Clinical research in cardiology : official journal of the German Cardiac Society最新文献

{"title":"Prognostic effect of sleep-disordered breathing on hospitalized patients following acute heart failure.","authors":"Sayaki Ishiwata, Takatoshi Kasai, Akihiro Sato, Shoko Suda, Hiroki Matsumoto, Jun Shitara, Shoichiro Yatsu, Azusa Murata, Megumi Shimizu, Takao Kato, Masaru Hiki, Yuya Matsue, Ryo Naito, Hiroyuki Daida, Tohru Minamino","doi":"10.1007/s00392-021-01969-x","DOIUrl":"10.1007/s00392-021-01969-x","url":null,"abstract":"<p><strong>Background: </strong>Identifying patients at risk for poor clinical outcomes following acute heart failure (AHF) is essential. However, data regarding the prognostic effect of sleep-disordered breathing (SDB) and treatment with positive airway pressure (PAP) on clinical outcomes of hospitalized patients following AHF is lacking.</p><p><strong>Objectives: </strong>This study investigated the prognostic effect of SDB, PAP treatment, and compliance with PAP treatment on patient clinical outcomes. Polysomnography was performed in hospitalized patients whose left ventricular ejection fraction was < 50%. Patients were divided into groups based on whether SDB was defined as an apnea-hypopnea index ≥ 15 and if they had received PAP treatment. Furthermore, patients with SDB and PAP were subdivided into more and less compliant groups. We assessed the incidences of deaths and rehospitalizations due to heart failure.</p><p><strong>Results: </strong>Overall, 241 patients were enrolled; 73% had SDB and 29% were initiated on PAP treatment. At a median follow-up of 1.7 years, 74 clinical events (32 deaths, 42 rehospitalizations) occurred. In the multivariable analysis, compared with the non-SDB group, SDB without PAP treatment was associated with an increased risk of clinical outcomes (hazard ratio [HR] 1.79, P = 0.049), whereas SDB with PAP treatment was not (HR 0.78, P = 0.582). Among patients with PAP treatment, a more compliant group was also inversely associated with clinical events (HR 0.11, P = 0.012).</p><p><strong>Conclusions: </strong>In hospitalized patients with AHF, untreated SDB was associated with worse clinical outcomes that might be reversible by PAP treatment. However, this potential may be suppressed in less compliant patients.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"663-672"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39717399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Diagnostic value of ¹⁸F-FDG PET/CT in infective endocarditis.","authors":"Vanesa Anton-Vazquez,&nbsp;Antonio Cannata,&nbsp;George Amin-Youssef,&nbsp;Samuel Watson,&nbsp;Amanda Fife,&nbsp;Nicola Mulholland,&nbsp;Margaret Gunning,&nbsp;Alexandros Papachristidis,&nbsp;Phil MacCarthy,&nbsp;Max Baghai,&nbsp;Ranjit Deshpande,&nbsp;Habib Khan,&nbsp;Jonathan Byrne,&nbsp;Rafal Dworakowski","doi":"10.1007/s00392-021-01984-y","DOIUrl":"https://doi.org/10.1007/s00392-021-01984-y","url":null,"abstract":"","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"721"},"PeriodicalIF":5.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39603083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of ¹⁸F-FDG PET/CT in infective endocarditis.","authors":"Vanesa Anton-Vazquez, Antonio Cannata, George Amin-Youssef, Samuel Watson, Amanda Fife, Nicola Mulholland, Margaret Gunning, Alexandros Papachristidis, Phil MacCarthy, Max Baghai, Ranjit Deshpande, Habib Khan, Jonathan Byrne, Rafal Dworakowski","doi":"10.1007/s00392-021-01975-z","DOIUrl":"10.1007/s00392-021-01975-z","url":null,"abstract":"<p><strong>Introduction: </strong>18F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG-PET/CT) is not routinely recommended for the diagnosis of infective endocarditis (IE) due to the lack of clinical impact.</p><p><strong>Materials and methods: </strong>Between January 2016 and January 2020, clinical data from patients with a possible diagnosis of IE were reviewed retrospectively to evaluate the value of ¹⁸F-FDG-PET/CT in the diagnosis of IE. ¹⁸F-FDG PET/CT scan was performed as an additional diagnostic tool in possible IE when echocardiography was inconclusive or in patients with definite IE to identify extracardiac complications. Cases were classified according to modified Duke criteria as rejected, definite or possible.</p><p><strong>Results: </strong>313 patients with suspected IE were included. 72 (23%) patients underwent 18F-FDG PET/CT. ¹⁸F-FDG PET/CT resulted in a reclassification of Duke criteria in 29/72 (40%) patients, from \"possible\" to \"definite\" (n, 10) and to \"rejected\" (n, 19). Patients who benefited from a Duke criteria reclassification following ¹⁸F-FDG PET/CT were more frequently classified as possible IE at inclusion or had a non-conclusive baseline echocardiography (100% vs 58%; p 0.001) and had more likely a prosthetic metallic valve replacement (59% vs 21%; p 0.001). Abnormal perivalvular uptake was identified in 46 patients (71% prosthetic vs 50% native; p 0.118). ¹⁸F-FDG PET/CT identified extracardiac uptake consistent with septic emboli in 14/72 (19%) patients. In addition, extracardiac uptake indicative of an alternative diagnosis was identified in 5 patients (2% prosthetic vs 17% native; p 0.039).</p><p><strong>Conclusion: </strong>The use of ¹⁸F-FDG-PET/CT has shown to be useful in the diagnosis of IE, particularly in prosthetic IE and may provide additional value in the detection of septic emboli and/or the identification of an alternative diagnosis different from IE.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"673-679"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39658157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: An unintentional complication during an intentional procedure-Sinus of Valsalva laceration during BASILICA.","authors":"Norman Mangner,&nbsp;Mohamed Abdel-Wahab,&nbsp;Krunoslav Sveric,&nbsp;Utz Kappert,&nbsp;Julia Fischer,&nbsp;Stephan Haussig,&nbsp;Axel Linke","doi":"10.1007/s00392-021-01949-1","DOIUrl":"https://doi.org/10.1007/s00392-021-01949-1","url":null,"abstract":"","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"720"},"PeriodicalIF":5.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9151498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39558741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A drug-induced hypotensive challenge to verify catheter-based radiofrequency renal denervation in an obese hypertensive swine model.","authors":"Lucas Lauder,&nbsp;L Boyce Moon,&nbsp;Catherine A Pipenhagen,&nbsp;Sebastian Ewen,&nbsp;Jeffrey M Fish,&nbsp;Renu Virmani,&nbsp;James A Jensen,&nbsp;Michael Böhm,&nbsp;Felix Mahfoud","doi":"10.1007/s00392-020-01764-0","DOIUrl":"https://doi.org/10.1007/s00392-020-01764-0","url":null,"abstract":"<p><strong>Objective: </strong>Sham-controlled trials provided proof-of-principle for the blood pressure-lowering effect of catheter-based renal denervation (RDN). However, indicators for the immediate assessment of treatment success are lacking. This study sought to investigate the impact of RDN on renal renin arteriovenous difference (renal renin AV-Δ) following a hypotensive challenge (HC).</p><p><strong>Methods: </strong>Twelve hypertensive Ossabaw swine underwent either combined surgical and chemical (n = 3) or catheter-based RDN (n = 9). A telemetry monitor was implanted to acquire hemodynamic data continuously. Before and after RDN, a sodium nitroprusside-induced HC was performed. Renal renin AV-Δ was calculated as the difference of plasma renin concentrations drawn from the renal artery and vein.</p><p><strong>Results: </strong>In total, complete renal renin AV data were obtained in eight animals at baseline and six animals at baseline and 3 months of follow-up. Baseline renal renin AV-Δ correlated inversely with change in 24-h minimum systolic (- 0.764, p = 0.02), diastolic (r = - 0.679, p = 0.04), and mean (r = - 0.663, p = 0.05) blood pressure. In the animals with complete renin secretion data at baseline and follow-up, the HC increased renal renin AV-Δ at baseline, while this effect was attenuated following RDN (0.55 ± 0.34 pg/ml versus - 0.10 ± 0.16 pg/ml, p = 0.003). Renin urinary excretion remained unchanged throughout the study (baseline 0.286 ± 0.187 pg/ml versus termination 0.305 ± 0.072 pg/ml, p = 0.789).</p><p><strong>Conclusion: </strong>Renin secretion induced by HC was attenuated following RDN and may serve as an indicator for patient selection and guide successful RDN procedures.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"595-603"},"PeriodicalIF":5.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-020-01764-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38556138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble triggering receptor expressed on myeloid cells-1 is a marker of organ injuries in cardiogenic shock: results from the CardShock Study.","authors":"Antoine Kimmoun, Kevin Duarte, Veli-Pekka Harjola, Tuukka Tarvasmäki, Bruno Levy, Alexandre Mebazaa, Sebastien Gibot","doi":"10.1007/s00392-021-01823-0","DOIUrl":"10.1007/s00392-021-01823-0","url":null,"abstract":"<p><strong>Aims: </strong>Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle, positioning leucocytes as central protagonists and potential therapeutic targets. High levels of circulating Triggering Receptor Expressed on Myeloid cells-1 (TREM-1), were associated with death in acute myocardial infarction confirming excessive inflammation as determinant of bad outcome. The present study aims to describe the association of soluble TREM-1 with 90-day mortality and with various organ injuries in patients with CS.</p><p><strong>Methods and results: </strong>This is a post-hoc study of CardShock, a prospective, multicenter study assessing the clinical presentation and management in patients with CS. At the time of this study, 87 patients had available plasma samples at either baseline, and/or 48 h and/or 96-120 h for soluble TREM-1 (sTREM-1) measurements. Plasma concentration of sTREM-1 was higher in 90-day non-survivors than survivors at baseline [median: 1392 IQR: (724-2128) vs. 621 (525-1233) pg/mL, p = 0.008), 48 h (p = 0.019) and 96-120 h (p = 0.029). The highest tertile of sTREM-1 at baseline (threshold: 1347 pg/mL) was associated with 90-day mortality with an unadjusted HR 3.08 CI 95% (1.48-6.42). sTREM-1 at baseline was not associated to hemodynamic parameters (heart rate, blood pressure, use of vasopressors or inotropes) but rather with organ injury markers: renal (estimated glomerular filtration rate, p = 0.0002), endothelial (bio-adrenomedullin, p = 0.018), myocardial (Suppression of Tumourigenicity 2, p = 0.002) or hepatic (bilirubin, p = 0.008).</p><p><strong>Conclusion: </strong>In CS patients TREM-1 pathway is highly activated and gives an early prediction of vital organ injuries and outcome.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"604-613"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25442888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial in-hospital heart rate is associated with long-term survival in patients with acute ischemic stroke.","authors":"Jiann-Der Lee,&nbsp;Ya-Wen Kuo,&nbsp;Chuan-Pin Lee,&nbsp;Yen-Chu Huang,&nbsp;Meng Lee,&nbsp;Tsong-Hai Lee","doi":"10.1007/s00392-021-01953-5","DOIUrl":"https://doi.org/10.1007/s00392-021-01953-5","url":null,"abstract":"<p><strong>Aims: </strong>Increased heart rate has been associated with stroke risk and outcomes. The purpose of this study was to explore the long-term prognostic value of initial in-hospital heart rate in patients with acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>We analyzed data from 21,655 patients with AIS enrolled (January 2010-September 2018) in the Chang Gung Research Database. Mean initial in-hospital heart rates were averaged and categorized into 10-beat-per-minute (bpm) increments. The primary and secondary outcomes were all-cause mortality and cardiovascular death. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable adjusted Cox proportional hazard models, using the heart rate < 60 bpm subgroup as the reference.</p><p><strong>Results: </strong>The adjusted HRs for all-cause mortality were 1.23 (95% CI 1.08-1.41) for heart rate 60-69 bpm, 1.74 (95% CI 1.53-1.97) for heart rate 70-79 bpm, 2.16 (95% CI 1.89-2.46) for heart rate 80-89 bpm, and 2.83 (95% CI 2.46-3.25) for heart rate ≥ 90 bpm compared with the reference group. Likewise, heart rate ≥ 60 bpm was also associated with an increased risk of cardiovascular death (adjusted HR 1.18 [95% CI 0.95-1.46] for heart rate 60-69 bpm, 1.57 [95% CI 1.28-1.93] for heart rate 70-79 bpm, 1.98 [95% CI 1.60-2.45] for heart rate 80-89 bpm, and 2.36 [95% CI 1.89-2.95] for heart rate ≥ 90 bpm).</p><p><strong>Conclusions: </strong>High initial in-hospital heart rate is an independent predictor of all-cause mortality and cardiovascular death in patients with AIS.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"651-662"},"PeriodicalIF":5.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9151537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39551804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry.","authors":"Shinwan Kany,&nbsp;Johannes Brachmann,&nbsp;Thorsten Lewalter,&nbsp;Ibrahim Akin,&nbsp;Horst Sievert,&nbsp;Uwe Zeymer,&nbsp;Jakob Ledwoch,&nbsp;Hüseyin Ince,&nbsp;Dierk Thomas,&nbsp;Matthias Hochadel,&nbsp;Jochen Senges,&nbsp;Paulus Kirchhof,&nbsp;Andreas Rillig","doi":"10.1007/s00392-021-01874-3","DOIUrl":"https://doi.org/10.1007/s00392-021-01874-3","url":null,"abstract":"<p><strong>Background: </strong>Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death.</p><p><strong>Methods: </strong>Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE).</p><p><strong>Results: </strong>A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA₂DS₂-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA₂DS₂-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02-2.72, p = 0.041).</p><p><strong>Conclusion: </strong>Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"511-521"},"PeriodicalIF":5.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-021-01874-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39038395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a benefit of ICD treatment in patients with persistent severely reduced systolic left ventricular function after TAVI?","authors":"Richard J Nies,&nbsp;Christian Frerker,&nbsp;Matti Adam,&nbsp;Elmar Kuhn,&nbsp;Victor Mauri,&nbsp;Felix S Nettersheim,&nbsp;Simon Braumann,&nbsp;Thorsten Wahlers,&nbsp;Stephan Baldus,&nbsp;Tobias Schmidt","doi":"10.1007/s00392-021-01826-x","DOIUrl":"https://doi.org/10.1007/s00392-021-01826-x","url":null,"abstract":"<p><strong>Background: </strong>In patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) and heart failure with severely reduced ejection fraction, prediction of postprocedural left ventricular ejection fraction (LVEF) improvement is challenging. Decision-making and timing for implantable cardioverter defibrillator (ICD) treatment are difficult and benefit is still unclear in this patient population.</p><p><strong>Objective: </strong>Aims of the study were to analyse long-term overall mortality in TAVI-patients with a preprocedural LVEF ≤ 35% regarding LVEF improvement and effect of ICD therapy.</p><p><strong>Methods and results: </strong>Retrospective analysis of a high-risk TAVI-population suffering from severe AS and heart failure with a LVEF ≤ 35%. Out of 1485 TAVI-patients treated at this center between January 2013 and April 2018, 120 patients revealed a preprocedural LVEF ≤ 35% and had sufficient follow-up. 36.7% (44/120) of the patients suffered from persistent reduced LVEF without a postprocedural increase above 35% within 1 year after TAVI or before death, respectively. Overall mortality was neither significantly reduced by LVEF recovery above 35% (p = 0.31) nor by additional ICD treatment in patients with persistent LVEF ≤ 35% (p = 0.33).</p><p><strong>Conclusion: </strong>In high-risk TAVI-patients suffering from heart failure with LVEF ≤ 35%, LVEF improvement to more than 35% did not reduce overall mortality. Patients with postprocedural persistent LVEF reduction did not seem to benefit from ICD treatment. Effects of LVEF improvement and ICD treatment on mortality are masked by the competing risk of death from relevant comorbidities.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"492-501"},"PeriodicalIF":5.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00392-021-01826-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25510775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile health solutions for atrial fibrillation detection and management: a systematic review.","authors":"Astrid N L Hermans, Monika Gawalko, Lisa Dohmen, Rachel M J van der Velden, Konstanze Betz, David Duncker, Dominique V M Verhaert, Hein Heidbuchel, Emma Svennberg, Lis Neubeck, Jens Eckstein, Deirdre A Lane, Gregory Y H Lip, Harry J G M Crijns, Prashanthan Sanders, Jeroen M Hendriks, Nikki A H A Pluymaekers, Dominik Linz","doi":"10.1007/s00392-021-01941-9","DOIUrl":"10.1007/s00392-021-01941-9","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to systematically review the available literature on mobile Health (mHealth) solutions, including handheld and wearable devices, implantable loop recorders (ILRs), as well as mobile platforms and support systems in atrial fibrillation (AF) detection and management.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The electronic databases PubMed (NCBI), Embase (Ovid), and Cochrane were searched for articles published until 10 February 2021, inclusive. Given that the included studies varied widely in their design, interventions, comparators, and outcomes, no synthesis was undertaken, and we undertook a narrative review.</p><p><strong>Results: </strong>We found 208 studies, which were deemed potentially relevant. Of these studies included, 82, 46, and 49 studies aimed at validating handheld devices, wearables, and ILRs for AF detection and/or management, respectively, while 34 studies assessed mobile platforms/support systems. The diagnostic accuracy of mHealth solutions differs with respect to the type (handheld devices vs wearables vs ILRs) and technology used (electrocardiography vs photoplethysmography), as well as application setting (intermittent vs continuous, spot vs longitudinal assessment), and study population.</p><p><strong>Conclusion: </strong>While the use of mHealth solutions in the detection and management of AF is becoming increasingly popular, its clinical implications merit further investigation and several barriers to widespread mHealth adaption in healthcare systems need to be overcome. Mobile health solutions for atrial fibrillation detection and management: a systematic review.</p>","PeriodicalId":401855,"journal":{"name":"Clinical research in cardiology : official journal of the German Cardiac Society","volume":" ","pages":"479-491"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39437649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}