G Dannberg

Friedrich-Schiller-University Jena, Jena, Thuringia, Germany

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Publications (30)48.87 Total impact

  • Biomedizinische Technik/Biomedical Engineering 09/2013; · 1.16 Impact Factor
  • Biomedizinische Technik/Biomedical Engineering 09/2013; · 1.16 Impact Factor
  • Biomedizinische Technik/Biomedical Engineering 09/2012; · 1.16 Impact Factor
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    ABSTRACT: Transcatheter treatment of heart valve disease is well established today. However, for the treatment of tricuspid regurgitation (TR), no effective catheter-based approach is available. Herein, we report the first human case description of transcatheter treatment of severe TR in a 79-year-old patient with venous congestion and associated non-cardiac diseases. In this patient, surgical treatment had been declined and pharmacological therapy had been ineffective. After ex vivo and animal studies, the treatment of TR was performed by percutaneous caval valve implantation. In a transcatheter approach through the right femoral vein, a custom-made self-expanding heart valve was implanted into the inferior vena cava (IVC). The device was anchored in the IVC at the cavoatrial junction with the level of the valve aligned immediately above the hepatic inflow and protruding into the right atrium. After deployment, excellent valve function was observed resulting in a marked reduction in caval pressure and an abolition of the ventricular wave in the IVC. Sequential echocardiographic exams over a follow-up period of 8 weeks confirmed continuous device function without paravalvular leakage or remaining venous regurgitation. The patient experienced improved physical capacity and was able to resume off-bed activities. There was no recurrence of right heart failure during follow-up and a partial reduction of ascites. The patient was discharged from hospital into a rehabilitation programme. Transcatheter treatment of severe TR by caval valve implantation is feasible resulting in an immediate abolition of IVC regurgitation and mid-term clinical improvement. Thus, in selected non-surgical patients, caval valve implantation may become a therapeutic option to treat venous regurgitation and improve associated non-cardiac diseases. Further confirmatory experience with longer follow-up is required to evaluate the long-term clinical benefit of the procedure as well as potential deleterious effects.
    European Heart Journal 02/2011; 32(10):1207-13. · 14.10 Impact Factor
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    ABSTRACT: Cardiac resynchronisation therapy (CRT) by biventricular (BV) pacing is an established therapy for heart failure (HF) patients with interventricular delay (IVD), but not all patients improved clinically. The aim of the study was to evaluate directed transesophageal signal averaged electrocar diography (SAECG) for recording of right ventricular (RV) far field potential and left ventricular (LV) potential in evalua tion of IVD and LV delay (LVD) in patients with HF and left bundle branch block (LBBB). Methods: Ten HF patients (age 69 ± 10 years; 2 females, 8 males) in NYHA class 3, 27 ± 5 % LV ejection fraction and 167 ± 20 ms QRS duration (QRSD) were analyzed IVD and LVD using directed transesophageal bipolar recording of the posterior LV wall potential with hemispherical electrodes before implantation with devices for CRT. IVD was the interval between onset of RV potential and onset of LV potential in the transesophageal SAECG. LVD was the interval between onset and offset of LV potential in the transesophageal SAECG. Results: Recording of directed transesophageal signal averaged RV and LV potential was possible in 100% of HF patients with LBBB. Transesophageal IVD was not different than transesophageal LVD (85 ± 18 ms vs. 71 ± 20 ms, P = 0.190). Transesophageal IVD and LVD were smaller than QRSD (P < 0.001). Transesophageal IVD was not different than intracardiac RV-LV-interval between BV pacing device electrodes (85 ± 18 ms vs. 69 ± 26 ms, P = 0.144). Finite element simulation evaluated electrical cardiac pacing field. Conclusion: Directed transesophageal LV and RV far field SAECG may detect IVD and LVD in symptomatic HF patients with LBBB before implantation of BV pacing device. Highresolution transesophageal SAECG recording may be a useful non-invasive technique to evaluate RV and LV desynchronisation in HF patients. Keywordstransesophageal electrocardiography-interventricular delay-heart failure-biventricular pacing-cardiac resynchronisation therapy
    01/2010: pages 764-767;
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    ABSTRACT: Cardiac resynchronisation therapy (CRT) by biventricular (BV) pacing is an established therapy for heart failure (HF) patients with ventricular desynchronisation, but not all patients improved clinically. The aim of the study was to assess directed transesophageal electrocardiography (ECG) of left atrial (LA) potential and left ventricular (LV) potential in evaluation of interatrial delay (IAD) and interventricular delay (IVD) in patients with HF. Methods: 45 HF patients (age 61 ± 12 years; 9 females, 36 males) in NYHA class 2.9 ± 0.4, 26 ± 9 % LV ejection fraction and 157 ± 40 ms QRS duration (QRSD) were analyzed IAD and IVD using directed transesophageal bipolar recording of the posterior LA and LV wall potentials with hemispherical electrodes. IAD was the right atrial - LA - interval between onset of P-wave in the surface ECG and onset of LA potential in the transesophageal ECG. IVD was the right ventricular - LV - interval between onset of QRS complex in the surface ECG and onset of LV potential in the transesophageal ECG. Results: Transesophageal IVD was smaller than transesophageal IAD (66 ± 32 ms vs. 82 ± 39 ms, P = 0.036) in HF patients with impaired LV function. Transesophageal IAD was smaller than QRSD (P< 0.001) and transesophageal IVD was also smaller than QRSD (P< 0.001). Enlarged left atria were smaller than enlarged left ventricles (48 ± 9 mm vs. 61 ± 9 mm, P< 0.001) in HF patients. Finite element simulation of electrical pacing field evaluated transesophageal directed electrical field electrodes. Conclusion: Directed transesophageal LA and LV ECG may detect IAD and IVD in symptomatic HF patients before implantation of BV pacing device. Transesophageal LA and LV ECG recording may be a useful non-invasive technique to detect atrial and ventricular desynchronisation in HF patients. Keywordstransesophageal electrocardiography-interatrial delay-interventricular delay-heart failure-biventricular pacing
    01/2010: pages 137-140;
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    ABSTRACT: INTRODUCTION: The purpose of this study was to evaluate termination of atrial flutter (AFL) by directed rapid transesophageal atrial pacing (TAP) with and without simultaneous transesophageal echocardiography (TEE) performed using a novel TEE tube electrode. MATERIALS AND METHODS, AND RESULTS: A total of 16 AFL patients (age 63+/-12 years; 13 males) with mean AFL cycle length of 224+/-24 ms (n=12) and mean ventricular cycle length of 448+/-47 ms (n=12) were analyzed using either an esophageal TO electrode (n=10) or a novel TEE tube electrode consisting of a tube with four hemispherical electrodes that is pulled over the echo probe (n=6). AFL could be terminated by directed rapid TAP using an esophageal TO electrode, leading to induction of atrial fibrillation (AF) (n=6), induction of AF and spontaneous conversion to sinus rhythm (SR) (n=3), and with conversion to SR (n=1). AFL could also be terminated by directed rapid TAP using the TEE tube electrode, with induction of AF (n=3) or induction of AF and spontaneous conversion to SR (n=3). CONCLUSION: AFL can be terminated by directed rapid TAP with hemispherical electrodes with and without simultaneous TEE. TAP with the directed TEE tube electrode is a safe, simple, and useful method for terminating AFL.
    Biomedizinische Technik 02/2007; 52(2):180-4. · 1.16 Impact Factor
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    ABSTRACT: INTRODUCTION: Biventricular (BV) pacing is an established therapy for heart failure (HF) patients with intraventricular conduction delay, but not all patients improved clinically. We investigated the interventricular delay (IVD) by means of the transesophageal left ventricular posterior wall potential (LVPWP). MATERIALS AND METHODS, AND RESULTS: A total of 18 HF patients (age 62+/-9 years; 15 males) with NYHA class 3.1+/-0.3, LV ejection fraction 22+/-7%, left bundle branch block and a QRS duration (QRSD) of 171+/-27 ms were analyzed using transesophageal LVPWP before implantation of a BV pacing device. The median follow up was 14+/-14 months. In 14 responders, IVD was 81+/-25 ms with a QRSD/IVD ratio of 2.2+/-0.3 with reclassification of NYHA class 3.1+/-0.3 to 2.0+/-0.5 (p<0.001) and an increase in LV ejection fraction from 22+/-7% to 36+/-11% (p=0.001) during long-term BV pacing. In four non-responders, transesophageal IVD was significantly smaller at 30+/-11 ms (p=0.001). CONCLUSION: Transesophageal IVD may be a useful method to detect responders to BV pacing. Transesophageal LVPWP may be a simple and useful technique to detect clinical responders to BV pacing in HF patients.
    Biomedizinische Technik 01/2007; 52(2):173-9. · 1.16 Impact Factor
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    ABSTRACT: Previous studies of biventricular (BV) pacing for treatment of heart failure (HF) patients with left bundle branch block (LBBB) evaluated responders to BV pacing with acute transvenous left ventricular (LV) pacing and arterial pulse pressure (PP). The aim of this study was to assess transoesophageal LV pacing in evaluation of the haemodynamic response with a view to upgrading responders from permanent right ventricular (RV) pacing to BV pacing. Ten HF patients (age 62+/-8 years; one female, nine males) in NYHA III, LV ejection fraction 24+/-9% and permanent RV pacing by means of an implanted pacemaker or ICD were tested using transoesophageal LV pacing and PP. Permanently RV-paced HF patients were analysed with transoesophageal atrial sensed LV pacing in VAT mode with a different AV delay (n = 6) and with transoesophageal LV pacing in V00 mode during atrial fibrillation (n = 4). In five responders, PP was higher during transoesophageal LV pacing than PP during RV pacing (74+/-42 versus 57+/-31 mmHg, P = 0.015). Responders were upgraded by means of an LV lead via the coronary sinus in the posterior (n = 1) or posterolateral (n = 4) walls and after attaining a high LV pacing threshold with an epicardial LV lead on the anterior (n = 1) or anterolateral (n = 1) walls. NYHA class improved from 3 to 2+/-0.3 (P = 0.003) during 204+/-120 days follow-up and cardiac output increased from 4.4+/-1.5 to 5.6+/-1.7 l/min (P = 0.027) when comparing BV pacing and optimal AV delay with RV pacing. In five nonresponders, PP was not higher during transoesophageal LV pacing than during RV pacing. Transoesophageal LV pacing may be a useful technique to detect responders to BV pacing in permanently RV-paced HF patients.
    Europace 12/2005; 7(6):617-20. · 2.77 Impact Factor
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    ABSTRACT: Aside from enteroviruses and other viruses, e.g., adenoviruses, which are known to be associated with idiopathic dilated cardiomyopathy (IDC), a cardiac tropism is also attributed to parvovirus B19 (PVB19). The purpose of the present study was to determine the prevalence of enterovirus, adenovirus and PVB19 genomes in the myocardium of adult patients with IDC and to analyze the significance of PVB19 with regard to the course of the disease, as compared to the other cardiotropic viruses. In 52 adult patients with IDC and 10 control patients with normal left ventricular ejection fraction (> or =55%) undergoing coronary artery bypass surgery, myocardial tissue samples were investigated for enteroviral RNA using polymerase chain reaction (PCR) and Southern blot hybridization of the PCR product. Specific nested PCR was used to assess the prevalence of adenovirus and PVB19 DNA, in addition to sequencing of the latter. The clinical and echocardiographic course of the disease was followed for a mean (+/- SD) period of 21.1+/-9.5 months. Fourteen of the 52 patients (27%) were enterovirus-positive, 2/52 (4%) patients were adenovirus-positive, 14/52 (27%) patients were PVB19-positive, 8/52 (15%) patients were enterovirus plus PVB19-positive, and in 14/52 (27%) patients no viral genomes were found. Six patients died during the follow-up period, without any significant difference between the patient groups: 1/14 (7%) in the enterovirus-positive, 0/2 (0%) in the adenovirus-positive, 2/14 (14%) in the PVB19-positive, 1/8 (12.5%) in the enterovirus plus PVB19-positive, and 2/14 (14%) in the virus-negative group. PVB19 genome was found in 4 of the 10 (40%) control patients, but no enterovirus or adenovirus genomes were detected in these patients. In conclusion, in the myocardium of patients with IDC, PVB19 is detectable as frequently as enteroviral genome. PVB19-positive patients with IDC have a rather favorable prognosis and do not differ significantly from the other virus-positive or virus-negative patient groups with respect to survival. Finally, the pathogenetic and prognostic significance of PVB19 in IDC still remains unclear.
    Medical Microbiology and Immunology 06/2004; 193(2-3):75-82. · 3.55 Impact Factor
  • Europace 01/2003; 4. · 2.77 Impact Factor
  • Europace 01/2003; 4. · 2.77 Impact Factor
  • Europace 01/2003; 4. · 2.77 Impact Factor
  • Europace 01/2003; 4. · 2.77 Impact Factor
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    ABSTRACT: Stent loss and failure of retrieval are rare; nevertheless, complications have to be taken into account during percutaneous coronary intervention. Here we report a case of an unexpanded, irretrievable Palmaz-Schatz stent in the proximal right coronary artery near to the ostium and the successful management by implanting a synthetic stent graft.
    Catheterization and Cardiovascular Interventions 04/1999; 46(3):344-9. · 2.51 Impact Factor
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    ABSTRACT: In 19 patients with different supraventricular tachycardias the antiarrhythmic drug AWD-G256 was studied to investigate the effects on hemodynamic parameters. Over all, stroke volume, pulmonary pressure and systemic blood pressure were not significantly altered. The only main adverse effect was a transient rise of serum transaminases in two patients. We conclude that AWD-G256 is usually hemodynamically tolerated, but the antiarrhythmically effective dosage is not reached yet.
    Pharmazie 06/1993; 48(5):385-7. · 0.96 Impact Factor
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    ABSTRACT: The effects of the new antiarrhythmic drug AWD-G256 (1) were investigated by clinical electrophysiology (His bundle electrography, programmed electrical stimulation) in 19 patients with supraventricular tachycardias but without structural heart disease. In a maximal dosage of 0.45 mg/kg body mass 1 only minimally affects electrophysiological parameters of the impulse formation and conduction. At this time the therapeutic value of 1 is not clear.
    Pharmazie 06/1993; 48(5):380-5. · 0.96 Impact Factor
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    ABSTRACT: To evaluate the therapeutic significance of noninvasive transesophageal pacing for termination of tachycardias the method of rapid atrial or ventricular transesophageal pacing was used in 233 patients with different tachycardiac arrhythmias. We were able to terminate atrial flutter in 136 of 162 patients by transesophageal rapid atrial stimulation (conversion to sinus rhythm in 75 cases, induction of atrial fibrillation in 61 cases). Atrial tachycardias were interrupted in 17 of 23 patients (sinus rhythm in 11 cases, atrial fibrillation in six cases). AV reciprocating/AV nodal supraventricular reentry tachycardias were terminated in 62 of 63 patients (sinus rhythm in 58 cases, atrial fibrillation in four cases). By transesophageal rapid ventricular pacing ventricular tachycardias could be terminated in ten of 15 patients. The success rate of transesophageal pacing was influenced by the pacing rate, by the type of tachycardiac arrhythmia inclusive by the type of atrial flutter and by the tachycardia's cycle length. Because the success rates are comparable with invasive technique and the procedure is simpler, the noninvasive transesophageal antitachycardiac pacing should be respected as the method of the first choice in patients with supraventricular tachycardias.
    Pacing and Clinical Electrophysiology 12/1992; 15(11 Pt 2):1962-6. · 1.75 Impact Factor
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    ABSTRACT: The electrophysiologic effects and antiarrhythmic efficacy of tiracizine, a new class I antiarrhythmic drug, were studied in 16 patients with documented sustained ventricular tachycardia (VT) after intravenous drug application and in 6 patients after oral drug administration by means of programmed ventricular stimulation (PVS). After intravenous tiracizine (0.3 mg/kg) the VT was no longer inducible by PVS in 3 of 16 patients and became nonsustained in another patient. In 11 of 13 patients with further inducible VT the cycle duration of VT increased after tiracizine (mean 29 ms). After oral tiracizine (150-225 mg/day) the VT induction was suppressed in one patient. In a second patient the VT became nonsustained. Cycle length of VT in 4 patients with persistent induction of VT was longer after therapy (mean 88 ms). Antiarrhythmic efficacy of intravenous or oral tiracizine can be expected in at least one third of patients with VT.
    Zeitschrift für die gesamte innere Medizin und ihre Grenzgebiete 01/1992; 46(17):635-41.
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    ABSTRACT: We were able to terminate atrial flutter in 136 of 162 patients by transesophageal rapid atrial stimulation (conversion to sinus rhythm in 75 cases, induction of atrial fibrillation in 61 cases). Atrial tachycardias were interrupted in 17 of 23 patients (sinus rhythm in 11, atrial fibrillation in 6 cases), AV reciprocating resp. AV nodal supraventricular tachycardias were terminated in 32 of 33 patients (sinus rhythm in 28 cases, atrial fibrillation in 4 cases). By transesophageal rapid ventricular and/or atrial pacing, ventricular tachycardias could be terminated in 10 of 15 patients. The success rate of transesophageal pacing is influenced by the type of tachyarrhythmia, by the type of atrial flutter and by the stimulation rate. It is not influenced by the tachycardia's cycle length. Because the success rates are comparable with invasive technique and the procedure is simpler, the non-invasive transesophageal antitachycardia pacing represents a useful method for termination of tachycardic arrhythmias.
    Zeitschrift für Kardiologie 07/1991; 80(6):382-8. · 0.97 Impact Factor

Publication Stats

71 Citations
48.87 Total Impact Points

Institutions

  • 1987–2007
    • Friedrich-Schiller-University Jena
      • • Clinic of Internal Medicine III
      • • Department of Anaesthesiology and Intensive Care Medicine
      • • Section of Cardiology
      Jena, Thuringia, Germany
  • 2005
    • Universitätsklinikum Jena
      Jena, Thuringia, Germany