leon, primary, Schäffer, Benjamin, additional, Akbulak, Özge, additional, Jularic, Mario, additional, Hartmann, Jens, additional, Klatt, Niklas, additional, Dickow, Jannis, additional, Gunawardene, Melanie, additional, Münkler, Paula, additional, Hakmi, Samer, additional, Pecha, Simon, additional, Sultan, Arian, additional, Lüker, Jakob, additional, Pinnschmidt, Hans, additional, Hoffmann, Boris, additional, Gosau, Nils, additional, Eickholt, Christian, additional, Willems, Stephan, additional, Steven, Daniel, additional, and Meyer, Christian, additional

Published
2019
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115. The role of the multidisciplinary health care team in the management of patients with Marfan syndrome

Author

von Kodolitsch,Yskert, Rybczynski,Meike, Vogler,Marina, Mir,Thomas, Schüler,Helke, Kutsche,Kerstin, Rosenberger,Georg, Detter,Christian, Bernhardt,Alexander M., Larena-Avellaneda,Axel, Kölbel,Tilo, Debus,E. Sebastian, Schroeder,Malte, Linke,Stephan J., Fuisting,Bettina, Napp,Barbara, Kammal,Anna, Püschel,Klaus, Bannas,Peter, Hoffmann,Boris, Gessler,Nele, Vahle-Hinz,Eva, Kahl-Nieke,Bärbel, Thomalla,Götz, Weiler-Normann,Christina, Ohm,Gunda, Neumann,Stefan, Benninghoven,Dieter, Blankenberg,Stefan, and Pyeritz,Reed E.

Subjects
Journal of Multidisciplinary Healthcare
Abstract

Yskert von Kodolitsch,1 Meike Rybczynski,1 Marina Vogler,2 Thomas S Mir,3 Helke Schüler,1 Kerstin Kutsche,4 Georg Rosenberger,4 Christian Detter,5 Alexander M Bernhardt,5 Axel Larena-Avellaneda,6 Tilo Kölbel,6 E Sebastian Debus,6 Malte Schroeder,7,8 Stephan J Linke,9,10 Bettina Fuisting,9 Barbara Napp,1 Anna Lena Kammal,11 Klaus Püschel,11 Peter Bannas,12 Boris A Hoffmann,13 Nele Gessler,13 Eva Vahle-Hinz,14 Bärbel Kahl-Nieke,14 Götz Thomalla,15 Christina Weiler-Normann,16 Gunda Ohm,17 Stefan Neumann,18 Dieter Benninghoven,19 Stefan Blankenberg,1 Reed E Pyeritz20 1Clinic of Cardiology, University Heart Centre, 2Marfan Hilfe Deutschland e.V., Zentrumsehstärke, 3Clinic for Pediatric Cardiology, University Heart Centre, 4Institute of Human Genetics, 5Clinic of Cardiovascular Surgery, University Heart Centre, 6Clinic of Vascular Medicine, University Heart Centre, 7Department of Trauma, Hand, and Reconstructive Surgery, 8Department of Orthopedics, 9Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 10Smilow Center for Translational Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 11Department of Legal Medicine, 12Diagnostic and Interventional Radiology Department and Clinic, 13Clinic of Electrophysiology, University Heart Centre, 14Department of Orthodontics, Center for Dental and Oral Medicine, 15Clinic of Neurology, 16Martin Zeitz Center for Rare Diseases, 17Strategic Business Development, 18Business Unit Quality Management, University Medical Center Hamburg-Eppendorf, 19Mühlenberg-Clinic for Rehabilitation, Bad Malente-Gremsmühlen, 20Zentrumsehstärke, Hamburg, Germany Abstract: Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS. First, we show how the initiative and collaboration of patient representatives, scientists, and physicians resulted in the foundation of Marfan centers, initially in the US and later in Germany, and how and why such centers evolved over time. Then, we elucidate the three main structural elements; a team of coordinators, core disciplines, and auxiliary disciplines of health care. Moreover, we explain how a multidisciplinary health care team integrates into many other health care structures of a university medical center, including external quality assurance; quality management system; clinical risk management; center for rare diseases; aorta center; health care teams for pregnancy, for neonates, and for rehabilitation; and in structures for patient centeredness. We provide accounts of medical goals and standards for each core discipline, including pediatricians, pediatric cardiologists, cardiologists, human geneticists, heart surgeons, vascular surgeons, vascular interventionists, orthopedic surgeons, ophthalmologists, and nurses; and of auxiliary disciplines including forensic pathologists, radiologists, rhythmologists, pulmonologists, sleep specialists, orthodontists, dentists, neurologists, obstetric surgeons, psychiatrist/psychologist, and rehabilitation specialists. We conclude that a multidisciplinary health care team is a means to maximize therapeutic success. Keywords: multidisciplinary, Marfan syndrome, health care, team, profession, sociology, management

Published
2016

117. Sympathetic and Parasympathetic Coactivation Induces Perturbed Heart Rate Dynamics in Patients with Paroxysmal Atrial Fibrillation

Author

Eickholt, Christian, primary, Jungen, Christiane, additional, Drexel, Thomas, additional, Alken, Fares, additional, Kuklik, Pawel, additional, Muehlsteff, Jens, additional, Makimoto, Hisaki, additional, Hoffmann, Boris, additional, Kelm, Malte, additional, Ziegler, Dan, additional, Kloecker, Nikolaj, additional, Willems, Stephan, additional, and Meyer, Christian, additional

Published
2018
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119. Incidence of intracardiac thrombus formation prior to electrical cardioversion in respect to the mode of oral anticoagulation

Author

Schaeffer, Benjamin, primary, Rüden, Lea, additional, Salzbrunn, Tim, additional, Pinnschmidt, Hans O., additional, Akbulak, Ruken Özge, additional, Moser, Julia Magdalena, additional, Jularic, Mario, additional, Meyer, Christian, additional, Eickholt, Christian, additional, Sultan, Arian, additional, Lüker, Jakob, additional, Steven, Daniel, additional, Willems, Stephan, additional, and Hoffmann, Boris Alexander, additional

Published
2018
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120. Image integration into 3-dimensional-electro-anatomical mapping system facilitates safe ablation of ventricular arrhythmias originating from the aortic root and its vicinity

Author

Jularic, Mario, primary, Akbulak, Ruken Özge, additional, Schäffer, Benjamin, additional, Moser, Julia, additional, Nuehrich, Jana, additional, Meyer, Christian, additional, Eickholt, Christian, additional, Willems, Stephan, additional, and Hoffmann, Boris A, additional

Published
2017
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121. Local Electrical Dyssynchrony during Atrial Fibrillation: Theoretical Considerations and Initial Catheter Ablation Results

Author

Kuklik, Pawel, primary, Schäffer, Benjamin, additional, Hoffmann, Boris A., additional, Ganesan, Anand N., additional, Schreiber, Doreen, additional, Moser, Julia M., additional, Akbulak, Ruken Ö., additional, Sultan, Arian, additional, Steven, Daniel, additional, Maesen, Bart, additional, Schotten, Ulrich, additional, Meyer, Christian, additional, and Willems, Stephan, additional

Published
2016
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122. Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation

Author

Gunawardene, Melanie A., primary, Hoffmann, Boris A., additional, Schaeffer, Benjamin, additional, Chung, Da-Un, additional, Moser, Julia, additional, Akbulak, Ruken Oezge, additional, Jularic, Mario, additional, Eickholt, Christian, additional, Nuehrich, Jana, additional, Meyer, Christian, additional, and Willems, Stephan, additional

Published
2016
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123. Pulmonary Vein Isolation Versus Defragmentation: The CHASE-AF Clinical Trial

Author

Sultan, Arian, Vogler, Julia, Servatius, Helge Simon, Schreiber, Doreen, Schäffer, Benjamin, Hoffmann, Boris A, Willems, Stephan, Moser, Julia, Lüker, Jakob, and Steven, Daniel

Subjects
610 Medicine & health
Abstract

BACKGROUND Long-term success rates using ablation for persistent atrial fibrillation (AF) are disappointing and usually do not exceed 60%. OBJECTIVES This study sought to compare arrhythmia-free survival between pulmonary vein isolation (PVI) and a stepwise approach (full defrag) consisting of PVI, ablation of complex fractionated electrograms, and additional linear ablation lines in the setting of atrial tachycardias (AT) in patients with persistent AF after PVI. METHODS From November 2010 to February 2013, 205 patients (151 men; 61.7 ± 10.2 years of age) underwent de novo ablation for persistent AF. Subsequently, patients were prospectively randomized to either PVI alone (n = 78) or full defrag (n = 75), with 52 patients not randomized due to AF termination with the original PVI. The primary endpoint was recurrence of any AT after a blanking period of 3 months. RESULTS During the entire study, 241 ablations were performed (mean: 1.59 in the PVI-alone group, 1.55 in the full-defrag group). With the stepwise approach, termination of AF occurred in 45 (60%) patients. However, arrhythmia-free survival did not differ whether patients underwent single or multiple procedures (p = 0.468). Procedure duration, fluoroscopy time, and radiofrequency duration were significantly longer in the full-defrag group (all p < 0.001). CONCLUSIONS A stepwise approach aimed at AF termination does not seem to provide additional benefit over PVI alone in patients with persistent AF, but it is associated with significantly longer procedural and fluoroscopic duration as well as radiofrequency application time. (The Randomized Catheter Ablation of Persist End Atrial Fibrillation Study [CHASE-AF]; NCT01580124).

Published
2015
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124. Characterization, Mapping, and Ablation of Complex Atrial Tachycardia: Initial Experience With a Novel Method of Ultra High‐Density 3D Mapping

Author

SCHAEFFER, BENJAMIN, primary, HOFFMANN, BORIS A., additional, MEYER, CHRISTIAN, additional, AKBULAK, RUKEN Ö., additional, MOSER, JULIA, additional, JULARIC, MARIO, additional, EICKHOLT, CHRISTIAN, additional, NÜHRICH, JANA M., additional, KUKLIK, PAWEL, additional, and WILLEMS, STEPHAN, additional

Published
2016
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125. Redefining the Blanking Period After Catheter Ablation for Paroxysmal Atrial Fibrillation

Author

Willems, Stephan, primary, Khairy, Paul, additional, Andrade, Jason G., additional, Hoffmann, Boris A., additional, Levesque, Sylvie, additional, Verma, Atul, additional, Weerasooriya, Rukshen, additional, Novak, Paul, additional, Arentz, Thomas, additional, Deisenhofer, Isabel, additional, Rostock, Thomas, additional, Steven, Daniel, additional, Rivard, Lena, additional, Guerra, Peter G., additional, Dyrda, Katia, additional, Mondesert, Blandine, additional, Dubuc, Marc, additional, Thibault, Bernard, additional, Talajic, Mario, additional, Roy, Denis, additional, Nattel, Stanley, additional, and Macle, Laurent, additional

Published
2016
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131. Atrial Fibrillation Complexity Parameters Derived From Surface ECGs Predict Procedural Outcome and Long-Term Follow-Up of Stepwise Catheter Ablation for Atrial Fibrillation

Author

Lankveld, Theo, primary, Zeemering, Stef, additional, Scherr, Daniel, additional, Kuklik, Pawel, additional, Hoffmann, Boris A., additional, Willems, Stephan, additional, Pieske, Burkert, additional, Haïssaguerre, Michel, additional, Jaïs, Pierre, additional, Crijns, Harry J., additional, and Schotten, Ulrich, additional

Published
2016
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132. Impact of Complete Versus Incomplete Circumferential Lines Around the Pulmonary Veins During Catheter Ablation of Paroxysmal Atrial Fibrillation

Author

Kuck, Karl-Heinz, primary, Hoffmann, Boris A., additional, Ernst, Sabine, additional, Wegscheider, Karl, additional, Treszl, Andras, additional, Metzner, Andreas, additional, Eckardt, Lars, additional, Lewalter, Thorsten, additional, Breithardt, Günter, additional, and Willems, Stephan, additional

Published
2016
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133. Pulmonary Vein Isolation Versus Defragmentation

Author

Vogler, Julia, primary, Willems, Stephan, additional, Sultan, Arian, additional, Schreiber, Doreen, additional, Lüker, Jakob, additional, Servatius, Helge, additional, Schäffer, Benjamin, additional, Moser, Julia, additional, Hoffmann, Boris A., additional, and Steven, Daniel, additional

Published
2015
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136. Catheter ablation of persistent and long-standing persistent atrial fibrillation. Strategies and results

Author

Steven, Daniel, Sultan, Arian, Schäffer, Benjamin, Servatius, Helge, Hoffmann, Boris, Lüker, Jakob, and Willems, Stephan

Subjects
610 Medicine & health
Abstract

Catheter ablation for paroxysmal atrial fibrillation is a meanwhile established therapy option, which is most frequently performed using radiofrequency ablation. Mid-term success rate of 70 % are achievable with a single ablation procedure. However, the mechanistics of persistent atrial fibrillation are less well understood and catheter ablation is a far more challenging procedure. Different ablation approaches are being performed to treat persistent atrial fibrillation ranging from sole pulmonary vein isolation to additional ablation of fractionated electrograms aiming for termination of atrial fibrillation. Thus far, it has not been investigated which strategy is most successful in treating persistent atrial fibrillation. After extended ablation of atrial fibrillation, occurrence of organized atrial arrhythmias is not uncommon and can be successfully ablated. These consecutive arrhythmias can be considered as a next step towards stable sinus rhythm after repeat ablation. Improvement of mapping methods as well as a better understanding of mechanisms of atrial fibrillation may increase success rate of catheter ablation of persistent atrial fibrillation and may also help to improve success rate of these complex procedures.

Published
2013

137. The T-peak-to-T-end interval: a novel ECG marker for ventricular arrhythmia and appropriate ICD therapy in patients with hypertrophic cardiomyopathy.

Author

Dinshaw, Leon, Münch, Julia, Dickow, Jannis, Lezius, Susanne, Willems, Stephan, Hoffmann, Boris A., and Patten, Monica

Abstract

Introduction: Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of sudden cardiac death (SCD) primarily due to ventricular arrhythmia (VA). In patients (pts.) with a high risk of SCD, the implantation of an intracardiac cardioverter defibrillator (ICD) is thus indicated. Previous studies suggest that a prolonged interval between the peak and the end of the T wave, T-peak to T-end (TpTe), is associated with an elevated risk of VA and SCD in various clinical settings. The aim of our study was to evaluate the association between TpTe and VA in HCM pts. with a previously implanted ICD.Methods: In 40 HCM pts. (51.4 ± 16.4 years; 62.5% men), TpTe was measured using the baseline digital standard resting 12-lead ECG during sinus rhythm. VA was assessed by device follow-up.Results: Within 41.8 ± 35.1 months, 7 (17.5%) pts. had VA leading to appropriate therapy (AT), 7 pts. (17.5%) had non-sustained VA, and 26 pts. (65.0%) had no VA. The maximum TpTe was significantly prolonged in pts. with VA leading to AT compared to pts. without VA (101.3 ± 19.6 vs. 79.9 ± 15.3 ms; p = 0.004). Maximum TpTe was associated with an elevated risk of VA leading to AT (hazard ratio per 10 ms increase 1.63; 95% CI 1.04–2.54; p = 0.031) and pts. with a maximum TpTe ≤ 78 ms were without any VA leading to AT during follow-up. There was no correlation of maximum TpTe to other clinical parameters in our patient cohort.Conclusion: A prolonged TpTe is associated with VA and AT in HCM. Our findings suggest that TpTe can possibly serve as a marker for ventricular arrhythmogenesis in pts. with HCM and assessment of TpTe might, therefore, optimize SCD risk stratification. [ABSTRACT FROM AUTHOR]

Published
2018
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138. Leitfaden Rettungsdienst

Author

Bert, Alfons, Hoffmann, Boris, Flake, Frank, Bert, Alfons, Hoffmann, Boris, and Flake, Frank

Subjects
Emergency medicine--Handbooks, manuals, etc, Emergency medical technicians--Handbooks, manuals, etc
Abstract

Hier finden Sie geballte Rettungsdienst-Fachkompetenz für Praxis und Ausbildung. Genial einfach strukturiert, bietet der Leitfaden Rettungsdienst sofortige Orientierung, z.B. durch Algorithmen, Wegweiser an Scheidewegen, Entscheidungskriterien (z.B. zum Nachfordern des Notarztes), Pharmaprofile der wichtigsten'Notfall-'Medikamente etc. Jetzt neu in der 5. Auflage!NEU in der 5. Auflage:- Reanimationsrichtlinien 2010 nach ERC- Aktualisierung nach neuen Richtlinien, u.a. Traumatologie- Zahlreiche Arbeitstechniken, u. a. MAD, EZ-IO

Published
2011

139. Implantable loop recorder monitoring after concomitant surgical ablation for atrial fibrillation (AF): insights from more than 200 continuously monitored patients

Author

Pecha, Simon, primary, Aydin, Muhammet Ali, additional, Ahmadzade, Teymour, additional, Hartel, Friederike, additional, Hoffmann, Boris, additional, Steven, Daniel, additional, Willems, Stephan, additional, Reichenspurner, Hermann, additional, and Wagner, Florian Mathias, additional

Published
2015
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140. Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation

Author

AKBULAK, RUKEN ÖZGE, primary, SCHÄFFER, BENJAMIN, additional, JULARIC, MARIO, additional, MOSER, JULIA, additional, SCHREIBER, DOREEN, additional, SALZBRUNN, TIM, additional, MEYER, CHRISTIAN, additional, EICKHOLT, CHRISTIAN, additional, KUKLIK, PAWEL, additional, HOFFMANN, BORIS A., additional, and WILLEMS, STEPHAN, additional

Published
2015
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141. Five-Year Follow-Up After Catheter Ablation of Persistent Atrial Fibrillation Using the Stepwise Approach and Prognostic Factors for Success

Author

Schreiber, Doreen, primary, Rostock, Thomas, additional, Fröhlich, Max, additional, Sultan, Arian, additional, Servatius, Helge, additional, Hoffmann, Boris A., additional, Lüker, Jakob, additional, Berner, Imke, additional, Schäffer, Benjamin, additional, Wegscheider, Karl, additional, Lezius, Susanne, additional, Willems, Stephan, additional, and Steven, Daniel, additional

Published
2015
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142. Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry

Author

Nührich, Jana Mareike, primary, Kuck, Karl-Heinz, additional, Andresen, Dietrich, additional, Steven, Daniel, additional, Spitzer, Stefan G., additional, Hoffmann, Ellen, additional, Schumacher, Burghard, additional, Eckardt, Lars, additional, Brachmann, Johannes, additional, Lewalter, Thorsten, additional, Hochadel, Matthias, additional, Senges, Jochen, additional, Willems, Stephan, additional, and Hoffmann, Boris A., additional

Published
2014
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144. Impact of biatrial defragmentation in patients with paroxysmal atrial fibrillation: Results from a randomized prospective study

Author

Nührich, Jana Mareike, primary, Steven, Daniel, additional, Berner, Imke, additional, Rostock, Thomas, additional, Hoffmann, Boris, additional, Servatius, Helge, additional, Sultan, Arian, additional, Lüker, Jakob, additional, Treszl, András, additional, Wegscheider, Karl, additional, and Willems, Stephan, additional

Published
2014
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147. Observational Cohort Study of Ventricular Arrhythmia in Adults with Marfan Syndrome Caused by FBN1 Mutations

Author

Aydin, Ali, primary, Adsay, Baran A., additional, Sheikhzadeh, Sara, additional, Keyser, Britta, additional, Rybczynski, Meike, additional, Sondermann, Claudia, additional, Detter, Christian, additional, Steven, Daniel, additional, Robinson, Peter N., additional, Berger, Jürgen, additional, Schmidtke, Jörg, additional, Blankenberg, Stefan, additional, Willems, Stephan, additional, von Kodolitsch, Yskert, additional, and Hoffmann, Boris A., additional

Published
2013
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148. Impact of Structural Heart Disease on the Acute Complication Rate in Atrial Fibrillation Ablation: Results from the German Ablation Registry

Author

HOFFMANN, BORIS A., primary, KUCK, KARL‐HEINZ, additional, ANDRESEN, DIETRICH, additional, SPITZER, STEFAN G., additional, HOFFMANN, ELLEN, additional, SCHUMACHER, BURGHARD, additional, ECKARDT, LARS, additional, BRACHMANN, JOHANNES, additional, BECKER, RÜDIGER, additional, STEVEN, DANIEL, additional, ROSTOCK, THOMAS, additional, JÜNGER, CLAUS, additional, SENGES, JOCHEN, additional, and WILLEMS, STEPHAN, additional

Published
2013
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