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1. Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial

Author

May, Andreas, Seitzer, Peter, Schmidt, Roland, Keta, Dritan, Janke, Viktoria, Schläger, Christian, André, Elisabeth, Brandt, Niels, Schön, Alexandra, Zollner, Alfred, Freyer, Luisa, Hamm, Wolfgang, Beil, Johannes, Strüven, Anna Katharina, Loew, Anja, Fichtner, Stephanie, Lange, Philipp, Krasniqi, Aresa, Grabmeier, Ulrich, Estner, Heidi, Bengel, Philipp, Lüthje, Lars, Kirova, Aleksandra, Fischer, Thomas, Bergau, Leonard, Herting, Jonas, Schlögl, Simon, Haarmann, Helge, Schlögl (Illes), Klaudia, Uecer, Ekrem, Sag, Sabine, Tafelmeier, Maria, Jungbauer, Carsten, Fredersdorf-Hahn, Sabine, Strack, Christina, Seither, Benedikt, Seegers, Joachim, Millenaar, Dominic, Wintrich, Jan, Fischer, Patrick, Buob, Axel, Razouk, Amjad, Demming, Thomas, Frank, Johanne, Kühl, Constantin, Ellendt, Ulrike, Sandrock, Sarah, Gänsbacher, Julia, Cupa, Janosch, Sinnecker, Daniel, Laugwitz, Karl-Ludwig, Steger, Alexander, Berkefeld, Anna, Schinke, Karin, Barthel, Petra, Dommasch, Michael, Amadei, Maiwand, Hindricks, Gerhard, Obradovic, Danilo, Döring, Michael, Bode, Kerstin, Hilbert, Sebastian, Löbe, Susanne, Knopp, Helge, König, Sebastian, John, Silke, Schöne, Katharina, Hartung, Philipp, Binner, Christian, Meyer-Zürn, Christine, Duckheim, Martin, Eick, Christian, Simpfle, Fabian, Schreieck, Jürgen, Mizera, Lars, Tscholl, Verena, Steinbeck, Lisa, Güc, Nadija, Schatz, Anne-Sophie, Attanasio, Philipp, Heuberger, Andrea, Roser, Mattias, Bellmann, Barbara, Nagel, Patrick, Biewener, Sebastian, Suhail, Saba, Juri, Benjamin, Meyer, Christian, Wiilems, Stephan, Jungen, Christiane, Schmitt, Susanne, Münkerer, Paula, Vogler, Julia, Kaiser, Lukas, Schäffer, Benjamin, Nies, Moritz, Tönnis, Tobias, Fluschnik, Nina, Grahn, Hanno, Waldeyer, Christoph, Kany, Shinwan, Sörensen, Nils Arne, Winkelmann, Simon, Akbulak, Özge, Gosau, Nils Arne, Würger, Tilman, Arnold, Natalie, Geßler, Nele, Jobs, Alexander, Münkler, Paula, Rausch, Stefan, Köster, Jelena, Brüggemann, Ben, Abdin, Amr, Wacker, Christian, Grotherr, Philipp, Fries, Bastian, Faust, Maximilian, Steuer, Stefanie, Swojanowsky, Patrick, Willems, Stephan, Portz, Nathaniel, Ujeyl, Amar, Krüger, Matthias, Gramlich, Robert, Köhler, Till, Sause, Armin, Nover, Ina, Ziakos, Athanasios-Panagiotis, Ciobanu, Veaceslav, Spelsberg, Norman, Siebermair, Johannes, Mahabadi, Amir-Abbas, Köhler, Miriam, Vonderlin, Nadine, Riesinger, Lisa, Abdiu, Edison, Bachmann, Anja, Frenzel, Marie, Hummel, Astrid, Lehnert, Kristin, Krüger, Anne, Busse, Franke, Napp, Andreas, Müller-Wieland, Dirk, Battermann, Simone, Lacour, Philipp, Trippel, Tobias, Beetz, Nick Lasse, Schleußner, Leonhard, Zach, Veronika, Rozados, Christina, Mudra, Harald, Staubach, Stephan, Illmann, Alexander, Joner, Michael, Bock, Matthias, Kolb, Christof, Koch, Tobias, Fröhlich, Rebecca, Lennerz, Carsten, Lenz, Tobias, Fuchs, Patrick, Freißmuth, Markus, Grebmer, Christian, Kuschyk, Jürgen, Kranert, Malte, Fastenrath, Fabian, Yücel, Gökhan, Rudic, Boris, Würfel, Sarah, Römer, Albrecht, Böhmer, Andreas, Honold, Jörg, Georgopoulos, Stamatis, Gleirscher, Lukas, Lederle, Susanne, Chaplygin, Artem, Pauschinger, Matthias, Brinker-Paschke, Andrea, Kropacek, Jana, Eckardt, Lars, Ellermann, Christian, Bode, Niklas, Reinke, Florian, Engelke, Hauke, Höllriegel, Robert, Woitek, Felix, Winzer, Ephraim, Ibrahim, Karim, Pflücke, Christian, Ende, Georg, Speiser, Uwe, Haußig, Stephan, Wachter, Rolf, Uhe, Tobias, Konrad, Torsten, Zitron, Edgar, Destani, Jeton, Fu, Fangyi, Al Said, Samer, Kaya, Ziya, Schgör, Wilfried, Senoner, Thomas, Bauer, Axel, Sappler, Nikolay, von Stülpnagel, Lukas, Klemm, Mathias, Schreinlechner, Michael, Wenner, Felix, Schier, Johannes, Al Tawil, Amani, Dolejsi, Theresa, Eiffener, Elodie, Bongarth, Christa, Stühlinger, Markus, Huemer, Martin, Gori, Tommaso, Wakili, Reza, Sahin, Riza, Schwinger, Robert, Lutz, Matthias, Luik, Armin, Gessler, Nele, Clemmensen, Peter, Linke, Axel, Maier, Lars S, Hinterseer, Martin, Busch, Mathias C, Blaschke, Florian, Sack, Stefan, Licka, Manuela, Tilz, Roland R, Ukena, Christian, Ehrlich, Joachim R, Zabel, Markus, Schmidt, Georg, Mansmann, Ulrich, Kääb, Stefan, Rizas, Konstantinos D, and Massberg, Steffen

Published
2022
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2. An investigation of equine injuries in Thoroughbred flat racing in North America

Author

Georgopoulos, Stamatis Panagiotis

Subjects
636.1, SF600 Veterinary Medicine
Abstract

The aim of this research work was to investigate and quantify the risk of fatal and fracture injury for Thoroughbreds participating in flat racing in the US and Canada so that horses at particular risk can be identified and the risk of fatal injury reduced. Risk factors associated with fatalities and fractures were identified and predictive models for both fatalities and fractures were developed and their performance was evaluated. Our analysis was based on 188,269 Thoroughbreds that raced on 89 racecourses reporting injuries to the Equine Injury Database (EID) in the US and Canada from 1st January 2009 to 31st December 2015. This included 2,493,957 race starts and 4,592,162 exercise starts. The race starts reported to the EID represented the starts for 90.0% of all official Thoroughbred racing events in the United States and Canada during the 7-year observation period. The annual average risk of fatal and fracture equine injuries for the period 2009 - 2015 was estimated and a description of the different injury types that resulted in fatalities and fractures was given, based on the cases recorded in the EID. Possible risk factors were pre-screened using univariable logistic regression models; risk factors with an association indicated by p < 0.20 were then included in a stepwise logistic regression selection process. A forward bidirectional elimination approach using Akaike's Information Criterion was utilised for the stepwise selection. We identified more than 20 risk factors that were found to be significantly associated with fatal injury (p < 0.05) and more than 20 risk factors associated with fracture injury, across the final multi-variable models. The risk factors identified are related to the horse’s previous racing history, the trainer, the race, the horse's expected performance and the horse's racing history. Five different algorithms were used to develop predictive models based on the data available from the period 2009 - 2014 for both fatal and fracture injuries. Firstly, we used Multivariable Logistic Regression, commonly used in risk factor analysis. Secondly, Improved Balanced Random Forests were developed, a machine learning algorithm based on a modification of the random forests algorithm. Because fatal injuries are extremely rare events, less than 2 instances per 1000 starts on average, balanced samples were used to develop the Random Forest model to deal with the class-imbalance problem. Furthermore, we trained an Artificial Neural Network with a single layer and two networks with deep architecture, a Deep Belief Network and a Stacked Denoising Autoencoder. As artificial neural networks and deep learning models have been successfully used to solve complex problems in a diverse field of domains we wanted to explore the possibility of using them to successfully predict equine injuries. The performance of each classifier was evaluated by calculating the Area Under the Receiver Operating Characteristic Curve (AUC), using the data available from 2015 for validation. AUC results ranged from 0.62 to 0.64 for the best performing algorithm and similar predictive results were obtained from the wide array of different models created. This is the first study to make use of the extensive information contained in the EID to identify risk factors associated with equine fatal and fracture injuries in the US and Canada for this period. To our knowledge, this is the largest retrospective observational study investigating the risk of equine fatal and fracture injuries during flat racing in the literature. This is also the first study to train logistic regression and machine learning models to predict equine injuries using such an extensive amount of data and a full year of horse racing events for prediction and evaluation. We believe the results could help identify horses at high risk of (fatal) injury on entering a race and inform the design and implementation of preventive measures aimed at minimising the number of Thoroughbreds sustaining fatal injuries during racing in North America.

Published
2017

5. The Tpeak − Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis

Author

Tse, Gary, Gong, Mengqi, Wong, Wing Tak, Georgopoulos, Stamatis, Letsas, Konstantinos P., Vassiliou, Vassilios S., Chan, Yat Sun, Yan, Bryan P., Wong, Sunny Hei, Wu, William K.K., Ciobanu, Ana, Li, Guangping, Shenthar, Jayaprakash, Saguner, Ardan M., Ali-Hasan-Al-Saegh, Sadeq, Bhardwaj, Aishwarya, Sawant, Abhishek C., Whittaker, Paula, Xia, Yunlong, Yan, Gan-Xin, and Liu, Tong

Published
2017
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8. Predictors of Adverse Outcomes in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy: A Meta-Analysis of Observational Studies

Author

Bazoukis, George, Letsas, Konstantinos P., Thomopoulos, Costas, Tse, Gary, Korantzopoulos, Panagiotis, Naka, Katerina K., Kalfakakou, Vassiliki, Vlachos, Konstantinos, Bazoukis, Xenophon, Papadatos, Stamatis S., Michelongona, Paschalia, Saplaouras, Athanasios, Georgopoulos, Stamatis, Karamichalakis, Nikolaos, Asvestas, Dimitris, Liu, Tong, Efremidis, Michael, Sideris, Antonios, Tsioufis, Costas, Baranchuk, Adrian, and Stavrakis, Stavros

Published
2019
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14. Low‐voltage areas detected by high‐density electroanatomical mapping predict recurrence after ablation for paroxysmal atrial fibrillation

Author

Vlachos, Konstantinos, Efremidis, Michael, Letsas, Konstantinos P., Bazoukis, George, Martin, Ruairidh, Kalafateli, Maria, Lioni, Louiza, Georgopoulos, Stamatis, Saplaouras, Athanasios, Efremidis, Theodore, Liu, Tong, Valkanas, Kosmas, Karamichalakis, Nikolaos, Asvestas, Dimitrios, and Sideris, Antonios

Published
2017
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15. Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial

Author

Bauer, Axel, primary, Sappler, Nikolay, additional, von Stülpnagel, Lukas, additional, Klemm, Mathias, additional, Schreinlechner, Michael, additional, Wenner, Felix, additional, Schier, Johannes, additional, Al Tawil, Amani, additional, Dolejsi, Theresa, additional, Krasniqi, Aresa, additional, Eiffener, Elodie, additional, Bongarth, Christa, additional, Stühlinger, Markus, additional, Huemer, Martin, additional, Gori, Tommaso, additional, Wakili, Reza, additional, Sahin, Riza, additional, Schwinger, Robert, additional, Lutz, Matthias, additional, Luik, Armin, additional, Gessler, Nele, additional, Clemmensen, Peter, additional, Linke, Axel, additional, Maier, Lars S, additional, Hinterseer, Martin, additional, Busch, Mathias C, additional, Blaschke, Florian, additional, Sack, Stefan, additional, Lennerz, Carsten, additional, Licka, Manuela, additional, Tilz, Roland R, additional, Ukena, Christian, additional, Ehrlich, Joachim R, additional, Zabel, Markus, additional, Schmidt, Georg, additional, Mansmann, Ulrich, additional, Kääb, Stefan, additional, Rizas, Konstantinos D, additional, Massberg, Steffen, additional, May, Andreas, additional, Seitzer, Peter, additional, Schmidt, Roland, additional, Keta, Dritan, additional, Janke, Viktoria, additional, Schläger, Christian, additional, André, Elisabeth, additional, Brandt, Niels, additional, Schön, Alexandra, additional, Zollner, Alfred, additional, Freyer, Luisa, additional, Hamm, Wolfgang, additional, Beil, Johannes, additional, Strüven, Anna Katharina, additional, Loew, Anja, additional, Fichtner, Stephanie, additional, Lange, Philipp, additional, Grabmeier, Ulrich, additional, Estner, Heidi, additional, Bengel, Philipp, additional, Lüthje, Lars, additional, Kirova, Aleksandra, additional, Fischer, Thomas, additional, Bergau, Leonard, additional, Herting, Jonas, additional, Schlögl, Simon, additional, Haarmann, Helge, additional, Schlögl (Illes), Klaudia, additional, Uecer, Ekrem, additional, Sag, Sabine, additional, Tafelmeier, Maria, additional, Jungbauer, Carsten, additional, Fredersdorf-Hahn, Sabine, additional, Strack, Christina, additional, Seither, Benedikt, additional, Seegers, Joachim, additional, Millenaar, Dominic, additional, Wintrich, Jan, additional, Fischer, Patrick, additional, Buob, Axel, additional, Razouk, Amjad, additional, Demming, Thomas, additional, Frank, Johanne, additional, Kühl, Constantin, additional, Ellendt, Ulrike, additional, Sandrock, Sarah, additional, Gänsbacher, Julia, additional, Cupa, Janosch, additional, Sinnecker, Daniel, additional, Laugwitz, Karl-Ludwig, additional, Steger, Alexander, additional, Berkefeld, Anna, additional, Schinke, Karin, additional, Barthel, Petra, additional, Dommasch, Michael, additional, Amadei, Maiwand, additional, Hindricks, Gerhard, additional, Obradovic, Danilo, additional, Döring, Michael, additional, Bode, Kerstin, additional, Hilbert, Sebastian, additional, Löbe, Susanne, additional, Knopp, Helge, additional, König, Sebastian, additional, John, Silke, additional, Schöne, Katharina, additional, Hartung, Philipp, additional, Binner, Christian, additional, Meyer-Zürn, Christine, additional, Duckheim, Martin, additional, Eick, Christian, additional, Simpfle, Fabian, additional, Schreieck, Jürgen, additional, Mizera, Lars, additional, Tscholl, Verena, additional, Steinbeck, Lisa, additional, Güc, Nadija, additional, Schatz, Anne-Sophie, additional, Attanasio, Philipp, additional, Heuberger, Andrea, additional, Roser, Mattias, additional, Bellmann, Barbara, additional, Nagel, Patrick, additional, Biewener, Sebastian, additional, Suhail, Saba, additional, Juri, Benjamin, additional, Meyer, Christian, additional, Wiilems, Stephan, additional, Jungen, Christiane, additional, Schmitt, Susanne, additional, Münkerer, Paula, additional, Vogler, Julia, additional, Kaiser, Lukas, additional, Schäffer, Benjamin, additional, Nies, Moritz, additional, Tönnis, Tobias, additional, Fluschnik, Nina, additional, Grahn, Hanno, additional, Waldeyer, Christoph, additional, Kany, Shinwan, additional, Sörensen, Nils Arne, additional, Winkelmann, Simon, additional, Akbulak, Özge, additional, Gosau, Nils Arne, additional, Würger, Tilman, additional, Arnold, Natalie, additional, Geßler, Nele, additional, Jobs, Alexander, additional, Münkler, Paula, additional, Rausch, Stefan, additional, Köster, Jelena, additional, Brüggemann, Ben, additional, Abdin, Amr, additional, Wacker, Christian, additional, Grotherr, Philipp, additional, Fries, Bastian, additional, Faust, Maximilian, additional, Steuer, Stefanie, additional, Swojanowsky, Patrick, additional, Willems, Stephan, additional, Portz, Nathaniel, additional, Ujeyl, Amar, additional, Krüger, Matthias, additional, Gramlich, Robert, additional, Köhler, Till, additional, Sause, Armin, additional, Nover, Ina, additional, Ziakos, Athanasios-Panagiotis, additional, Ciobanu, Veaceslav, additional, Spelsberg, Norman, additional, Siebermair, Johannes, additional, Mahabadi, Amir-Abbas, additional, Köhler, Miriam, additional, Vonderlin, Nadine, additional, Riesinger, Lisa, additional, Abdiu, Edison, additional, Bachmann, Anja, additional, Frenzel, Marie, additional, Hummel, Astrid, additional, Lehnert, Kristin, additional, Krüger, Anne, additional, Busse, Franke, additional, Napp, Andreas, additional, Müller-Wieland, Dirk, additional, Battermann, Simone, additional, Lacour, Philipp, additional, Trippel, Tobias, additional, Beetz, Nick Lasse, additional, Schleußner, Leonhard, additional, Zach, Veronika, additional, Rozados, Christina, additional, Mudra, Harald, additional, Staubach, Stephan, additional, Illmann, Alexander, additional, Joner, Michael, additional, Bock, Matthias, additional, Kolb, Christof, additional, Koch, Tobias, additional, Fröhlich, Rebecca, additional, Lenz, Tobias, additional, Fuchs, Patrick, additional, Freißmuth, Markus, additional, Grebmer, Christian, additional, Kuschyk, Jürgen, additional, Kranert, Malte, additional, Fastenrath, Fabian, additional, Yücel, Gökhan, additional, Rudic, Boris, additional, Würfel, Sarah, additional, Römer, Albrecht, additional, Böhmer, Andreas, additional, Honold, Jörg, additional, Georgopoulos, Stamatis, additional, Gleirscher, Lukas, additional, Lederle, Susanne, additional, Chaplygin, Artem, additional, Pauschinger, Matthias, additional, Brinker-Paschke, Andrea, additional, Kropacek, Jana, additional, Eckardt, Lars, additional, Ellermann, Christian, additional, Bode, Niklas, additional, Reinke, Florian, additional, Engelke, Hauke, additional, Höllriegel, Robert, additional, Woitek, Felix, additional, Winzer, Ephraim, additional, Ibrahim, Karim, additional, Pflücke, Christian, additional, Ende, Georg, additional, Speiser, Uwe, additional, Haußig, Stephan, additional, Wachter, Rolf, additional, Uhe, Tobias, additional, Konrad, Torsten, additional, Zitron, Edgar, additional, Destani, Jeton, additional, Fu, Fangyi, additional, Al Said, Samer, additional, Kaya, Ziya, additional, Schgör, Wilfried, additional, and Senoner, Thomas, additional

Published
2022
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16. Διαστρωμάτωση κινδύνου ασθενών με σύνδρομο Brugada

Author

Georgopoulos Stamatis

Subjects
Health Sciences, Επιστήμες Υγείας
Abstract

Ο αιφνίδιος καρδιακός θάνατος αποτελεί ένα τραγικό γεγονός. Ένα από τα νοσήματα που συσχετίζονται άμεσα με την εμφάνιση αιφνίδιου καρδιακού θανάτου είναι το σύνδρομο Brugada. Από το 1992, όταν περιγράφηκε για πρώτη φορά αυτή η κλινική οντότητα, έχει γίνει μεγάλη πρόοδος στην κατανόηση των παθοφυσιολογικών μηχανισμών του συνδρόμου, στη διάγνωση και στη θεραπεία. Η εμφύτευση απινιδιστή παραμένει έως σήμερα η αποτελεσματικότερη θεραπευτική παρέμβαση για την αποφυγή του αιφνίδιου καρδιακού θανάτου. Ωστόσο είναι μια παρέμβαση που δεν στερείται μακροχρόνιων επιπλοκών, οι οποίες επηρεάζουν τη νοσηρότητα και θνητότητα των ασθενών. Η απόφαση εμφύτευσης απινιδιστή εξαρτάται άμεσα από τον κίνδυνο που διατρέχει ένας ασθενής για την εμφάνιση αιφνίδιου καρδιακού θανάτου. Όπως είναι φανερό, η διαστρωμάτωση του κινδύνου των ασθενών είναι μείζονος σημασίας στη διαχείριση και αντιμετώπιση των ασθενών. Στη βιβλιογραφία υπάρχουν διαφορετικά και αντικρουόμενα δεδομένα σχετικά με την προγνωστική αξία διάφορων κλινικών, ηλεκτροκαρδιογραφικών ή ηλεκτροφυσιολογικών δεικτών και το συγκεκριμένο πεδίο παραμένει ασαφές. Η παρούσα μελέτη αφορά τη διαστρωμάτωση αρρυθμιολογικού κινδύνου των ασθενών με σύνδρομο Brugada με στόχο την ανεύρεση ενός πολυπαραγοντικού μοντέλου διαστρωμάτωσης που θα συνεισφέρει στη βελτιστοποίηση της αντιμετώπισης των ασθενών. Sudden cardiac death is a tragic event. One of the diseases that is directly associated with the occurrence of sudden cardiac death is Brugada syndrome. Since 1992, when this clinical entity was first described, much progress has been made in understanding the pathophysiological mechanisms of the syndrome, in diagnosis and in treatment. The implantation of a cardioverter-defibrillator remains to date the most effective therapeutic intervention to prevent sudden cardiac death. However, it is an intervention that is not devoid of long-term complications, which affect the morbidity and mortality of patients. The decision to implant a defibrillator depends directly on patient's risk of sudden cardiac death. As is obvious, the risk stratification is of major importance in the management and treatment of patients. In the literature there are different and conflicting data on the prognostic value of various clinical, electrocardiographic or electrophysiological markers and the specific field remains unclear. The present study concerns the stratification of arrhythmic risk of patients with Brugada syndrome with the aim of finding a multiparametric risk stratification model that will contribute to the optimization of the treatment of patients.

Published
2021

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Author

Georgopoulos Stamatis and Georgopoulos Stamatis

Abstract

Sudden cardiac death is a tragic event. One of the diseases that is directly associated with the occurrence of sudden cardiac death is Brugada syndrome. Since 1992, when this clinical entity was first described, much progress has been made in understanding the pathophysiological mechanisms of the syndrome, in diagnosis and in treatment. The implantation of a cardioverter-defibrillator remains to date the most effective therapeutic intervention to prevent sudden cardiac death. However, it is an intervention that is not devoid of long-term complications, which affect the morbidity and mortality of patients. The decision to implant a defibrillator depends directly on patient's risk of sudden cardiac death. As is obvious, the risk stratification is of major importance in the management and treatment of patients. In the literature there are different and conflicting data on the prognostic value of various clinical, electrocardiographic or electrophysiological markers and the specific field remains unclear. The present study concerns the stratification of arrhythmic risk of patients with Brugada syndrome with the aim of finding a multiparametric risk stratification model that will contribute to the optimization of the treatment of patients.

Published
2021

21. Atrial fibrillation in Brugada syndrome: Current perspectives

Author

Vlachos, Konstantinos, primary, Mascia, Giuseppe, additional, Martin, Claire A., additional, Bazoukis, George, additional, Frontera, Antonio, additional, Cheniti, Ghassen, additional, Letsas, Konstantinos P., additional, Efremidis, Micheal, additional, Georgopoulos, Stamatis, additional, Gkalapis, Charis, additional, Duchateau, Josselin, additional, Parmbrun, Thomas, additional, Derval, Nicholas, additional, Hocini, Mélèze, additional, Haissaguerre, Michel, additional, Jais, Pierre, additional, and Sacher, Frédéric, additional

Published
2020
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22. Clinical characteristics and long-term clinical course of patients with Brugada syndrome without previous cardiac arrest: a multiparametric risk stratification approach

Author

Letsas, Konstantinos P, primary, Bazoukis, George, additional, Efremidis, Michael, additional, Georgopoulos, Stamatis, additional, Korantzopoulos, Panagiotis, additional, Fragakis, Nikolaos, additional, Asvestas, Dimitrios, additional, Vlachos, Konstantinos, additional, Saplaouras, Athanasios, additional, Sakellaropoulou, Antigoni, additional, Mililis, Panagiotis, additional, Strempelas, Panagiotis, additional, Giannopoulos, Georgios, additional, Gavrielatos, Gerasimos, additional, Tzeis, Stylianos, additional, Kardamis, Christoforos, additional, Katsivas, Apostolos, additional, Deftereos, Spyridon, additional, Stavrakis, Stavros, additional, and Sideris, Antonios, additional

Published
2019
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23. Efficacy and safety of novel anticoagulants in the elderly

Author

Karamichalakis, Nikolaos, Georgopoulos, Stamatis, Vlachos, Konstantinos, Liatakis, Ioannis, Efremidis, Michael, Sideris, Antonios, and Letsas, Konstantinos P

Subjects
Efficacy, Review, Safety, Atrial fibrillation, Novel oral anticoagulants, Venous thromboembolism
Abstract

Atrial fibrillation and venous thromboembolism (VTE) are common disorders associated with maleficent thrombotic events, particularly in the elderly patients. Polypharmacy, co-morbidities, and altered pharmacokinetics, often present in these patients, render the use of anticoagulants quite challenging. Novel oral anticoagulants (NOACs) have recently emerged as alternatives to Vitamin K Antagonists (VKAs) and are gradually increasing their popularity mainly because of their fewer drug and food interactions and ease of use. Their effectiveness and safety has been well-established in the general population but the balance between benefit and harm in the elderly is still unclear. Routine use in these patients is uncommon. Accumulating data have shown that the benefit of NOACs is consistent among all age groups, featuring equal or greater efficacy in preventing thrombotic events. Excess bleedings were lower with NOACs in comparison to VKAs, but bleeding patterns were disparate among them and head to head comparison is not available. The present review highlights on the efficacy and safety of novel anticoagulants in the elderly population.

Published
2016

24. The T peak - T end interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis

Author

Tse, Gary, Gong, Mengqi, Wong, Wing Tak, Georgopoulos, Stamatis, Letsas, Konstantinos P, Vassiliou, Vassilios S, Chan, Yat Sun, Yan, Bryan P, Wong, Sunny Hei, Wu, William K K, Ciobanu, Ana, Li, Guangping, Shenthar, Jayaprakash, Saguner, Ardan M, Ali-Hasan-Al-Saegh, Sadeq, Bhardwaj, Aishwarya, Sawant, Abhishek C, Whittaker, Paula, Xia, Yunlong, Yan, Gan-Xin, Liu, Tong, University of Zurich, and Tse, Gary

Subjects
2737 Physiology (medical), 10209 Clinic for Cardiology, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine
Published
2017
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25. Safety, long-term outcomes and predictors of recurrence following a single catheter ablation procedure for atrial fibrillation

Author

Efremidis, Michael, primary, Letsas, Konstantinos P., additional, Georgopoulos, Stamatis, additional, Karamichalakis, Nikolaos, additional, Vlachos, Konstantinos, additional, Lioni, Louiza, additional, Bazoukis, George, additional, Saplaouras, Athanasios, additional, Sakellaropoulou, Antigoni, additional, Kolokathis, Angelos Michael, additional, Rokiza, Aikaterini, additional, Anagnostou, Aikaterini, additional, Valkanas, Kosmas, additional, and Sideris, Antonios, additional

Published
2018
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26. Meta-analysis of T peak –T end and T peak –T end /QT ratio for risk stratification in congenital long QT syndrome

Author

Tse, Gary, primary, Gong, Mengqi, additional, Meng, Lei, additional, Wong, Cheuk Wai, additional, Georgopoulos, Stamatis, additional, Bazoukis, George, additional, Wong, Martin C.S., additional, Letsas, Konstantinos P., additional, Vassiliou, Vassilios S., additional, Xia, Yunlong, additional, Baranchuk, Adrian M., additional, Yan, Gan-Xin, additional, and Liu, Tong, additional

Published
2018
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29. The T peak − T end interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis

Author

Tse, Gary, primary, Gong, Mengqi, additional, Wong, Wing Tak, additional, Georgopoulos, Stamatis, additional, Letsas, Konstantinos P., additional, Vassiliou, Vassilios S., additional, Chan, Yat Sun, additional, Yan, Bryan P., additional, Wong, Sunny Hei, additional, Wu, William K.K., additional, Ciobanu, Ana, additional, Li, Guangping, additional, Shenthar, Jayaprakash, additional, Saguner, Ardan M., additional, Ali-Hasan-Al-Saegh, Sadeq, additional, Bhardwaj, Aishwarya, additional, Sawant, Abhishek C., additional, Whittaker, Paula, additional, Xia, Yunlong, additional, Yan, Gan-Xin, additional, and Liu, Tong, additional

Published
2017
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30. Safety and efficacy of DOACs vs acenocoumarol in patients undergoing catheter ablation of atrial fibrillation

Author

Vlachos, Konstantinos, primary, Efremidis, Michael, additional, Bazoukis, George, additional, Letsas, Konstantinos P., additional, Saplaouras, Athanasios, additional, Georgopoulos, Stamatis, additional, Karamichalakis, Nikolaos, additional, Rokiza, Aikaterini, additional, Sakellaropoulou, Antigoni, additional, Kolokathis, Angelos Michail, additional, Efremidis, Theodoros, additional, Asvestas, Dimitrios, additional, and Sideris, Antonios, additional

Published
2017
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31. Right ventricular outflow tract high-density endocardial unipolar voltage mapping in patients with Brugada syndrome: evidence for electroanatomical abnormalities

Author

Letsas, Konstantinos P, primary, Efremidis, Michael, additional, Vlachos, Konstantinos, additional, Georgopoulos, Stamatis, additional, Karamichalakis, Nikolaos, additional, Asvestas, Dimitrios, additional, Valkanas, Kosmas, additional, Korantzopoulos, Panagiotis, additional, Liu, Tong, additional, and Sideris, Antonios, additional

Published
2017
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34. A meta-analysis on the prognostic significance of inferolateral early repolarization pattern in Brugada syndrome

Author

Georgopoulos, Stamatis, primary, Letsas, Konstantinos P, additional, Liu, Tong, additional, Kalafateli, Maria, additional, Korantzopoulos, Panagiotis, additional, Bürkle, Gerd, additional, Vlachos, Konstantinos, additional, Giannopoulos, Georgios, additional, Efremidis, Michael, additional, Deftereos, Spyridon, additional, Sideris, Antonios, additional, Takagi, Masahiko, additional, Yan, Gan-Xin, additional, and Ehrlich, Joachim R, additional

Published
2017
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36. Adenosine‐Guided Pulmonary Vein Antral Isolation for Paroxysmal Atrial Fibrillation: A Randomized Study

Author

EFREMIDIS, MICHAEL, primary, LETSAS, KONSTANTINOS P., additional, LIONI, LOUIZA, additional, VLACHOS, KONSTANTINOS, additional, GEORGOPOULOS, STAMATIS, additional, SAPLAOURAS, ATHANASIOS, additional, GELADARI, ELENI, additional, GIANNOPOULOS, GEORGE, additional, LIU, TONG, additional, DEFTEREOS, SPYRIDON, additional, and SIDERIS, ANTONIOS, additional

Published
2016
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37. Tpeak‐Tend, Tpeak‐Tend/QT ratio and Tpeak‐Tend dispersion for risk stratification in Brugada Syndrome: A systematic review and meta‐analysis.

Author

Tse, Gary, Gong, Mengqi, Li, Christien Ka Hou, Leung, Keith Sai Kit, Georgopoulos, Stamatis, Bazoukis, George, Letsas, Konstantinos P., Sawant, Abhishek C., Mugnai, Giacomo, Wong, Martin C.S., Yan, Gan Xin, Brugada, Pedro, Chierchia, Gian‐Battista, Asmundis, Carlo, Baranchuk, Adrian, and Liu, Tong

Abstract

Background: Brugada syndrome is an ion channelopathy that predisposes affected subjects to ventricular tachycardia/fibrillation (VT/VF), potentially leading to sudden cardiac death (SCD). Tpeak‐Tend intervals, (Tpeak‐Tend)/QT ratio and Tpeak‐Tend dispersion have been proposed for risk stratification, but their predictive values in Brugada syndrome have been challenged recently. Methods: A systematic review and meta‐analysis was conducted to examine their values in predicting arrhythmic and mortality outcomes in Brugada Syndrome. PubMed and Embase databases were searched until 1 May 2018, identifying 29 and 57 studies. Results: Nine studies involving 1740 subjects (mean age 45 years old, 80% male, mean follow‐up duration was 68 ± 27 months) were included. The mean Tpeak‐Tend interval was 98.9 ms (95% CI: 90.5‐107.2 ms) for patients with adverse events (ventricular arrhythmias or SCD) compared to 87.7 ms (95% CI: 80.5‐94.9 ms) for those without such events, with a mean difference of 11.9 ms (95% CI: 3.6‐20.2 ms, P = 0.005; I2 = 86%). Higher (Tpeak‐Tend)/QT ratios (mean difference = 0.019, 95% CI: 0.003‐0.036, P = 0.024; I2 = 74%) and Tpeak‐Tend dispersion (mean difference = 7.8 ms, 95% CI: 2.1‐13.4 ms, P = 0.007; I2 = 80%) were observed for the event‐positive group. Conclusion: Tpeak‐Tend interval, (Tpeak‐Tend)/QT ratio and Tpeak‐Tend dispersion were higher in high‐risk than low‐risk Brugada subjects, and thus offer incremental value for risk stratification. [ABSTRACT FROM AUTHOR]

Published
2018
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38. Right ventricular outflow tract high-density endocardial unipolar voltage mapping in patients with Brugada syndrome: evidence for electroanatomical abnormalities.

Author

Letsas, Konstantinos P., Efremidis, Michael, Vlachos, Konstantinos, Georgopoulos, Stamatis, Karamichalakis, Nikolaos, Asvestas, Dimitrios, Valkanas, Kosmas, Korantzopoulos, Panagiotis, Tong Liu, and Sideris, Antonios

Abstract

Aims Epicardial structural abnormalities at the right ventricular outflow tract (RVOT) may provide the arrhythmia substrate in Brugada syndrome (BrS). Electroanatomical endocardial unipolar voltage mapping is an emerging tool that accurately identifies epicardial abnormalities in different clinical settings. This study investigated whether endocardial unipolar voltage mapping of the RVOT detects electroanatomical abnormalities in patients with BrS. Methods and results Ten asymptomatic patients (8 males, 34.5 ± 11.2 years) with spontaneous type 1 ECG pattern of BrS and negative late gadolinium enhancement-cardiac magnetic resonance imaging (LGE-c-MRI) underwent high-density endocardial electroanatomical mapping (>800 points). Using a cut-off of 1 mV and 4 mV for normal bipolar and unipolar voltage, respectively, derived from 20 control patients without structural heart disease established by LGE-c-MRI, the extend of low-voltage areas within the RVOT was estimated using a specific calculation software. The mean RVOT area presenting low-voltage bipolar signals in BrS patients was 3.4 ± 1.7 cm2 (range 1.5–7 cm2). A significantly greater area of abnormal unipolar signals was identified (12.6 ± 4.6 cm2 [range 7–22 cm2], P : 0.001). Both bipolar and unipolar electroanatomical abnormalities were mainly located at the free wall of the RVOT. The mean RVOT activation time was significantly prolonged in BrS patients compared to control population (86.4 ± 16.5 vs. 63.4 ± 9.7 ms, P  < 0.001). Isochronal mapping demonstrated lines of conduction slowing within the RVOT in 8/10 BrS patients. Conclusion Wide areas of endocardial unipolar voltage abnormalities that possibly reflect epicardial structural abnormalities are identified at the RVOT of BrS patients. [ABSTRACT FROM AUTHOR]

Published
2018
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39. Meta-analysis of Tpeak-Tend and Tpeak-Tend/QT ratio for risk stratification in congenital long QT syndrome.

Author

Tse, Gary, Gong, Mengqi, Meng, Lei, Wong, Cheuk Wai, Georgopoulos, Stamatis, Bazoukis, George, Wong, Martin C.S., Letsas, Konstantinos P., Vassiliou, Vassilios S., Xia, Yunlong, Baranchuk, Adrian M., Yan, Gan-Xin, and Liu, Tong

Abstract

Background and Objectives: Congenital long QT syndrome (LQTS) predisposes affected individuals to ventricular tachycardia/fibrillation (VF/VF), potentially resulting in sudden cardiac death. The Tpeak-Tend interval and the Tpeak-Tend/QT ratio, electrocardiographic markers of dispersion of ventricular repolarization, were proposed for risk stratification but their predictive values in LQTS have been controversial. A systematic review and meta-analysis was conducted to examine the value of Tpeak-Tend intervals and Tpeak-Tend/QT ratios in predicting arrhythmic and mortality outcomes in congenital LQTS.Method: PubMed and Embase databases were searched until 9th May 2017, identifying 199 studies.Results: Five studies on long QT syndrome were included in the final meta-analysis. Tpeak-Tend intervals were longer (mean difference [MD]: 13ms, standard error [SE]: 4ms, P=0.002; I2=34%) in congenital LQTS patients with adverse events [syncope, ventricular arrhythmias or sudden cardiac death] compared to LQTS patients without such events. By contrast, Tpeak-Tend/QT ratios were not significantly different between the two groups (MD: 0.02, SE: 0.02, P=0.26; I2=0%).Conclusion: This meta-analysis showed that Tpeak-Tend interval is significant higher in individuals who are at elevated risk of adverse events in congenital LQTS, offering incremental value for risk stratification. [ABSTRACT FROM AUTHOR]

Published
2018
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41. Managing atrial fibrillation in the very elderly patient: challenges and solutions

Author

Karamichalakis,Nikolaos, Letsas,Konstantinos P, Vlachos,Konstantinos, Georgopoulos,Stamatis, Bakalakos,Athanasios, Efremidis,Michael, Sideris,Antonios, Karamichalakis,Nikolaos, Letsas,Konstantinos P, Vlachos,Konstantinos, Georgopoulos,Stamatis, Bakalakos,Athanasios, Efremidis,Michael, and Sideris,Antonios

Abstract

Nikolaos Karamichalakis, Konstantinos P Letsas, Konstantinos Vlachos, Stamatis Georgopoulos, Athanasios Bakalakos, Michael Efremidis, Antonios Sideris Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece Abstract: Atrial fibrillation (AF) is the most common arrhythmia affecting elderly patients. Management and treatment of AF in this rapidly growing population of older patients involve a comprehensive assessment that includes comorbidities, functional, and social status. The cornerstone in therapy of AF is thromboembolic protection. Anticoagulation therapy has evolved, using conventional or newer medications. Percutaneous left atrial appendage closure is a new invasive procedure evolving as an alternative to systematic anticoagulation therapy. Rate or rhythm control leads to relief in symptoms, fewer hospitalizations, and an improvement in quality of life. Invasive methods, such as catheter ablation, are the new frontier of treatment in maintaining an even sinus rhythm in this particular population. Keywords: elderly, atrial fibrillation, anticoagulation, drugs, catheter ablation

Published
2015

44. Total cosine R-to-T for predicting ventricular arrhythmic and mortality outcomes: A systematic review and meta-analysis.

Author

Tse, Gary, Gong, Mengqi, Wong, Cheuk Wai, Chan, Cynthia, Georgopoulos, Stamatis, Chan, Yat Sun, Yan, Bryan P., Li, Guangping, Whittaker, Paula, Ciobanu, Ana, Ali‐Hasan‐Al‐Saegh, Sadeq, Wong, Sunny H., Wu, William K. K., Bazoukis, George, Lampropoulos, Konstantinos, Wong, Wing Tak, Tse, Lap Ah, Baranchuk, Adrian M., Letsas, Konstantinos P., and Liu, Tong

Abstract

Background: The total cosine R-to-T (TCRT), a vectorcardiographic marker reflecting the spatial difference between the depolarization and repolarization wavefronts, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death (SCD) in different clinical settings. However, its prognostic value has been controversial.Objective: This systematic review and meta-analysis evaluated the significance of TRCT in predicting arrhythmic and/or mortality endpoints.Methods: PubMed and Embase databases were searched through December 31, 2016.Results: Of the 890 studies identified initially, 13 observational studies were included in our meta-analysis. A total of 11,528 patients, mean age 47 years old, 72% male, were followed for 43 ± 6 months. Data from five studies demonstrated lower TCRT values in myocardial infarction patients with adverse events (syncope, ventricular arrhythmias, or sudden cardiac death) compared to those without these events (mean difference = -0.36 ± 0.05, p < .001; I2  = 48%). By contrast, only two studies analyzed outcomes in heart failure, and pooled meta-analysis did not demonstrate significant difference in TCRT between event-positive and event-negative patients (mean difference = -0.01 ± 0.10, p > .05; I2  = 80%).Conclusion: TCRT is lower in MI patients at high risk of adverse events when compared to those free from such events. It can provide additional risk stratification beyond the use of clinical parameters and traditional electrocardiogram markers. Its value in other diseases such as heart failure requires further studies. [ABSTRACT FROM AUTHOR]

Published
2018
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45. The Tpeak - Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis.

Author

Tse, Gary, Gong, Mengqi, Wong, Wing Tak, Georgopoulos, Stamatis, Letsas, Konstantinos P., Vassiliou, Vassilios S., Chan, Yat Sun, Yan, Bryan P., Wong, Sunny Hei, Wu, William K.K., Ciobanu, Ana, Li, Guangping, Shenthar, Jayaprakash, Saguner, Ardan M., Ali-Hasan-Al-Saegh, Sadeq, Bhardwaj, Aishwarya, Sawant, Abhishek C., Whittaker, Paula, Xia, Yunlong, and Yan, Gan-Xin

Abstract

Background: The Tpeak - Tend interval (the interval from the peak to the end of the T wave), an electrocardiographic marker reflecting transmural dispersion of repolarization, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death in different clinical settings.Objective: This systematic review and meta-analysis evaluated the significance of the Tpeak - Tend interval in predicting arrhythmic and/or mortality end points.Methods: PubMed, Embase, Cochrane Library, and CINAHL Plus databases were searched through November 30, 2016.Results: Of the 854 studies identified initially, 33 observational studies involving 155,856 patients were included in our meta-analysis. Tpeak - Tend interval prolongation (mean cutoff value 103.3 ± 17.4 ms) was a significant predictor of the arrhythmic or mortality outcomes (odds ratio [OR] 1.14; 95% confidence interval [CI] 1.11-1.17; P < .001). When different end points were analyzed, the ORs were as follows: VT/VF, 1.10 (95% CI 1.06-1.13; P < .0001); sudden cardiac death, 1.27 (95% CI 1.17-1.39; P < .0001); cardiovascular death, 1.40 (95% CI 1.19-1.64; P < .0001); and all-cause mortality, 4.56 (95% CI 0.62-33.68; P < .0001). Subgroup analysis for each disease revealed that the risk of VT/VF or death was highest for Brugada syndrome (OR 5.68; 95% CI 1.57-20.53; P < .01), followed by hypertension (OR 1.52; 95% CI 1.26-1.85; P < .0001), heart failure (OR 1.07; 95% CI 1.04-1.11; P < .0001), and ischemic heart disease (OR 1.06; 95% CI 1.02-1.10; P = 0.001).Conclusion: The Tpeak - Tend interval is a useful risk stratification tool in different diseases and in the general population. [ABSTRACT FROM AUTHOR]

Published
2017
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46. Tpeak‐Tend, Tpeak‐Tend/QTratio and Tpeak‐Tenddispersion for risk stratification in Brugada Syndrome: A systematic review and meta‐analysis

Author

Tse, Gary, Gong, Mengqi, Li, Christien Ka Hou, Leung, Keith Sai Kit, Georgopoulos, Stamatis, Bazoukis, George, Letsas, Konstantinos P., Sawant, Abhishek C., Mugnai, Giacomo, Wong, Martin C.S., Yan, Gan Xin, Brugada, Pedro, Chierchia, Gian‐Battista, Asmundis, Carlo, Baranchuk, Adrian, and Liu, Tong

Abstract

Brugada syndrome is an ion channelopathy that predisposes affected subjects to ventricular tachycardia/fibrillation (VT/VF), potentially leading to sudden cardiac death (SCD). Tpeak‐Tendintervals, (Tpeak‐Tend)/QTratio and Tpeak‐Tenddispersion have been proposed for risk stratification, but their predictive values in Brugada syndrome have been challenged recently. A systematic review and meta‐analysis was conducted to examine their values in predicting arrhythmic and mortality outcomes in Brugada Syndrome. PubMed and Embase databases were searched until 1 May 2018, identifying 29 and 57 studies. Nine studies involving 1740 subjects (mean age 45 years old, 80% male, mean follow‐up duration was 68 ± 27 months) were included. The mean Tpeak‐Tendinterval was 98.9 ms (95% CI: 90.5‐107.2 ms) for patients with adverse events (ventricular arrhythmias or SCD) compared to 87.7 ms (95% CI: 80.5‐94.9 ms) for those without such events, with a mean difference of 11.9 ms (95% CI: 3.6‐20.2 ms, P= 0.005; I2= 86%). Higher (Tpeak‐Tend)/QTratios (mean difference = 0.019, 95% CI: 0.003‐0.036, P= 0.024; I2= 74%) and Tpeak‐Tenddispersion (mean difference = 7.8 ms, 95% CI: 2.1‐13.4 ms, P= 0.007; I2= 80%) were observed for the event‐positive group. Tpeak‐Tendinterval, (Tpeak‐Tend)/QTratio and Tpeak‐Tenddispersion were higher in high‐risk than low‐risk Brugada subjects, and thus offer incremental value for risk stratification.

Published
2018
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47. Brugada Syndrome:Risk Stratification And Management.

Author

Letsas, Konstantinos P., Georgopoulos, Stamatis, Vlachos, Konstantinos, karamichalakis, Nikolaos, Liatakis, Ioannis, Korantzopoulos, Panagiotis, Tong Liu, Efremidis, Michael, and Sideris, Antonios

Subjects
*ETIOLOGY of diseases, *ARRHYTHMOGENIC right ventricular dysplasia, BRUGADA syndrome diagnosis
Abstract

The Brugada syndrome (BrS) is an arrhythmogenic disease associated with an increased risk of ventricular fibrillation and sudden cardiac death. The risk stratification and management of BrS patients, particularly of asymptomatic ones, still remains challenging. A previous history of aborted sudden cardiac death or arrhythmic syncope in the presence of spontaneous type 1 ECG pattern of BrS phenotype appear to be the most reliable predictors of future arrhythmic events. Several other ECG parameters have been proposed for risk stratification. Among these ECG markers, QRS-fragmentation appears very promising. Although the value of electrophysiological study still remains controversial, it appears to add important information on risk stratification, particularly when incorporated in multiparametric scores in combination with other known risk factors. The present review article provides an update on the pathophysiology, risk stratification and management of patients with BrS. [ABSTRACT FROM AUTHOR]

Published
2016

48. An update on risk factors for drug-induced arrhythmias.

Author

Vlachos, Konstantinos, Georgopoulos, Stamatis, Efremidis, Michael, Sideris, Antonios, and Letsas, Konstantinos P

Subjects
ARRHYTHMIA, DRUG side effects, BRUGADA syndrome, DISEASE risk factors
Abstract

A variety of drugs, either anti-arrhythmics or non-antiarrhythmics, have been associated with drug-induced arrhythmias. Drug-induced arrhythmias are usually observed in the presence of long QT interval or Brugada electrocardiographic pattern. Clinical risk factors, such as female gender, structural heart disease, metabolic and electrolyte abnormalities, bradycardia and conduction disease, increased drug bioavailability, and silent channelopathies act as ‘‘effect amplifiers’’ which can make an otherwise relatively safe drug dangerous with regard to risk for polymorphic ventricular tachycardia in the setting of QT interval prolongation. A drug-induced type 1 electrocardiographic pattern of Brugada syndrome is considered highly proarrhythmic. Specific electrocardiographic markers including the corrected QT interval, QRS duration, Tpeak–Tend/QT ratio, and others may predict the risk of arrhythmias in both situations. The present review highlights on the current clinical and electrocardiographic risk factors for prediction of drug-induced arrhythmias. [ABSTRACT FROM PUBLISHER]

Published
2016
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49. Managing atrial fibrillation in the very elderly patient: challenges and solutions.

Author

Karamichalakis, Nikolaos, Letsas, Konstantinos P., Vlachos, Konstantinos, Georgopoulos, Stamatis, Bakalakos, Athanasios, Efremidis, Michael, and Sideris, Antonios

Subjects
ATRIAL fibrillation treatment, ARRHYTHMIA, COMORBIDITY, DISEASES in older people, THROMBOEMBOLISM, ANTICOAGULANTS
Abstract

Atrial fibrillation (AF) is the most common arrhythmia affecting elderly patients. Management and treatment of AF in this rapidly growing population of older patients involve a comprehensive assessment that includes comorbidities, functional, and social status. The cornerstone in therapy of AF is thromboembolic protection. Anticoagulation therapy has evolved, using conventional or newer medications. Percutaneous left atrial appendage closure is a new invasive procedure evolving as an alternative to systematic anticoagulation therapy. Rate or rhythm control leads to relief in symptoms, fewer hospitalizations, and an improvement in quality of life. Invasive methods, such as catheter ablation, are the new frontier of treatment in maintaining an even sinus rhythm in this particular population. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
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50. An investigation of equine injuries in Thoroughbred flat racing in North America

Author

Georgopoulos, Stamatis Panagiotis and Georgopoulos, Stamatis Panagiotis

Abstract

The aim of this research work was to investigate and quantify the risk of fatal and fracture injury for Thoroughbreds participating in flat racing in the US and Canada so that horses at particular risk can be identified and the risk of fatal injury reduced. Risk factors associated with fatalities and fractures were identified and predictive models for both fatalities and fractures were developed and their performance was evaluated. Our analysis was based on 188,269 Thoroughbreds that raced on 89 racecourses reporting injuries to the Equine Injury Database (EID) in the US and Canada from 1st January 2009 to 31st December 2015. This included 2,493,957 race starts and 4,592,162 exercise starts. The race starts reported to the EID represented the starts for 90.0% of all official Thoroughbred racing events in the United States and Canada during the 7-year observation period. The annual average risk of fatal and fracture equine injuries for the period 2009 - 2015 was estimated and a description of the different injury types that resulted in fatalities and fractures was given, based on the cases recorded in the EID. Possible risk factors were pre-screened using univariable logistic regression models; risk factors with an association indicated by p < 0.20 were then included in a stepwise logistic regression selection process. A forward bidirectional elimination approach using Akaike's Information Criterion was utilised for the stepwise selection. We identified more than 20 risk factors that were found to be significantly associated with fatal injury (p < 0.05) and more than 20 risk factors associated with fracture injury, across the final multi-variable models. The risk factors identified are related to the horse’s previous racing history, the trainer, the race, the horse's expected performance and the horse's racing history. Five different algorithms were used to develop predictive models based on the data available from the period 2009 - 2014 for both fatal and fracture i

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