Endothelialization and Inflammatory Reactions After Intracardiac Device Implantation

Edlinger, Christoph; Paar, Vera; Kheder, Salma Haj; Krizanic, Florian; Lalou, Eleni; Boxhammer, Elke; Butter, Christian; Dworok, Victoria; Bannehr, Marwin; Hoppe, Uta C.; Kopp, Kristen; Lichtenauer, Michael

doi:10.1007/5584_2022_712

Cited by 5 publications

(4 citation statements)

References 174 publications

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“…Several factors including poor perceived health status, more severe anxiety and heightened fatigue emerged as the most significant, unique correlates of overall depression scores in this sample. These findings dovetail with previous findings documenting higher risk for severe depression among pacemaker implantation recipients due to more highly compromised immune systems (55), poorer health status and limited access to appropriate care during the COVID-19 pandemic (56), anxiety symptoms, increased sleep disturbances (57), fatigue, and lower socioeconomic status (52).…”

Section: Discussionsupporting

confidence: 88%

Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis

et al. 2023

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BackgroundThis study was designed to investigate the prevalence and predictors of depression in patients after pacemaker implantation during the COVID-19 pandemic in addition to identifying specific depressive symptoms associated with quality of life (QOL) using network analysis (NA).MethodsThis cross-sectional, observational study was conducted in China between July 1, 2021, and May 17, 2022. Descriptive analysis was used to calculate depression prevalence. Univariate analyses were used to compare differences in demographic and clinical characteristics between depressed and non-depressed patients following pacemaker implantation. Binary logistic regression analysis was used to assess factors independently associated with depression. Network analysis “expected influence,” and flow function indexes were used to identify symptoms central to the depression network of the sample and depressive symptoms that were directly associated with QOL, respectively. Network stability was examined using a case-dropping bootstrap procedure.ResultsIn total, 206 patients implanted with a pacemaker met the study entry criteria and completed the assessment. The overall prevalence of depression (PHQ-9 total score ≥ 5) was 39.92% [95% confidence interval (CI) = 29.37−42.47%]. A binary logistic regression analysis revealed that patients with depression were more likely to report a poor health status (p = 0.031), severe anxiety symptoms (p < 0.001), and fatigue (p < 0.001). In the network model for depression, “Sad mood,” “Poor Energy,” and “Guilt” were the most influential symptoms. “Fatigue” had the strongest negative association with QOL, followed by “Sad mood” and “Appetite”.ConclusionDepression is common among patients having undergone pacemaker implantation during the COVID-19 pandemic. Anxiety, central symptoms of depression (i.e., “Sad mood”, “Poor Energy”, and “Guilt”) and depressive symptoms linked to QOL (i.e., “Sad mood”, “Appetite”, and “Fatigue”) identified in this study are promising targets for interventions and preventive measures for depression in patients who have undergone pacemaker implants.

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Section: Discussionsupporting

confidence: 88%

Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis

et al. 2023

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“…Moreover, less than 3% of patients reported a migraine at the one-month follow-up visit. Although these symptoms might be under-reported in cases with a mild degree of migraine, it is interesting to note that the Occlutech devices are made of Titanium oxide-covered nitinol, which should result in the lowest possible release of nickel [ 36 ]. Nickel allergies are type IV: contact allergies caused by sustained exposure, usually after several hours or days.…”

Section: Discussionmentioning

confidence: 99%

The RISE Study: Retrospective Registry for the International Safety and Efficacy Results of Patent Foramen Ovale Closure with Figulla Flex Il PFO and UNI Occluders

Pioch,

Trabattoni,

Bouvaist

et al. 2024

JCM

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Background: Transcatheter closure of a patent foramen ovale (PFO) is performed in cryptogenic stroke and other conditions. Information is lacking for some devices. Methods: We aimed to evaluate the Figulla Flex II PFO Occluder (FFP) and Figulla Flex UNI Occluder (FFU) through a retrospective multi-center registry. Results: 527 patients were included. Mean age was 48.9 (±13.8) years. The procedure was under transthoracic, transesophageal or intracardiac echocardiography in 185 (35.1%), 193 (36.6%) and 149 (28.3%) cases, respectively, and under general anesthesia in 191 patients (36.2%). The FFP and FFU were used in 408 (77.4%) and 119 (22.6%) cases, respectively. The success rate was 99.1%. Median follow-up was 1.1 (0.5–2.5) years. A new atrial fibrillation/flutter within six months occurred in 14 (2.7%) cases, with no difference between devices. One device embolization in the pulmonary artery was identified two years post-procedure. Residual shunts occurred in 18 (6.9%) cases at 1 year, with TIA in three (16.6%) patients. Out of 437 patients with stroke/TIA, 260 (59%) were followed more than one year after closure. Median follow-up was 2.1 (1.17–3.1) years, with four recurrent strokes/TIA. Conclusions: The FFP and FFU devices are safe and effective for PFO closure, with very few atrial fibrillation/flutter and neurologic events, except in cases with a residual shunt.

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“…Similar to all medical devices implanted into the body, a longer implantation time beyond 90 days is expected to enable complete endothelialization for occluders post LAAC when exposed to circulating blood [ 19 , 20 ]. Thrombosis formation might occur on the exposed device and adequate antithrombotic regimens are required for DRT prevention.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effectiveness and Safety Comparison between Reduced Rivaroxaban Dose and Dual Antiplatelet Therapy for Nonvalvular Atrial Fibrillation Patients Following Percutaneous Left Atrial Appendage Closure: A Prospective Observational Study

Li,

Jin,

Yao

et al. 2023

Rev. Cardiovasc. Med.

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Background: Device-related thrombosis (DRT) after successful closure implantation on left atrial appendage (LAA) was considered as a major challenge and optimal strategy on antithrombotic therapy remains to be solved. This study was performed to compare the clinical effectiveness and safety of reduced rivaroxaban dose (RRD) and dual antiplatelet therapy (DAPT) after left atrial appendage closure (LAAC) implantation with the Watchman device. Methods: After successful LAAC, consecutive participants were medicated with a standard DAPT or RRD. The primary endpoints included DRT, thrombosis events (TE), and bleeding events that were documented during a 12-month follow-up period. Results: 767 patients (DAPT: n = 140; RRD: n = 627) were initially included. After propensity score matching (PSM), 140 patients treated with DAPT and 280 patients with RRD were included in each group with similar baseline information, thromboembolic and bleeding risk factors, cardiovascular risk factors and concomitant medication. In the RRD group, 193 patients were on rivaroxaban 15 mg ( ) and 47 received rivaroxaban 10 mg ( ). The incidence of DRT was documented in 12 (9.3%) patients in the DAPT group and 3 (6.3%) in and 7 (3.0%) in (log-rank p = 0.050). DAPT subgroups were more likely to experience shorter time to DRT as compared to ( vs . DAPT hazard ratio (HR) = 0.334, p = 0.015, 95% CI: 0.131–0.850). The median length of DRT in the group was significantly lower than that of the DAPT group (1.721 [1.610–1.818] mm vs . 1.820 [1.725–1.925] mm, p = 0.029). Compared with the unadjusted estimated rates of ischemic events for patients with similar congestive heart failure, hypertension, age 75 years, diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism, vascular disease, age 65–74 years, sex category ( - ) scores, a significant decrease of 68.6% in ischemic stroke rates was noted in the group, which contributed to a 54.9% reduction of overall thromboembolic events. The overall minor bleeding was not significantly different amongst the three groups ( p = 0.944). Procedural bleeding was more common in the DAPT group, as compared with the and groups. Conclusions: After successful closure implantation, long-term RRD significantly reduced the DRT and TE occurrence compared with DAPT.

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Endothelialization and Inflammatory Reactions After Intracardiac Device Implantation

Cited by 5 publications

References 174 publications

Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis

Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis

The RISE Study: Retrospective Registry for the International Safety and Efficacy Results of Patent Foramen Ovale Closure with Figulla Flex Il PFO and UNI Occluders

Clinical Effectiveness and Safety Comparison between Reduced Rivaroxaban Dose and Dual Antiplatelet Therapy for Nonvalvular Atrial Fibrillation Patients Following Percutaneous Left Atrial Appendage Closure: A Prospective Observational Study

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