Heart and Diabetes Center North Rhine-Westphalia

About: Heart and Diabetes Center North Rhine-Westphalia is a healthcare organization based out in Bad Oeynhausen, Germany. It is known for research contribution in the topics: Heart failure & Vitamin D and neurology. The organization has 288 authors who have published 357 publications receiving 9276 citations.

Abl05: spinal cord stimulation for refractory stable angina pectoris in patients with chronic pacemaker treatment

Abstract: Spinal cord stimulation (SCS) is a safe treatment modality in patients with severe angina pectoris. We studied possible interactions of procedures in patients treated with both, SCS for angina pectoris and permanent pacemaker (PPM) treatment for bradyarrhythmias. Methods used Since January 2001, we performed SCS in 61 patients (pts.) (48 men, 13 women, age 65±8 years, bmi 27±9 kg/qm). Nine pts. additionally needed PPM treatment for bradyarrhythmias. All pts. had severe angina pectoris (III to IV [39/22] according to Canadian Cardiovascular Society) under considered medication due to angiographically documented end-stage coronary artery disease (CAD), which could not be treated interventionally. After 3 to 5 days of successful test stimulation using an epidural lead a commercially available implantable pulse generator is placed in a subcutaneous pouch below the costal arch. Results In 58 pts. (95%) angina pectoris could be reduced significantly. In 3 pts. the lead was removed because of ineffectivity during the test period. There was no interaction between neurostimulation and PPM treatment during follow-up of 1 to 38 (mean 20±12) months. DDD pacemaker were used in bipolar sensing mode: n=4 Medtronic, n=3 Biotronik, n=2 Guidant. View this table: Conclusion SCS has proved to be a safe procedure in patients with severe angina pectoris and PPM treatment with bipolar sensing mode.

First clinical experience using a visualized sheath for atrial fibrillation ablation

Abstract: Introduction Recently, a novel steerable sheath allowing its real-time visualization within a 3D-mapping system was introduced to facilitate atrial fibrillation (AF) ablation. Aim This study aimed to assess safety and efficacy of AF ablation using the visualized sheath and to compare its performance with a matched control group of patients who received ablation with conventional and non-visualized sheaths. Methods The study included consecutive patients between 09/2019 and 02/2021 who underwent routine AF ablation using the visualized sheath. Patients were regularly followed-up in our outpatient's clinic. Arrhythmia recurrence was defined as any atrial fibrillation (AF)/ atrial tachycardia (AT) episode lasting > 30 s after a blanking period of 3 months. Results A total number of 100 patients undergoing ablation using the visualized sheath were compared to a group of 99 matched patients. No major complications were observed. Total procedure duration (108 ± 22 min vs. 112 ± 12 min; p = 0.045), fluoroscopy time (7 ± 3 min vs. 10 ± 5 min; p < 0.001) and –dose (507 ± 501 cGy*cm2 vs. 783 ± 433 cGy*cm2; p < 0.001) were significantly lower using the visualized sheath. The benefit in terms of procedure duration was mainly driven by a shortened left atrial dwell time (73 ± 13 min vs. 79 ± 12 min; p = 0.001). During a mean follow-up of 12 months, the overall procedural success was 85% in the visualized sheath group versus 83% in the control group (p = 0.948). Conclusion AF ablation using the novel visualized sheath is safe and effective and leads to a measurable decrease of procedure duration and radiation exposure. The integration of the novel sheath might help to further improve safety and efficacy of AF ablation.

Porcelain Aorta: Multislice Computed Tomography for Imaging of Aortic Arch Calcification and Modified Coronary Artery Bypass Graft

Abstract: Modified diagnostic and operative strategies are required in patients with severely calcified aortic arch (so-called porcelain aorta) in order to avoid severe embolic complications (e.g. stroke) [1–3]. We present the case of a 68-year-old female with known coronary artery disease, diffuse arteriosclerosis and aortic valve stenosis, who presented with progressive dyspnea (NYHA II–III), chest pain (CCS II), and syncope. 14 years earlier, coronary bypass surgery had been performed due to left main stenosis. Because of a porcelain aorta and a stenosis of the left subclavian artery, a venous Y-graft had been used to connect the right common carotid artery with the left anterior descending and the circumflex coronary artery [2]. Physical examination of the patient showed a fairly good general condition and a mid-systolic murmur. Echocardiography confirmed a severe aortic valve stenosis (mean transvalvular gradient 45 mmHg, aortic valve area 0.7 cm2). Given an indication for cardiac surgery on the one hand but the embolic hazard on the other, contrast-enhanced multislice computed tomography (MSCT) was performed providing multiplanar and maximum intensity projections (3 mm; Figure 1a) as well as volume rendering (Figure 1b) for noninvasive evaluation. MSCT verified open Y-bypass 1 Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany, 2 Department of Cardiology and Angiology, Marienhospital Herne, Ruhr University Bochum, Germany, 3 Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.