Cardiac implantable electronic devices: a marker for poor outcome in patients with COVID-19 infection

Abstract Background A high percentage of SARS-CoV-2 patients suffer from comorbidities and there is increasing evidence that previous cardiac disease contributes to poor outcome in these patients (1,2). There is a paucity of information regarding the implications of the disease in patients with cardiac implantable electronic devices (CIEDs). Due to the increasing use of CIEDs in the management of arrhythmias and heart failure, determining the association between CIEDs and the severity of this disease is essential. Aim To obtain an adequate understanding regarding the association between cardiac devices and severity of COVID-19 infection in order to achieve optimum management of these patients. Methods All clinical and demographic parameters were collected retrospectively from a cohort of patients who underwent implantation of CIED in our Medical Center, Israel. We included 42 patients who tested positive for SARS-CoV-2, between January and December of 2020. Propensity score matching based on age and gender and adjusted Kaplan Meier curve of mortality were performed in order to evaluate the clinical outcome of patients with CIEDs and SARS- CoV-2 infection in comparison to the control group. Results The mean age of patients was 72.9 years, compose of 50% male and 50% female in both groups. In the group of patients with CIEDs, 11 (26.1%) patients had implantable defibrillator, and 31 (73.8%) had pacemaker. Univariate analysis revealed that patients with CIEDs suffered more from heart failure, coronary artery disease and atrial fibrillation, as well as hypertension, diabetes, and chronic kidney disease. Four patients (9.5%) with cardiac devices were hospitalized in the ICU due to critical illness, as compared to 1 (0.6%) patient in the control group (p=0.005). Moreover, 10 patients in the cardiac devices group (23.8%) died of SARS-CoV-2 infection, versus 25 (14.9%) in the control group. Conclusions CIEDs are a marker of poor outcome in patients with SARS-CoV-2 infection. Patients with CIEDs suffer from increased comorbidities in comparison with age and gender matched population and therefore should be managed with the utmost caution. FUNDunding Acknowledgement Type of funding sources: None. KM curve of all-cause mortality

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Home Management of Heart Failure and Arrhythmias in Patients with Cardiac Devices during Pandemic

Journal of Clinical Medicine ◽

10.3390/jcm10081618 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1618

Author(s):

Andrea Matteucci ◽

Michela Bonanni ◽

Marco Centioni ◽

Federico Zanin ◽

Francesco Geuna ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Ventricular Tachycardia ◽

Hospital Admissions ◽

Electronic Devices ◽

Home Monitoring ◽

Home Management ◽

Cardiac Implantable Electronic Devices ◽

Cardiac Devices ◽

The Impact

Background: The in-hospital management of patients with cardiac implantable electronic devices (CIEDs) changed early in the COVID-19 pandemic. Routine in-hospital controls of CIEDs were converted into remote home monitoring (HM). The aim of our study was to investigate the impact of the lockdown period on CIEDs patients and its influence on in-hospital admissions through the analysis of HM data. Methods: We analysed data recorded from 312 patients with HM during the national quarantine related to COVID-19 and then compared data from the same period of 2019. Results: We observed a reduction in the number of HM events in 2020 when compared to 2019. Non-sustained ventricular tachycardia episodes decreased (18.3% vs. 9.9% p = 0.002) as well as atrial fibrillation episodes (29.2% vs. 22.4% p = 0.019). In contrast, heart failure (HF) alarm activation was lower in 2019 than in 2020 (17% vs. 25.3% p = 0.012). Hospital admissions for critical events recorded with CIEDs dropped in 2020, including those for HF. Conclusions: HM, combined with telemedicine use, has ensured the surveillance of CIED patients. In 2020, arrhythmic events and hospital admissions decreased significantly compared to 2019. Moreover, in 2020, patients with HF arrived in hospital in a worse clinical condition compared to previous months.

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P924Prognostic significance of moderate primary mitral regurgitation and atrial fibrillation

European Heart Journal ◽

10.1093/eurheartj/ehz747.0519 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Hayashi ◽

Y Abe ◽

T Kuriyama ◽

X Mu ◽

T Hamaguchi ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Mitral Regurgitation ◽

Cardiac Death ◽

Composite Endpoint ◽

Age And Gender ◽

Poor Outcome ◽

Kaplan Meier ◽

Primary Mitral Regurgitation ◽

And Gender

Abstract Background Severe primary mitral regurgitation [degenerativeMR (DMR)] is associated with poor outcome, including cardiac death and admission due to worsening heart failure. Whereas little information is available regarding the characteristics of moderate DMR and their impact on prognostic outcome. The aim of the present study was to investigate the prognosis and its determinant in patients with moderate DMR. Methods From 13,700 consecutive patients who underwent transthoracic echocardiography. We selected moderate DMR but without other underlying cardiac diseases. Characteristics and event free rate as compared with age- and gender-matched patients with none to mild MR. Results Of a total of our cohort, 185 (1%) patients had moderate DMR, and we compared with 185 age- and gender-matched patients with none to mild MR. During the follow-up period of 1372±655 days, 30 patients (8%) met the composite endpoint defined as cardiac death and admission due to worsening heart failure. Kaplan-Meier analysis showed patients with moderate DMR was significantly associated with a poor outcome compared to patients with none to mild MR (log-ranktest P<0.0001). Cox proportional hazard ratio revealed thatmoderate MR and atrial fibrillation (AF) were the independent predictors of the composite endpoint. Prgnostic outcome: AF and moderate DMR Conclusions Patients withmoderate DMR and concomitant AF had a significant poor outcome. An activesurveillance and some intervention for AF and moderate MR may be required.

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Dental and periodontal disease in patients with inflammatory bowel disease

Clinical Oral Investigations ◽

10.1007/s00784-021-03835-6 ◽

2021 ◽

Author(s):

Christopher X. W. Tan ◽

Henk S. Brand ◽

Bilgin Kalender ◽

Nanne K. H. De Boer ◽

Tymour Forouzanfar ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Periodontal Disease ◽

Bowel Disease ◽

Health Problems ◽

Control Group ◽

Age And Gender ◽

Preventive Dental Care ◽

Dmft Index ◽

Inflammatory Bowel ◽

And Gender

Abstract Objectives Although bowel symptoms are often predominant, inflammatory bowel disease (IBD) patients can have several oral manifestations. The aim of this study was to investigate the prevalence of dental caries and periodontal disease in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to an age and gender-matched control group of patients without IBD. Material and methods The DMFT (Decayed, Missing, Filled Teeth) scores and the DPSI (Dutch Periodontal Screening Index) of 229 IBD patients were retrieved from the electronic health record patient database axiUm at the Academic Centre for Dentistry Amsterdam (ACTA) and were compared to the DMFT scores and DPSI from age and gender-matched non-IBD patients from the same database. Results The total DMFT index was significantly higher in the IBD group compared to the control group. When CD and UC were analyzed separately, a statistically significant increased DMFT index was observed in CD patients but not in UC patients. The DPSI did not differ significantly between the IBD and non-IBD groups for each of the sextants. However, in every sextant, IBD patients were more frequently edentulous compared to the control patients. Conclusion CD patients have significantly more dental health problems compared to a control group. Periodontal disease did not differ significantly between IBD and non-IBD groups as determined by the DPSI. Clinical relevance It is important that IBD patients and physicians are instructed about the correlation between their disease and oral health problems. Strict oral hygiene and preventive dental care such as more frequent checkups should be emphasized by dental clinicians.

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A Study of Wideband Energy Reflectance in Patients with Otosclerosis: Data from a Chinese Population

BioMed Research International ◽

10.1155/2019/2070548 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Suju Wang ◽

Wenyang Hao ◽

Chunxiao Xu ◽

Daofeng Ni ◽

Zhiqiang Gao ◽

...

Keyword(s):

Resonance Frequency ◽

Racial Differences ◽

Chinese Population ◽

Ambient Pressure ◽

Control Group ◽

Age And Gender ◽

Significant Difference ◽

And Gender ◽

And Control ◽

Peak Pressures

Objective(s). The purpose of this study was to explore the effectiveness of wideband acoustic immittance (WAI) in the diagnosis of otosclerosis by comparing the differences in the energy reflectance (ER) of WAI between patients with otosclerosis and age- and gender-matched normal hearing controls in the Chinese population. Methods. Twenty surgically confirmed otosclerotic ears were included in the otosclerotic group. The ER of WAI at ambient and peak pressures, resonance frequency, and 226-Hz tympanogram were collected prior to surgery using a Titan hearing test platform (Interacoustics A/S, Middelfart, Denmark). All diagnoses of otosclerosis in the tested ear were confirmed by surgery after the measurements. Thirteen normal adults (26 ears) who were age- and gender-matched with the otosclerotic patients were included as the control group. Results. At peak pressure, the ERs of otosclerotic patients were higher than those of the control group for frequencies less than 4,000Hz and were lower for frequencies greater than 4,000Hz. In addition, within the analyzed frequencies, the differences observed at 2,520Hz was statistically significant (p<0.05/16=0.003, Bonferroni corrected). At ambient pressure, the differences observed at 1,260 and 6,350Hz were statistically significant (p<0.05/16=0.003, Bonferroni corrected). Although the differences between the otosclerotic and control groups exhibited similar trends to those in studies implemented in Caucasian populations, the norms in the present study in the control group were different from those in the Caucasian populations, suggesting racial differences in WAI test results. Regarding the middle ear resonance frequency, no significant difference was observed between the two groups (P>0.05). Conclusion. WAI can provide valuable information for the diagnosis of otosclerosis in the Chinese population. Norms and diagnostic criteria corresponding to the patient’s racial group are necessary to improve the efficiency of WAI in the diagnosis of otosclerosis.

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Sleep Disordered Breathing, Insomnia, and Health Related Quality of Life — A Comparison Between age and Gender Matched Elderly with Heart Failure or Without Cardiovascular Disease

European Journal of Cardiovascular Nursing ◽

10.1016/j.ejcnurse.2009.11.005 ◽

2010 ◽

Vol 9 (2) ◽

pp. 108-117 ◽

Cited By ~ 23

Author(s):

Peter Johansson ◽

Kristoffer Årestedt ◽

Urban Alehagen ◽

Eva Svanborg ◽

Ulf Dahlström ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Cardiovascular Disease ◽

Sleep Disordered Breathing ◽

Health Related Quality ◽

Age And Gender ◽

Related Quality ◽

Health Related ◽

And Gender

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Age and gender differences in physical heart failure symptom clusters

Heart & Lung ◽

10.1016/j.hrtlng.2021.07.001 ◽

2021 ◽

Vol 50 (6) ◽

pp. 832-837

Author(s):

Kristen A. Sethares ◽

Elizabeth Chin

Keyword(s):

Heart Failure ◽

Gender Differences ◽

Symptom Clusters ◽

Age And Gender ◽

Heart Failure Symptom ◽

Age And Gender Differences ◽

And Gender

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Immature granulocyte and other hematological inflammatory parameters in patients with migraine headache

10.51271/kmj-0025 ◽

2021 ◽

pp. 101-104

Keyword(s):

Complete Blood Count ◽

Control Group ◽

Age And Gender ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Inflammatory Parameters ◽

Group Data ◽

Healthy Control ◽

Immature Granulocyte ◽

And Gender

Background: Today, many hypotheses have been proposed in the pathogenesis of migraine. The inflammatory hypothesis is one of them. The immature granulocyte count (IGC) is also an inflammatory parameter which importance has been understood recently. There are no studies evaluating IGC in migraine. The aim of the study to investigate the levels of IGC and other hematological inflammatory parameters in migraine. Material and Method: Materials and Methods: Forty-eight patients diagnosed with migraine who applied to Kastamonu Training and Research Hospital Neurology outpatient clinic between 07.01.2020 and 10.01.2021 were included in the study. 42 people with similar age and gender distribution were included for the control group. Data on laboratory tests, age and gender of patients were obtained from the hospital Laboratory Information System (LIS). CBC parameters of the patients at the first admission and before any treatment, calculated with an automated hematological analyzer (XN-1000-Hematology-analyzer-Sysmex Corporation, Japan) were analyzed. Using Complete Blood Count (CBC) data, neutrophil count (NEUT#), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), and IGC were recorded. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII) values were calculated with the formula. Results: In our study, NLR and IGC was significantly higher than the healthy control group (p=0.002, p=0.025). PLR was also found to be high, but it was not statistically significant (p=0.063). Conclusion: The significantly higher NLR and IGC levels in migraine patients compared to the healthy controls support the role of inflammation in etiopathogenesis.

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Abstract 3104: Heart Failure: Is there an Epidemic? A 17-Year Longitudinal Study on the Incidence, Prevalence and Survival Outcomes

Circulation ◽

10.1161/circ.118.suppl_18.s_1092-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Tiew-Hwa K Teng ◽

Judith Finn ◽

Michael Hobbs ◽

Elizabeth Geelhoed ◽

Joseph Hung

Keyword(s):

Heart Failure ◽

Survival Outcomes ◽

Major Public Health Problem ◽

Ageing Population ◽

Base Period ◽

Age And Gender ◽

Equal Distribution ◽

Significant Downward Trend ◽

And Gender ◽

Incidence Prevalence

Background Despite concerns of a heart failure ‘epidemic’, long term population trends on the incidence, prevalence and survival outcomes of heart failure (HF) are not well characterized. Methods The Western Australian Hospital Morbidity Database was used to identify index patients with first-time admissions for HF from 1990 to 2006, with no prior admission for HF since 1 January 1980. Age and gender adjusted temporal trends in HF incidence were examined and Cox-proportional hazards model used to analyse 5-year survival following index admissions, adjusted for significant covariates. Prevalence was calculated at end of each calendar year. Base period used was 1990–1993. Results There were 70,967 index heart failure (HF) patients identified during 1990–2006, with almost equal distribution between genders. There was a significant downward trend for age and gender-adjusted incidence of HF with average decline of 1.73% (95% CI 1.5%, 1.9%, p=0.001) per year over the 17-year period. Incidence rate reached a peak in 1993 and thereafter there was a steady decline. Compared to the base period, age and gender-adjusted survival at 5-year after index HF admission improved with an absolute survival gain of 6.9% (95% CI 4.3%, 9.4% p=0.001) for 1994–97 period, 9.3% (95% CI 6.7%, 11.9%, p=0.001) for 1998–2001 period and 7.0% (95% CI 4.1%, 9.8%, p=0.001) for 2002– 05 period respectively. Prevalence of HF increased significantly over the different time periods, with a 2.26 fold higher prevalence in 2002–2006 compared to base period. The increase in prevalence was greatest in the 70–79 year age group, with an increase from 200.3 per 10,000 in the base period to 606.0 per 10,000 in 2002–2006. Conclusions In the last 17 years, incidence of hospitalized HF patients has declined steadily in both genders. However, there has been a marked increase in prevalence of HF due in part to an ageing population and improved HF survival. Management of these chronic elderly HF patients remains a major public health problem.

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Balance and motor coordination are not fully developed in 7 years old blind children

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2004000400016 ◽

2004 ◽

Vol 62 (3a) ◽

pp. 654-657 ◽

Cited By ~ 20

Author(s):

Andréa Sanchez Navarro ◽

Marcia Maiumi Fukujima ◽

Sissy Veloso Fontes ◽

Sandro Luiz de Andrade Matas ◽

Gilmar Fernandes do Prado

Keyword(s):

Visually Impaired ◽

Motor Coordination ◽

Psychomotor Development ◽

Control Group ◽

Age And Gender ◽

Blind Children ◽

Spatial Parameters ◽

And Gender ◽

Impaired Children ◽

Visually Impaired Children

Visually impaired children show difficulties in recognizing their own bodies, objects around then and the spatial parameters that are essential for independent movement. This study analyzes the neuro-psychomotor development of a group of congenitally visually impaired children as compared to children with normal sight. We have evaluated two groups of seven-year-olds by means of neurological evolution examination (NEE). The group studied comprised 20 blind children and the control group comprised 20 children with normal sight, and they were paired up according to age and gender. In some tests, the blind children were guided by touch. The visually impaired children performed worse in tests evaluating balance and appendage coordination compared to normal sighted children (p< 0.001), and this suggests that visual deficiency impairs children's neuro-psychomotor development.

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