Gerhard Hindricks

Kunststoff-Zentrum in Leipzig, Leipzig, Saxony, Germany

Are you Gerhard Hindricks?

Claim your profile

Publications (468)2212.63 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Left atrium (LA) size is a common predictor of ablation outcomes in atrial fibrillation (AF), but different LA diameters have not been adequately studied yet. We aimed to find the best predictor of ablation outcomes using single-linear LA dimensions by computed tomography (CT) or echocardiography. Patients (n = 103, 72 males, 59 ± 9 years) undergoing AF ablation were analyzed. LA diameter (LA-D) was measured by transthoracic echocardiography (parasternal long axis). After 3D reconstruction of CT data (EnSite Verismo, SJM, MN), maximal LA dimensions were measured on a coronal plane (superior-inferior, SI, and transversal, TV) and a sagittal plane (anterior-posterior, AP). Volume (LAV) was rendered after LA appendage and pulmonary vein exclusion. Patients with persistent AF (n = 40) had significantly larger LA size than those with paroxysmal AF (n = 63). After 26 ± 14 months, 31 (30 %) patients had AF recurrence. Univariate Cox regression analysis revealed that LA-D, LA-SI, LA-TV, LAV, and LAV-index (LAV/body surface area) were associated with AF recurrence. Multivariate Cox regression analysis revealed that LAV was the strongest independent predictor of AF recurrence (HR = 1.011 per ml, 95 % CI 1.003-1.020, p = 0.002). LA-TV had the best correlation with LAV (r = 0.69, p < 0.01) and was the strongest single-linear predictor (HR = 1.07 per mm, 95 % CI 1.022-1.121, p = 0.004). Independent of LA-D, an LA-TV>74.5 mm predicted AF recurrence similarly to LAV>126 ml. LA dilatation, especially on the coronal plane, is associated with reduced long-term success after catheter ablation. LA-TV is the best linear predictor of AF recurrence, stronger than the commonly used LA-D.
    Journal of Interventional Cardiac Electrophysiology 05/2015; DOI:10.1007/s10840-015-0010-8 · 1.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In patients with ischemic cardiomyopathy the size of bipolar low voltage areas (LVA) in electroanatomical maps (EAM) was associated with poorer outcomes after catheter ablation (CA) of ventricular tachycardia (VT). However, the effect of LVA size on the survival after VT ablation in patients with nonischemic dilated cardiomyopathy (NIDCM) has not been studied. In 55 patients with NIDCM (48 male, age 61±16 years., ejection fraction 32 ± 13%) an EAM to delineate the bipolar and unipolar LVAs was performed in 52 (94.5%) patients endocardially, in 24 (43.6%) patients epicardially, and in 21 (38.2%) patients on both surfaces. Additionally, activation mapping of the VT was possible in 22 (40%) patients. CA with lines transecting the scar and targeting late potentials was performed in all patients. Complete VT noninducibility at the end was achieved in 40 (72.7%) patients. During the median follow-up of 22 (interquartile range IQR 6, 34) months, VT recurrences were observed in 30 (54.5%) and cardiac death in 14 (25.5%) patients. The ROC analysis revealed that the size of endocardial unipolar LVA (< 8.3 mV) was associated with cardiac death (AUC 0.89, 95%CI 0.79-0.98, P<0.0001). UVA = 145 cm(2) discriminates for cardiac death with 83% sensitivity and 78% specificity. Endocardial UVA >145 cm(2) was a predictor for cardiac death (adjusted HR = 6.9; P = 0.014) and UVA ≥ 54% (of total endocardial LV surface) for VT recurrence (adjusted HR = 3.5; P = 0.016). The size of endocardial unipolar LVA (< 8.3 mV) was a strong and independent predictor for cardiac mortality and VT recurrence in patients with NIDCM. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Cardiovascular Electrophysiology 05/2015; DOI:10.1111/jce.12715 · 2.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A recent meta-analysis demonstrated a survival benefit in post-infarction patients whose ventricular tachycardia (VT) was rendered noninducible by catheter ablation. Furthermore, patients with noninducible VT had a lower VT recurrence rate than did patients whose VT remained inducible after ablation. The purpose of this multicenter cohort study was to assess whether noninducibility after VT ablation is independently associated with improved survival. Data from 1,064 patients who underwent VT ablation for post-infarction VT at seven international centers were analyzed. The ablation procedure was considered successful if no VT was inducible at the end of the procedure and unsuccessful if VT remained inducible or if programmed stimulation was not performed at the end of the ablation. Median follow-up time was 633 days. Noninducibility was independently associated with lower mortality (adjusted hazard ratio: 0.65; 95% confidence interval: 0.53 to 0.79; p < 0.001). Atrial fibrillation, diabetes, and age were other independent predictors of higher mortality. Ablation of only the clinical VT in patients who also had inducible, nonclinical VTs was not associated with improved survival. Noninducibility after VT ablation in patients with post-infarction VT is independently associated with lower mortality during long-term follow-up. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    Journal of the American College of Cardiology 04/2015; 65(18). DOI:10.1016/j.jacc.2015.02.058 · 15.34 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent atrial fibrillation (AF) occurs in up to 50 % of patients within 1 year after catheter ablation, and a clinical risk score to predict recurrence remains a critical unmet need. The aim of this study was to (1) develop a simple score for the prediction of rhythm outcome following catheter ablation; (2) compare it with the CHADS2 and CHA2DS2-VASc scores, and (3) validate it in an external cohort. Rhythm outcome between 3 and 12 months after AF catheter ablation were documented. The APPLE score [one point for age >65 years, persistent AF, impaired eGFR (<60 ml/min/1.73 m(2)), LA diameter ≥43 mm, EF < 50 %] was associated with AF recurrence and was validated in an external cohort in 261 patients with comparable ablation and follow-up. In 1145 patients (60 ± 10 years, 65 % male, 62 % paroxysmal AF) the APPLE score showed better prediction of AF recurrences (AUC 0.634, 95 % CI 0.600-0.668, p < 0.001) than CHADS2 (AUC 0.538) and CHA2DS2-VASc (AUC 0.542). Compared to patients with an APPLE score of 0, the odds ratio for AF recurrences was 1.73, 2.79 and 4.70 for APPLE scores 1, 2, or ≥3, respectively (all p < 0.05). In the external validation cohort, the APPLE score showed similar results (AUC 0.624, 95 % CI 0.562-0.687, p < 0.001). The novel APPLE score is superior to the CHADS2 and CHA2DS2-VASc scores for prediction of rhythm outcome after catheter ablation. It holds promise as a useful tool to identify patients with low, intermediate, and high risk for AF recurrence.
    Clinical Research in Cardiology 04/2015; DOI:10.1007/s00392-015-0856-x · 4.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract BACKGROUND: Galectin-3 (Gal-3) is an emerging biomarker in heart failure that is involved in fibrosis and inflammation. However, its potential value as a prognostic marker in atrial fibrillation (AF) is unknown. The aim of this study was to assess the impact of AF catheter ablation on Gal-3 and evaluate its prognostic impact for predicting rhythm outcome after catheter ablation. METHODS: Gal-3 was measured at baseline and after 6 months using specific ELISA. AF recurrences were defined as any atrial arrhythmia lasting longer than 30 sec within 6 months after ablation. RESULTS: In 105 AF patients (65% males, age 62±9 years, 52% paroxysmal AF) undergoing catheter ablation, Gal-3 was measured at baseline and after 6 months and compared with an AF-free control cohort (n=14, 50 % males, age 58±11 years). Gal-3 was higher in AF patients compared with AF-free controls (7.8±2.9 vs. 5.8±1.8, ng/mL, p=0.013). However, on multivariable analysis, BMI (p=0.007) but not AF (p=0.068) was associated with Gal-3. In the AF cohort, on univariable analysis higher Gal-3 levels were associated with female gender (p=0.028), higher BMI (p=0.005) and both CHADS2 (p=0.008) and CHA2DS2-VASC (p=0.016) scores, however, on multivariable analysis only BMI remained significantly associated with baseline Gal-3 (p=0.016). Gal-3 was similar 6 months after AF catheter ablation and was not associated with sinus rhythm maintenance. CONCLUSIONS: Although galectin-3 levels are higher in AF patients, this is driven by cardiometabolic co-morbidities and not heart rhythm. Gal-3 is not useful for predicting rhythm outcome of catheter ablation.
    PLoS ONE 04/2015; · 3.53 Impact Factor
  • Source
    PLoS ONE 04/2015; 10(4):e0123574. DOI:10.1371/journal.pone.0123574 · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: -Data on outcomes after catheter ablation (CA) of ventricular tachycardia (VT) in nonischemic dilated cardiomyopathy (NIDCM) patients are insufficient. We aimed to investigate the effects of successful CA of VT on cardiac mortality in patients with NIDCM. -102 patients with NIDCM (86 males, mean age 58.8 ± 15.2 years, mean ejection fraction 33.3 ± 11.9 %) underwent VT ablation. After CA a programmed ventricular stimulation to test for success was performed. Complete VT noninducibility was achieved in 62 (61%) patients, and partial success or failure in 32 (31%) patients. During 2-years of follow-up, VT recurrence was observed in 33 patients (53%) without inducible VTs and in 24 patients (75%) with inducible VT inducible (P=0.041). VT inducibility was associated with higher VT recurrence (adjusted HR=1.84; 95% CI 1.08-3.13; P=0.025). The primary endpoint of all-cause mortality was reached in 9 patients (15%) with non-inducible VTs vs. 11 patients (34%) with inducible sustained VTs (P=0.026). VT inducibility was associated with all-cause mortality (adjusted HR=2.73; 95% CI 1.003-7.43; P=0.049). -In patients with NIDCM and recurrent sustained VTs a complete ablation of all inducible VTs may be achieved in 60% of the cases. The complete noninducibility may be a preferable endpoint of ablation because it was associated with better long-term success. Importantly, if possible to achieve through ablation, a complete VT noninducibility was associated with reduction of the likelihood for all-cause mortality in patients with NIDCM.
    Circulation Arrhythmia and Electrophysiology 04/2015; DOI:10.1161/CIRCEP.114.002295 · 5.42 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Recently, an automatic, high-resolution mapping system has been used to accurately and quickly identify right atrial (RA) geometry and activation patterns in animals. However, mapping and ablation of LA arrhythmias as well as pulomonary vein (PV) isolation in humans has not been performed. Methods and Results: In 14 patients (age 67.4 ± 8.8 years , 5 male) with paroxysmal (n=10) or persistent AF (n=4) undergoing de-novo (n=9) or repeat (n=5) atrial fibrillation (AF) catheter ablation, electroanatomical maps of the PVs and LA were created with a mini basket. In total, partial (n=120) or complete (n=6) PV ultra-high resolution maps were successfully acquired in all patients without complications. Median acquisition time was 3.91 minutes (0:46 – 18:28 min) with shorter times for partial (3:40 ± 2:02 min) than for complete maps (9:35 ± 6:33 min). During mapping 2.795 (261 – 14.507) data points were automatically annotated without manual correction. LA and PV maps obtained during sinus rhythm created LA and PV geometry consistent with CT imaging. RF application produced conduction block and PV isolation. Gaps were identified by (1) low voltage channel mapping of the antral PV area (Figure 1) and (2) voltage and activation mapping of the PV only (Figures 2,3). Repeat LA maps after further ablation based on previously identified gaps demonstrated a long continuous line of block. Conclusion: Using a novel mini-basket and ultra high-density mapping system, LA and PV mapping and ablation was feasible and safe. It allowed for rapid assessment of atrial substrate, elucidation of left atrial tachycardia mechanisms, gap identification in linear ablation lesions as well as antral PV isolation.
    DGK Jahrestagung, Mannheim; 04/2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Recently, an automatic, high-resolution mapping system has been used to accurately and quickly identify right atrial (RA) geometry and activation patterns in animals. However, mapping and ablation of RA arrhythmias in humans has not been performed. Methods and results: In 15 patients (age 69.2 ± 10.4 years , 7 male), RA electroanatomical maps were created with a mini basket. In total, partial (n=31) or complete (n=14) RA ultra-high resolution maps were successfully acquired in all patients without complications. Median acquisition time was 6:04 minutes (0:39 – 23:05 min) with shorter times for partial (4:45 ± 4:21 min) than for complete maps (8:59 ± 4:46 min). During mapping 3.746 (710 – 16.306) data points were automatically annotated without manual correction. RA maps obtained during sinus rhythm created RA geometry consistent with CT imaging. Tachycardia mechanisms were explored in 6 patients with cavotricuspid isthmus dependent atrial flutter (figure 1), double loop reentry tachycardia (n=1, figure 2) and ectopic atrial tachycardia (n=2). After ablation of the cavotricuspid isthmus, 3 patients showed evidence of complete isthmus block while the presence of conduction across the ablation line was demonstrated based on activation maps during CS pacing and verified by voltage maps and narrow double potentials in 3 patients with a gap (figure 3). In those patients, targeted RF application produced complete conduction block across the gap. Repeat RA maps after ablation of the gap demonstrated a long continuous line of block. Conclusions: Using a novel mini-basket and ultra high-density mapping system, RA mapping and ablation was feasible and safe. It allowed for rapid identification of tachycardia mechanisms and assessment of linear ablation lesions.
    DGK Jahrestagung, Mannheim; 04/2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Recently, an automatic, high-resolution mapping system (RhythmiaTM, Boston Scientific) has been used to accurately and quickly identify right atrial (RA) geometry and activation patterns in animals. However, mapping and automatic annotation of low voltage potentials such as His-potentials and slow pathway potentials in humans has not been performed. Methods and results: In 7 patients (age 71.0 ± 8.4 years , 4 male), electroanatomical maps of the right atrial septum were created with a mini basket (OrionTM , Boston Scientific). In total, 12 ultra-high resolution maps (2679 ± 1887 mapping points) were successfully acquired in all patients without complications. Median acquisition time was 4:02 minutes (1:35 – 6:12 min). For His area identification the window of interest for signal annotation was changed from the atrial to the His potential and the voltage range was set to 0.05 mV - 0.5 mV to detect low-amplitude signals (Figure 1). This could be performed in all patients and is a potential target for atrioventricular node ablation. In all patients the slow pathway area was identified. The “safe zone” for slow pathway ablation was identified by first creating a voltage map of the His region. Electrograms were reviewed and activation time of the atrial signal in the electrogram with the largest His was determined. By setting the activation time to 20 ms past the timing of the previously identified atrial signal the map was then separated in two areas with (1) [A(H) – A(Map) ≥ 20 ms] (purple) and (2) [A(H) – A(Map) < 20 ms (red)] (Figure 2 right panel). The previously identified “safe zone” was reviewed for the presence of fractionated atrial and SP potentials (Figure 2, left panel) that were detected in all patients. Conclusions: Using a novel mini-basket and ultra high-density mapping system, RA septal mapping was feasible and safe. It allowed for rapid identification of low voltage potentials (e.g. HIS potential and slow pathway potential). By integrating these signals the exact areas of interest for atrioventricular node ablation or slow pathway ablation can be delineated.
    DGK Jahrestagung, Mannheim; 04/2015
  • Source
    Julia Koch, Arash Arya, Gerhard Hindricks, Charlotte Eitel
    Clinical Research in Cardiology 04/2015; DOI:10.1007/s00392-015-0849-9 · 4.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Numerous ECG criteria have been proposed for identifying the localization of outflow tract ventricular arrhythmias (OT-VA). However, in some cases it is difficult to accurately localize the origin of OT-VA using the surface ECG. To assess a simple criterion for localization of OT-VA during electrophysiology study. We measured the interval from the onset of the earliest QRS complex of premature ventricular contractions (PVCs) to the distal right ventricular apical signal, (the QRS-RVA interval), in 66 patients (31 male, age 53.3 ±14.0, RVOT origin 37) referred for ablation of symptomatic outflow tract PVCs. We validated prospectively this criterion in 39 patients (22 male, age 52 ±15; RVOT origin 19). Compared to patients with RVOT-PVCs, the QRS-RVA interval was significantly longer in patients with LVOT-PVCs (70±14 vs. 33.4±10, p<0.001). Receiver operating characteristic analysis showed that a QRS-RVA interval ≥49 ms has a sensitivity, specificity, positive and negative predictive values of 100%, 94.6%, 93.5%, 100% respectively, for prediction of an LVOT origin. The same analysis in the validation cohort showed sensitivity, specificity, positive and negative predictive values of 94.7%, 95%, 95%, 94.7% respectively. Combined together a QRS-RVA interval ≥49 ms has a sensitivity, specificity, positive and negative predictive values of 98%, 94.6%, 94.1%, 98.1% respectively, for prediction of an LVOT origin. A QRS-RVA interval ≥49 ms suggests an LVOT origin. The QRS-RVA interval is a simple and accurate criterion for differentiating the origin of outflow tract arrhythmia during electrophysiology study, however the accuracy of this criterion in identifying OT-VA from the right coronary cusp is limited. Copyright © 2015. Published by Elsevier Inc.
    Heart rhythm: the official journal of the Heart Rhythm Society 04/2015; DOI:10.1016/j.hrthm.2015.04.004 · 4.92 Impact Factor
  • Clinical Research in Cardiology 03/2015; DOI:10.1007/s00392-015-0847-y · 4.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A discordant left ventricular (LV) lead position can be responsible for cardiac resynchronization therapy (CRT) non-response. In this study, tailored optimization of the individual LV wall motion was evaluated for the outcome in these patients. Two hundred and forty-six CRT outpatients were screened for non-response due to a discordant LV lead. In 17 patients, three-dimensional data of fluoroscopic rotation scan and echocardiography were integrated to analyse the individual LV wall motion with respect to the LV lead position. Optimization was guided by the systolic dyssynchrony index (SDI) and LV ejection fraction (LVEF) during different interventricular (VV)-delay programming. If re-programming failed, implantation of a second LV lead was performed. A discordant or partly concordant LV lead position was found in nearly all patients (16/17, 94%), which contributed to an unchanged baseline amount of LV dyssynchrony with either CRT on or off (SDI 11.3 vs. 11.0%; P = 0.744). In the majority of patients, VV-delay re-programming achieved better resynchronization, 4/17 patients needed implantation of a second LV lead. After 3 months, significant improvement of NYHA functional class (1 class; P = 0.004), peak oxygen consumption (10 vs. 13 mL/min/kg; P = 0.008), LVEF (27 vs. 39%; P = 0.003), and SDI (11.0 vs. 5.8; P = 0.02) was observed. Clinical and echocardiographic responses were found in 77 and 59%, respectively, with even good results on long-term follow-up. Tailored optimization of the individual LV wall motion can lead to significant clinical and echocardiographic improvements in previous CRT non-responders with a discordant LV lead position. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
    Europace 03/2015; 17(5). DOI:10.1093/europace/euv034 · 3.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Atrial fibrillation (AF) is a global healthcare problem of growing prevalence and major significance. The consequences of AF include an increased rate of death, stroke and heart failure. Theoretically, a therapeutic strategy aiming at restoration and maintenance of sinus rhythm should offset the prognosis impairment associated with AF. However, these expectations were disproven in large randomised controlled trials comparing conventional antiarrhythmic drugs for rhythm control with conventional rate control. These apparently contradictory findings suggest that rhythm control strategies require better therapeutic instruments. These improvements may involve drugs and/or interventions with optimised risk-benefit profile and which also appreciate the specific atrial pathology and the patient's comorbidities. This article addresses important aspects of rhythm control strategies, which may have the potential of a beneficial contribution to the prognosis of AF patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    Heart (British Cardiac Society) 03/2015; 101(11). DOI:10.1136/heartjnl-2013-305152 · 6.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Reduction of radiation exposure using a sensor-based non-fluoroscopic catheter tracking (NFCT) system (MediGuide™, St Jude Medical, Inc.) was recently demonstrated by retrospective comparisons. We aimed to prospectively compare the effects of using NFCT vs. standard fluoroscopy on procedural parameters in patients undergoing radiofrequency ablation of typical atrial flutter. We prospectively randomized 40 patients undergoing cavotricuspid isthmus ablation for typical atrial flutter to either NFCT (n = 20) or conventional fluoroscopy (CONV, n = 20). Procedural parameters such as fluoroscopy time, radiation dose, and procedure duration, as well as periprocedural complications were compared. There were no statistically significant differences in baseline characteristics between the two groups. Bidirectional isthmus block was achieved in all patients. Fluoroscopy time was significantly reduced in the NFCT group {0.3 [inter-quartile range (IQR) 0.2; 0.48] min} when compared with CONV [5.7 (IQR 4.2; 11.5) min] (P < 0.001). This resulted in a significant reduction in radiation dose in patients randomized to NFCT [17.4 (IQR 11; 206.6) cGy cm(2)] vs. the CONV group [418.4 (IQR 277; 812.2) cGy cm(2)] (P < 0.001). There were no significant differences in procedure duration between the NFCT group [49.5 (IQR 37; 65) min] when compared with the CONV group [33.5 (IQR 26.3; 55.5) min] (P = 0.053). No adverse events were recorded. Freedom from atrial flutter at 6 months of follow-up was 19/20 (95%) in the NFCT and 18/20 (90%) in the CONV group (n.s.). In this first prospective randomized study, by comparing NFCT with standard fluoroscopy in patients undergoing radiofrequency ablation of typical atrial flutter, NFCT significantly reduced both radiation dose and fluoroscopy time with no effects on procedural duration. These findings support the incorporation of NFCT in routine clinical use. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
    Europace 03/2015; DOI:10.1093/europace/euu398 · 3.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There is limited knowledge on the extent and location of scarring that results from catheter ablation and its role in suppressing atrial fibrillation (AF). We examined the effect of atrial fibrosis and ablation induced scarring on catheter ablation outcomes in AF. We conducted a prospective multicenter study that enrolled 329 AF patients presenting for catheter ablation. Delayed enhancement magnetic resonance imaging (DE-MRI) of the left atrium was obtained pre-ablation. Scarring was evaluated in 177 patients with a DE-MRI scan obtained 90 days post-ablation. We evaluated residual fibrosis, defined as pre-ablation atrial fibrosis not covered by ablation scar. The primary outcome was freedom from recurrent atrial arrhythmia. In the analysis cohort of 177 patients, pre-ablation fibrosis was 18.7±8.7% of the atrial wall. Ablation aimed at pulmonary vein (PV) isolation was performed in 163 patients (92.1%). Ablation-induced scar averaged 10.6±4.4% of the atrial wall. Scarring completely encircled all 4 PVs only in 12 patients (7.3%). Residual fibrosis was calculated at 15.8 ± 8.0%. At 325 days follow-up 35% of patients experienced recurrent arrhythmia. Multivariable Cox proportional hazards models demonstrated that baseline atrial fibrosis (HR and 95% CIs) (1.09 (1.06-1.12), p < 0.001) and residual fibrosis (1.09 (1.05-1.13), p < 0.001) were associated with atrial arrhythmia recurrence, while PV encirclement and overall scar were not. Catheter ablation of AF targeting pulmonary veins rarely achieves permanent encircling scar in the intended areas. Overall atrial fibrosis present at baseline and residual fibrosis uncovered by ablation scar are associated with recurrent arrhythmia. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Cardiovascular Electrophysiology 02/2015; 26(5). DOI:10.1111/jce.12650 · 2.88 Impact Factor
  • International Journal of Cardiology 02/2015; 184C:315-317. DOI:10.1016/j.ijcard.2015.02.078 · 6.18 Impact Factor
  • International Journal of Cardiology 02/2015; 184C:321-322. DOI:10.1016/j.ijcard.2015.02.062 · 6.18 Impact Factor
  • International Journal of Cardiology 02/2015; 184C:321-322. · 6.18 Impact Factor

Publication Stats

9k Citations
2,212.63 Total Impact Points

Institutions

  • 2003–2015
    • Kunststoff-Zentrum in Leipzig
      Leipzig, Saxony, Germany
    • INSEAD The Business School for the World
      Fontainebleau, Île-de-France, France
  • 1970–2015
    • University of Leipzig
      • • Department of Cardiac Surgery
      • • Klinik und Poliklinik für Kinderchirurgie
      Leipzig, Saxony, Germany
  • 2014
    • Eskisehir Osmangazi University
      Dorylaeum, Eskişehir, Turkey
  • 2007–2014
    • Isar Heart Center
      Münchenbernsdorf, Thuringia, Germany
  • 2012
    • Johns Hopkins Medicine
      Baltimore, Maryland, United States
  • 2011–2012
    • Telekom Germany GmbH
      Bonn, North Rhine-Westphalia, Germany
  • 2007–2011
    • Attikon University Hospital
      • Department of Cardiology
      Athínai, Attica, Greece
  • 1988–2011
    • Universitätsklinikum Münster
      • Department für Kardiologie und Angiologie
      Muenster, North Rhine-Westphalia, Germany
  • 1999–2009
    • University of Münster
      • Department of Cardiology and Angiology
      Muenster, North Rhine-Westphalia, Germany
  • 1992
    • Arteriosclerosis Prevention Institute
      München, Bavaria, Germany
  • 1987
    • ZIM - Zentrum Innere Medizin
      Schleisheim, Bavaria, Germany