David Zweiker

• Dr. MD FEHRA FESC
• Researcher at Clinic Ottakring

Aim A recent European Heart Rhythm Association (EHRA) practical guide provides guidance on the use of novel digital devices for heart rhythm analysis using either electrocardiogram (ECG) or photoplethysmography (PPG) technology for the diagnosis of atrial fibrillation (AF). This survey assesses physicians' preferences to use digital devices in pati...

Background: There are limited data about left atrial appendage closure (LAAC) in patients with cancer. We therefore sought to compare the outcome after LAAC in patients with vs. without cancer in a multicentre registry. Methods: In this sub-analysis of the prospective Austrian LAAC Registry, we analysed consecutive patients undergoing LAAC to asses...

Renal sympathetic denervation (RDN) is an interventional supplement to medical treatment in patients with arterial hypertension. While the first sham-controlled trial, SYMPLICITY HTN‑3 was neutral, with improved procedural details, patient selection and follow-up, recent randomized sham-controlled trials of second-generation devices show a consiste...

Background: Despite being the most commonly performed valvular intervention, risk prediction for aortic valve replacement in patients with severe aortic stenosis by currently used risk scores remains challenging. The study aim was to develop a biomarker-based risk score by means of a neuronal network. Methods: In this multicenter study, 3595 patien...

Background Peri-interventional atrial fibrillation (AF) may be detected in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Data on the thromboembolic risk and long-term clinical outcome in patients with AF limited to the peri-interventional period is scarce. Purpose To assess the incide...

Background Patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) face an increased risk of cardiac events, including arrhythmias. Current guidelines therefore recommend ECG monitoring for at least 24 hours after AMI in patients with ST segment elevation myocardial infarction (STEMI) and high-risk non-ST...

Acute coronary syndrome (ACS) remains a major challenge in clinical practice, requiring rapid and effective antithrombotic treatment to mitigate adverse ischemic events while minimizing the risk of bleeding. In recent years, results from several clinical trials addressing this issue through various approaches have substantially improved the treatme...

Achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets remains a significant challenge in clinical practice. This review assesses the barriers to reaching LDL-C goals and explores the potential solutions to these issues. When aiming for the recommended LDL-C goal, strategies like “lower is better” and “strike early and...

Purpose Patients at risk for sudden cardiac death may temporarily need a wearable cardioverter-defibrillator (WCD). Exercise-based cardiac rehabilitation (CR) has a class I recommendation in patients with cardiac disease. The aim of this study was to evaluate the safety and feasibility of undergoing CR with a WCD. Methods We performed a retrospect...

Background: Current guidelines recommend a stepwise initiation of lipid-lowering therapy after percutaneous coronary interventions (PCI) in treatment-naïve individuals. Patients might benefit from an earlier and stronger low-density lipoprotein-cholesterol (LDL-C) reduction through upfront combination therapies. Methods: This retrospective study...

Aims This study aims to investigate the prevalence of Takotsubo syndrome (TTS) as a percentage of the total number of acute coronary syndrome (ACS), including non‐STE‐elevation myocardial infarction and ST‐elevation myocardial infarction, as well as the short‐term outcome of TTS patients before and during the COVID‐19 pandemic. Methods and results...

Background A steep rise in the use of transcatheter aortic valve implantation (TAVI) for the management of symptomatic severe aortic stenosis occurred. Minimalist TAVI procedures and streamlined patient pathways within experienced Heart Valve Centres are designed to overcome the challenges of ever-increasing procedural volume. Aims The 2022 Europe...

Background: After acute myocardial infarction (AMI), patients are at risk of sudden cardiac death. The VEST trial failed to show a reduction in arrhythmic mortality in AMI patients with an LVEF ≤ 35% prescribed with a WCD, having a lower-than-expected WCD wearing compliance. Objectives: The aim was to investigate on outcomes of patients in a rea...

Objectives: The authors sought to evaluate the incidence, predictors, and outcomes of new permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) with contemporary self-expanding valves (SEV). Background: Need for PPI is frequent post-TAVR, but conflicting data exist on new-generation SEV and on the prognostic...

The multidisciplinary assessment of hospitalized patients via validated scales and tools has become crucial in the early identification of sarcopenia. The objective of this study was to determine the prevalence of sarcopenia and its related factors in patients aged ≥65 years admitted to the neurological rehabilitation departments of cognitive motor...

Funding Acknowledgements Type of funding sources: None. Background Electric conduction disturbances are very common, however, patients in need for ventricular pacing may suffer from pacing-induced heart failure due to unphysiological pacing by the right ventricular lead. Conducting system pacing allows to overcome this common issue with a more phy...

Funding Acknowledgements Type of funding sources: None. Introduction Patient-device mismatch in patients undergoing left atrial appendage closure (LAAC) may lead to failure to implant, dislocation, and cardiac tamponade. There is limited data about patient cohorts that are especially susceptible to these complications. Objective To analyse the as...

Funding Acknowledgements Type of funding sources: None. Background Pulsed field ablation (PFA) is an emerging method for atrial fibrillation (AF) ablation. However, there is little data about incidence, types, and predictors of AF recurrences after PFA for AF ablation. Methods We report our single-centre experience with PFA for AF ablation. Each...

Background: mRNA COVID-19 vaccines have been associated with myocarditis in the general population. However, application of gold standard techniques is often missing, and data about patients with history of myocarditis have not been reported yet. Methods: We evaluated 21 patients (median age 27, 86% males) for suspected myocarditis after receivi...

Introduction Public knowledge of out-of-hospital cardiac arrest (OHCA), and initiation of basic life support (BLS) is crucial to increase survival in OHCA. Methods The study analysed the knowledge and willingness to perform BLS of laypersons passing an AED at a public train station. Interviewees were recruited at two time points before and after a...

Background: Excess cardiovascular (CV) morbidity and mortality has been observed in patients with COVID-19. Both interleukin-32 (IL-32) and interleukin-34 (IL-34) have been hypothesized to contribute to CV involvement in COVID-19. Methods: This prospective, observational study of patients with laboratory-confirmed COVID-19 infection was conducte...

Background In recent years, transcatheter aortic valve replacement (TAVR) techniques and technology have continuously improved. Data regarding the impact of these advancements on outcomes in large real-world settings are still limited. The aim of this study was to investigate temporal trends and assess contemporary outcomes after TAVR with Evolut P...

Background: As a preventive procedure, minimizing periprocedural risk is crucially important during left atrial appendage closure (LAAC). Methods: We included consecutive patients receiving LAAC at nine centres and assessed the relationship between baseline characteristics and the acute procedural outcome. Major procedural complications were def...

Arterial hypertension is a global burden leading to over 10.8 million deaths per year worldwide. May Measurement Month (MMM) is a global project initiated by the International Society of Hypertension to raise the awareness of high blood pressure (BP) in the population. Following the MMM protocol 2508 participants ≥18 years had their BP measured in...

Introduction Takotsubo syndrome (TTS) is an important form of acute heart failure with significant risk of acute complications and death. In this analysis we sought to identify predictors for in-hospital clinical outcome in TTS patients by concentrating on routine laboratory parameters at admission. Methods In this analysis from the Austrian natio...

Background: Limited data is available about the outcome of TLE in patients with vs. without high energy leads in the last decade. Methods: This is an analysis of consecutive patients undergoing TLE at a high-volume TLE centre from 2001 to 2021 using the stepwise approach. Baseline characteristics, procedural details and outcome of patients with...

Background: Takotsubo syndrome (TTS) is an important type of acute heart failure with significant risk of acute complications and death. In this analysis we sought to identify predictors for in-hospital clinical outcome in TTS patients and present long-term outcomes. Methods: In this analysis from the Austrian national TTS registry, univariable...

Background Abnormal ventricular signals(AVS) are the cornerstone of substrate-based ventricular tachycardia(VT) ablation in sinus rhythm. Signal characterization of AVS amongst ischaemic and non-ischaemic cardiomyopathies has never been performed. Objective To describe ventricular signal abnormalities in three different pathologies and study their...

Funding Acknowledgements Type of funding sources: None. Background Patients are at elevated risk of sudden cardiac death (SCD) after acute myocardial infarction (MI). The VEST trial failed to show a significant reduction in arrhythmic mortality in patients prescribed with a wearable converter-defibrillator (WCD), having a lower than expected weari...

A minority of premature ventricular contractions (PVC) and ventricular tachycardias (VT) have an intramural origin, which represents a challenge for conventional radiofrequency ablation. Bipolar ablation has the potential ability to create deeper and more transmural lesions and has been demonstrated to be optimal treatment in these cases. Bipolar a...

Background: Little is known regarding the characterization of electrical substrate in both atria in patients with atrial fibrillation (AF). Methods: Eight consecutive patients undergoing AF ablation (5 paroxysmal, 3 persistent) underwent electrical substrate characterization during sinus rhythm. Mapping of the left (LA) and right atrium (RA) was...

Background: Temporary pacing is necessary in pacemaker-dependent patients after transvenous lead extraction (TLE) for cardiac implantable electronic device infection. In case of unavailability of other accesses, we propose to use the ipsilateral subclavian access (ISA) combined with a standard permanent active fixation lead for the temporary pacem...

Introduction Left atrial appendage closure is associated with a relevant procedural complication rate. Baseline risk factors, such as pre-procedural lab results, may identify patients that develop acute complications. Methods We performed a retrospective analysis of the impact of baseline characteristics and preprocedural lab results on the acute...

Background: after transvenous lead extraction (TLE) of cardiac implantable electric devices (CIEDs), some patients may not benefit from device reimplantation. This study sought to analyse predictors and long-term outcome of patients after TLE with vs. without reimplantation in a high-volume centre. Methods: all patients undergoing TLE at our cen...

Background Many patients with cardiac implantable electronic devices (CIED) undergo magnetic resonance imaging (MRI); however, a relevant proportion have a CIED system that has not been classified as MRI-conditional because of generators and leads from different brands (mixed-brand group). The available data concerning the outcome of these mixed pa...

Despite constant breakthroughs in heart failure (HF) therapy, the population of HF patients resume to grow and is linked to increased mortality and morbidity. Ventricular arrhythmias (VA) are one of the leading causes of mortality in HF subjects. Implantable cardioverter-defibrillators (ICDs) are currently the gold standard in treatment, preventing...

Funding Acknowledgements Type of funding sources: None. Introduction The first wave of the COVID-19 crisis was associated with a reduction of patients presenting with acute cardiovascular disease. However, there is only limited data showing the trend of pacemaker implantations and their indications. Purpose To evaluate pacemaker implantations bef...

Funding Acknowledgements Type of funding sources: None. Introduction Many patients with cardiac implantable electronic devices (CIED) need to undergo magnetic resonance imaging (MRI). However, a significant proportion has a CIED system in place that has not been classified "MRI-conditional" because of generators and leads from different brands ("m...

Background: Right ventricular (RV) function predicts survival in numerous cardiac conditions, including left heart disease. The reference standard for non-invasive assessment of RV function is cardiac magnetic resonance imaging (CMR). The aim of this study was to investigate the association between pre-procedural CMR-derived RV functional parameter...

Background: Optimal antithrombotic therapy after left atrial appendage (LAA) occlusion is still not clear. The aim of this study was to investigate the role of different antithrombotic regimens after the procedure. Methods and results: We retrospectively analyzed data of 260 patients who underwent LAA occlusion and divided them into four groups...

Novel wearable devices for heart rhythm analysis using either photoplethysmography (PPG) or electrocardiogram (ECG) are in daily clinical practice. This survey aimed to assess impact of these technologies on physicians’ clinical decision-making and to define, how data from these devices should be presented and integrated into clinical practice. The...

Introduction Direct oral anticoagulants (DOACs) are superior to vitamin K antagonists (VKAs) for the prevention of stroke in atrial fibrillation (AF) patients with elevated stroke risk. Possible antiarrhythmic effects of DOACs have been discussed. We analyzed impact of DOAC treatment on recurrence-free survival after AF catheter ablation. Methods...

Aims Atrial contractile dysfunction contributes to worse prognosis in hypertensive heart disease (HHD), but the role of cardiomyocyte dysfunction in atrial remodelling in HHD is not well understood. We investigated and compared cellular mechanisms of left (LA) and right atrial (RA) contractile dysfunction in pigs with HHD. Methods and results In v...

Introduction Recent studies have demonstrated the predictive value of preprocedural cardiac biomarkers, such as N-terminal pro brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT), in patients with severe aortic valve stenosis undergoing valve replacement. Nonetheless, it remains still unclear whether hsTnT may be influence...

Background: Complete real-world data on the indications and outcomes of left atrial appendage closure (LAAC) outside of clinical trials are rare. In this study, we stratified patients undergoing LAAC by indication groups. Methods: This analysis of the national multicentre Austrian LAAC Registry comprised all patients that underwent LAAC up until...

Background Multiple wearable devices for rhythm analysis have been developed using either photoplethysmography (PPG) or handheld ECG. Hypothesis The aim of this survey was to assess impact of these technologies on physicians' clinical decision‐making regarding initiation of diagnostic steps, drug therapy, and invasive strategies. Methods The onli...

Development and progression of atrial fibrillation (AF) is driven by comorbidities such as arterial hypertension and diabetes mellitus. In animal models of chronic hyperglycaemia, progression of AF has been proposed to be triggered by oxidative stress, apoptosis and fibrosis. Acute glycosylation of CaMKII has been associated with increased suscepti...

Multiple wearable devices for rhythm analysis have been developed using either photoplethysmography (PPG) or handheld ECG. The aim of this survey was to assess how these technologies impact on physicians’ clinical decision-making regarding initiation of diagnostic steps, drug- and interventional therapy. Methods The present survey is conducted wit...

Background The wearable cardioverter-defibrillator (WCD) is a temporary treatment option for patients at high risk for sudden cardiac death (SCD) and/or for patients in whom implantation of a cardioverter defibrillator (ICD) is temporarily not possible. Purpose To investigate incidence and predictors of appropriate WCD shocks. Methods We performe...

Introduction In specific situations implantable cardioverter defibrillator (ICD) therapy is recommended for patients under the age of 40 years. Due to the active lifestyle of this patient population, complication rates in devices with conventional transvenous electrodes may be higher than for the remaining population. Methods The ICD-YOUNG study i...

Safety and feasibility of transfemoral Acurate neo implantation without systematic predilatation are not fully investigated. Our aim was to evaluate the use and impact of pre-implantation balloon aortic valvuloplasty (pre-BAV) before transcatheter aortic valve implantation (TAVI) with Acurate neo. The NEOPRO Registry retrospectively included 1,263...

Hereby, the supplemental data of the research article "Long-Term Prognostic Value of High-Sensitivity Troponin T added to N-Terminal Pro Brain Natriuretic Peptide Plasma Levels before Valve Replacement for Severe Aortic Stenosis" are presented [1]. It offers enhanced input on the predictive value of these biomarkers considering the influence of the...

Zusammenfassung Erhöhter Blutdruck bleibt eine Hauptursache von kardiovaskulären Erkrankungen, Behinderung und frühzeitiger Sterblichkeit in Österreich, wobei die Raten an Diagnose, Behandlung und Kontrolle auch in rezenten Studien suboptimal sind. Das Management von Bluthochdruck ist eine häufige Herausforderung für Ärztinnen und Ärzte vieler Fach...

Background: Cardiac power output (CPO), derived from the product of cardiac output and mean aortic pressure, is an important yet underexploited parameter for hemodynamic monitoring of critically ill patients in the intensive-care unit (ICU). The conductance catheter-derived pressure-volume loop area reflects left ventricular stroke work (LV SW). D...

Aims Optimal timing of valve implantation in patients with severe aortic stenosis (AS) is under debate, considering the subjective nature of symptom onset. We aimed to investigate the pre-procedural value of routinely available cardiac biomarkers in predicting postoperative long-term outcome in a large cohort undergoing either surgical or transcath...

Background/Introduction Three recently published sham-controlled studies proved the efficacy of renal denervation (RDN) in hypertensive patients. However, there it is still unclear which patients should be selected for RDN. Purpose This study seeks to clarify which patient subgroups benefit most from radiofrequency RDN by analysing a nationwide mu...

Background Previous studies indicate that frailty is associated with poor outcome following TAVI. Purpose This study aimed to investigate whether a questionnaire routinely administered by nurses might serve as a surrogate for frailty and predict outcome in TAVI patients in addition to conventional risk scores. Methods This is a retrospective sing...

Natriuretic peptide plasma levels help to manage patients with severe aortic stenosis (AS). The role of troponin plasma levels in this patient cohort remains speculative. A consortium of 4 university hospital centers in Austria analyzed retrospectively 3,595 patients admitted for valve replacement because of severe AS since 2007. The aim was to com...

Purpose: To evaluate changes in public knowledge regarding cardio-pulmonary resuscitation accompanying four years of cardiac arrest awareness campaigning. Materials & methods: Personal, structured interviews have been conducted with random passengers at the railway station of Graz, Austria (286.000 inhabitants) prior and four years after a regiona...

Objectives: Three recently published sham-controlled studies proved the efficacy of renal denervation (RDN) in hypertensive patients. The study presented here analyzed a nationwide multicentre registry database to clarify which patient subgroups benefit most from radiofrequency RDN. Methods: This is a post hoc analysis from the multicentre Austr...

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried o...

Objectives: The aim of this study was to compare transcatheter aortic valve replacement (TAVR) with the Acurate neo (NEO) and Evolut PRO (PRO) devices. Background: The NEO and PRO bioprostheses are 2 next-generation self-expanding devices developed for TAVR. Methods: The NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transca...

Background Catheter ablation of atrial fibrillation (AF) is an established second line therapy for patients with symptomatic paroxysmal AF (PAF) and may be considered as a first line therapy in selected patients who are highly symptomatic, considering patient choice, benefit, and risk, according to recent guidelines. Our study investigated whether...

Objectives: This study sought to investigate the outcome of high-risk and inoperable patients with severe symptomatic aortic stenosis undergoing transfemoral transcatheter aortic valve replacement (TAVR) in hospitals with (iOSCS) versus without institutional on-site cardiac surgery (no-iOSCS). Background: Current guidelines recommend the use of...

We sought to compare the effectiveness of two versus five fingers used for bag-valve-mask (BVM) ventilation on effective tidal volume (VTeff) delivery in an infant resuscitation model. In a randomised cross-over study, 40 healthcare professionals ventilated a modified leak-free infant resuscitation manikin with both two and five fingers, using a se...

Experimental data indicate that stimulation of the nitric oxide-soluble guanylate cyclase(sGC)-cGMP-PKG pathway can increase left ventricular (LV) capacitance via phosphorylation of the myofilamental protein titin. We aimed to test whether acute pharmacological sGC stimulation with BAY 41-8543 would increase LV capacitance via titin phosphorylation...

Background: Arterial hypertension (HT) contributes to progression of atrial fibrillation (AF) via unknown mechanisms. Objective: We aimed to characterize electrical and structural changes accounting for increased AF stability in a large animal model of rapid atrial pacing (RAP)-induced AF combined with desoxycorticosterone acetate (DOCA)-induced...

Objective Oral anticoagulation (OAC) is state-of-the-art therapy for atrial fibrillation (AF), the most common arrhythmia worldwide. However, little is known about the perception of patients with AF and how it correlates with risk scores used by their physicians. Therefore, we correlated patients’ estimates of their own stroke and bleeding risk wit...

Objective Application of therapeutic mild hypothermia in patients after resuscitation, often accompanied by myocardial infarction, cardiogenic shock and systemic inflammation may impact on cardiac rhythm. We therefore tested susceptibility to atrial arrhythmias during hyperthermia (HT, 40.5°C), normothermia (NT, 38.0°C) and mild hypothermia (MH, 33...

Objective To assess soluble suppression of tumorigenicity 2 (sST2) serum concentrations and predict mortality in patients undergoing transcatheter aortic valve implantation (TAVI). Methods We prospectively enrolled 74 patients with severe aortic stenosis (AS) who underwent TAVI and matched them to patients without aortic valve disease (n=74). AS p...

Background: There is controversial evidence if atrial fibrillation (AF) alters outcome after transcatheter aortic valve implantation (TAVI). TAVI itself may promote new-onset AF (NOAF). Methods: We performed a single-center study including 398 consecutive patients undergoing TAVI. Before TAVI, patients were divided into a sinus rhythm (SR) group...

Renal denervation (RDN) is a new procedure for treatment-resistant hypertensive patients. In order to monitor all procedures undergone in Austria, the Austrian Society of Hyperten-sion established the investigator-initiated Austrian Transcatheter Renal Denervation (TREND) Registry. From April 2011 to September 2014, 407 procedures in 14 Austrian ce...

All data (SAV format). (SAV)

All data (CSV format). (CSV)

Baseline BP and responses to RDN at 2–6 weeks, 3, 6, and 12 months after procedure, expressed as median (interquartile range). p<0.001 for all BP changes. (PDF)

Office BP and 24-h BP responders among patients with available data (n = 154). (PDF)