Publications by authors named "Jonas Wörmann"

6 Publications

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ICD therapy in the elderly: a retrospective single-center analysis of mortality.

Herzschrittmacherther Elektrophysiol 2021 Jan 29. Epub 2021 Jan 29.

Department of Electrophysiology, Cologne, University Heart Center Cologne, Kerpener Str. 62, 50937, Köln, Germany.

Background: Current implantable cardioverter-defibrillator (ICD) guidelines do not impose age limitations for ICD implantation (IMPL) and generator exchange (GE); however, patients (pts) should be expected to survive for 1 year. With higher age, comorbidity and mortality due to non-sudden cardiac death increase. Thus, the benefit of ICD therapy in elderly pts remains unclear. Mortality after ICD IMPL or GE in pts ≥ 75 years was assessed.

Methods: Consecutive pts aged ≥ 75 years with ICD IMPL or GE at the University Hospital Cologne, Germany, between 01/2013 and 12/2017 were included in this retrospective analysis.

Results: Of 418 pts, 82 (20%) fulfilled the inclusion criteria; in 70 (55 = IMPL, 79%, 15 = GE, 21%) follow-up (FU) was available. The median FU was 3.1 years. During FU, 40 pts (57%) died (29/55 [53%] IMPL; 11/15 [73%] GE). Mean survival after surgery was 561 ± 462 days. The 1‑year mortality rate was 19/70 (27%) overall, 9/52 (17%) in pts ≥ 75 and 10/18 (56%) in pts ≥ 80 years. Deceased pts were more likely to suffer from chronic renal failure (85% vs. 53%, p = 0.004) and peripheral artery disease (18% vs. 0%, p = 0.02). During FU, seven pts experienced ICD shocks (four appropriate, three inappropriate). In primary prevention (n = 35) mortality was 46% and four pts experienced ICD therapies (two adequate); in secondary prevention (n = 35) mortality was 69% (p = 0.053) with three ICD therapies (two adequate).

Conclusion: Mortality in ICD pts aged ≥ 80 years was 56% at 1 and 72% at 2 years in this retrospective analysis. The decision to implant an ICD in elderly pts should be made carefully and individually.
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http://dx.doi.org/10.1007/s00399-021-00742-xDOI Listing
January 2021

Gender-related differences in treatment and outcome of extracorporeal cardiopulmonary resuscitation-patients.

Artif Organs 2020 Oct 14. Epub 2020 Oct 14.

Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, Germany.

Extracorporeal cardiopulmonary resuscitation (eCPR) is a rapidly growing treatment strategy due to significant improvement in selected patients' survival rates. Gender-related differences might impact the outcome of therapeutic measures. Therefore, we sought to investigate patients with eCPR at our interdisciplinary extracorporeal membrane oxygenation center regarding sex-related differences with the view to potentially adjusting current selection criteria. From January 2016 to December 2019, 71 patients underwent eCPR at our institution. Data before eCPR and early outcome parameters were analyzed comparing male and female patients. The cohort analyzed consisted of 60 male (84%) and 11 female (15%) patients. Comparing both groups, male patients significantly more frequently suffered out-of-hospital cardiac arrest (68% male vs. 36% female, P = .04), whereas female patients were associated with more in-hospital cardiac arrest (32% male vs. 64% female, P = .04). Creatinine levels differed significantly (1.5 (1.1;2.1) mg/dL in male vs. 1.0 (0.7;1.5) mg/dL in female patients, P = .03). Also, several hepatic parameters showed a significant difference between the groups: aspartate aminotransferase 423 (249;804) U/L in male vs. 115 (61;408) U/L in female patients, P = .01; alanine aminotransferase 174 (102;446) U/L in male vs. 86 (36;118) U/L in female patients, P = .01). Renal failure requiring hemodialysis occurred more frequently in men than in women (P < .01). There is a significant effect of male sex regarding renal failure with subsequent continuous venovenous hemodialysis (CVVH) (R  = 0.11, ANOVA P = .01, 95% CI = -0.79--0.079). However, in-hospital mortality was comparable between the groups (78% in male vs. 72% in female patients, P = .68). Our retrospective study showed several gender-related differences associated with different cardiac arrest scenarios. Male sex was associated with a significantly higher risk for renal failure requiring CVVH. Survival rates were comparable between the groups. Further investigations should include gender in the evaluation of risk stratification for eCPR-related complications to further improve selection criteria for this demanding therapy.
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http://dx.doi.org/10.1111/aor.13844DOI Listing
October 2020

First transcatheter leadless pacemaker implantation in a pediatric patient with a genetic disease.

Herzschrittmacherther Elektrophysiol 2020 Jun 5;31(2):235-237. Epub 2020 May 5.

Department of Electrophysiology, Heart Center, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

A pediatric patient suffering from Marden-Walker syndrome, a rare genetic disease, was referred to the authors' hospital for syncope due to bradycardia. Since this disease is associated with severe joint contractures, a transcatheter leadless pacing system (TPS) was chosen. Despite the small body size and complex anatomy, TPS implantation was feasible, demonstrating that it is a safe alternative in difficult venous access compared to a conventional pacemaker with increased risk of lead complications in these patients.
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http://dx.doi.org/10.1007/s00399-020-00685-9DOI Listing
June 2020

[Rhythmogenic syncopes and survived sudden cardiac death].

Herzschrittmacherther Elektrophysiol 2019 Mar 7;30(1):72-88. Epub 2019 Mar 7.

Medizinische Klinik I, Krankenhaus Landshut-Achdorf, Achdorfer Weg 3, 84036, Landshut, Deutschland.

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http://dx.doi.org/10.1007/s00399-019-0614-2DOI Listing
March 2019

[Narrow complex tachycardias].

Herzschrittmacherther Elektrophysiol 2019 Mar;30(1):24-37

Herzzentrum, Abteilung für Elektrophysiologie, Universitätsklinik Köln, Kerpenerstraße 62, 50937, Köln, Deutschland.

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http://dx.doi.org/10.1007/s00399-019-0608-0DOI Listing
March 2019