G Dannberg

Universitätsklinikum Jena, Jena, Thuringia, Germany

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Publications (39)59.37 Total impact

  • M. Heinke · H. Kühnert · T. Heinke · J. Tumampos · G. Dannberg
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    ABSTRACT: Cardiac resynchronization therapy (CRT) is an established biventricular pacing therapy in heart failure patients with left bundle branch block and reduced left ventricular ejection fraction, but not all patients improved clinically as CRT responder. Purpose of the study was to evaluate electrical left atrial conduction delay (LACD) with focused transesophageal electrocardiography in CRT responder and CRT nonresponder. Methods: Twenty heart failure patients (age 66.6±8.2 years; 2 females, 18 males) with New York Heart Association functional class 3.0±0.3 and 174.2±40.2ms QRS duration were analysed using posterior left atrial transesophageal electrocardiography with hemispherical electrodes. Electrical LACD was measured between onset and offset of transesophageal left atrial signal before implantation of CRT devices. Results: Electrical LACD could be evaluated by bipolar transesophageal left atrial electrocardiography using TO Osypka electrode in all heart failure patients with negative correlation between 54.7±18.1ms LACD and 24.9±6.4% left ventricular ejection fraction (r=-0.65, P=0.002). There were 16 CRT responders with reduction of New York Heart Association functional class from 3.0±0.29 to 2.1±0.2 (r=0.522, P=0.038) during 9.41±10.96 month biventricular pacing and negative correlation between 49.6±14.2ms LACD and 26.0±6.2% left ventricular ejection fraction (r=-0.533, P=0.034). There were 4 CRT non-responders with no reduction of New York Heart Association functional class from 3.0±0.4 to 2.8±0.5 (r=0.816, P=0.184) during with 13.88±16.39 month biventricular pacing and no correlation between 75.25±19.17ms LACD and 20.75±6.4% left ventricular ejection fraction (r=-0.831, P=0.169). Conclusions: Focused transesophageal left atrial electrocardiography can be utilized to analyse electrical LACD in heart failure patients. LACD correlated negative with left ventricular ejection fraction in CRT responders. LACD may be a useful parameter to evaluate electrical left atrial desynchronization in heart failure patients.
    No preview · Article · Jan 2015 · IFMBE proceedings
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    ABSTRACT: Cardiac resynchronization therapy (CRT) is an established class I level A biventricular pacing therapy in chronic heart failure patients with left bundle branch block and reduced left ventricular ejection fraction, but not all patients improved clinically. Purpose of the study was to evaluate electrical interatrial conduction delay (IACD) to interventricular conduction delay (IVCD) ratio with focused transesophageal left atrial and left ventricular electrocardiography. Methods: Thirty eight chronic heart failure patients (age 63.4±10.2 years; 3 females, 35 males) with New York Heart Association (NYHA) functional class 3.0±0.2 and 171.71±36.17ms QRS duration were analysed using posterior left atrial and left ventricular transesophageal electrocardiography with hemispherical electrodes before CRT. Electrical IACD was measured between onset of P-wave in the surface ECG and onset of left atrial signal. Electrical IVCD was measured between onset of QRS complex in the surface ECG and onset of left ventricular signal. Results: Electrical IACD and IVCD could be evaluated by transesophageal left atrial and left ventricular electrocardiography in all heart failure patients with correlation to 1.18±0.92 IACD-IVCD-ratio (r=-0.57, P<0.001; r=0.66, P<0.001). There were 32 CRT responder with reduction of NYHA class from 3.0±0.22 to 1.97±0.31 (P<0.001) during 16.5±18.9 month CRT with 75.19±33.49ms IACD, 78.91±24.73ms IVCD, 1.04±0.66 IACD-IVCD-ratio and correlation between IACD and IACDIVCD- ratio (r=0.84, P<0.001). There were 6 CRT nonresponder with no reduction of NYHA class from 3.0±0.3 to 2.9±0.5 during 14.3±13.7 month biventricular pacing, 50.0±28.26ms IVCD (P=0.014), 1.92±1.65 IACD-IVCD-ratio (P=0,029) and correlation between 67.0±24.9ms IACD and IACD-IVCD-ratio (r=0.85, P=0.031). Conclusions: Focused transesophageal left atrial and left ventricular electrocardiography can be utilized to analyse electrical IACD and IVCD in heart failure patients. IACDIVDC- ratio may be a useful parameter to evaluate electrical left cardiac desynchronization in heart failure patients.
    No preview · Article · Jan 2015 · IFMBE proceedings
  • M. Heinke · G. Dannberg · T. Heinke · H. Kuehnert
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    ABSTRACT: Cardiac resynchronization therapy is an established therapy for heart failure patients with sinus rhythm, reduced left ventricular ejection fraction and prolongation of QRS duration. The aim of the study was to evaluate ventricular desynchronization with electrical interventricular delay (IVD) to left ventricular delay (LVD) ratio in atrial fibrillation heart failure patients. IVD and LVD were measured by transesophageal posterior left ventricular ECG recording. In atrial fibrillation heart failure patients with prolonged QRS duration, the mean IVD-to-LVD-ratio was 0.84 +/- 0.42 with a range from 0.17 to 2.2 IVD-to-LVD-ratio. IVD-to-LVD-ratio correlated with QRS duration. IVD-to-LVD-ratio may be a useful parameter to evaluate electrical ventricular desynchronization in atrial fibrillation heart failure patients.
    No preview · Conference Paper · Oct 2014
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    ABSTRACT: Cardiac resynchronization therapy with atrioventricular and interventricular pacing delay optimized biventricular pacing is an established therapy for heart failure patients with sinus rhythm and reduced left ventricular ejection fraction. The aim of the study was to evaluate atrioventricular and interventricular pacing delay optimization in cardiac resynchronization therapy by transthoracic impedance cardiography in biventricular pacing with different left ventricular electrode position. In biventricular pacing heart failure patients with lateral, posterolateral and anterolateral left ventricular electrode position, the mean optimal atrioventricular sening delay was 108.6 +/- 20.3 ms and the mean optimal interventricular pacing delay -12.3 +/- 25.9 ms. Transthoracic impedance cardiography may be a useful technique to optimize atrioventricular and interventricular pacing delay in biventricular pacing with different left ventricular electrode position.
    No preview · Conference Paper · Oct 2014
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    Full-text · Article · Nov 2013 · Wiener klinische Wochenschrift
  • M Heinke · B Ismer · G Dannberg · T Heinke · H Kühnert

    No preview · Article · Sep 2013 · Biomedizinische Technik/Biomedical Engineering
  • M Heinke · B Ismer · H Kühnert · T Heinke · G Dannberg · H R Figulla

    No preview · Article · Sep 2013 · Biomedizinische Technik/Biomedical Engineering
  • M. Lichtenauer · G. Dannberg · H. Figulla · A. Hamadanchi

    No preview · Article · Sep 2013 · Wiener klinische Wochenschrift
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    ABSTRACT: Capture threshold (CT) for transesophageal left atrial (LA) pacing (TLAP) and transesophageal left ventricular (LV) pacing (TLVP) with conventional cylindrical electrodes (CE) are higher than TLAP feeling threshold (FT). Purpose of the study was to evaluate focused TLAP CT and FT for supraventricular tachycardia (SVT) initiation and focused TLVP CT for cardiac resynchronisation therapy (CRT) simulation. Methods: SVT initiation in patients (P) with palpitations (n=49, age 47±17 years) was analysed during spontaneous rhythm and during focused bipolar TLAP with atrial constant current stimulus output, distal CE and three or seven 6 mm hemispherical electrodes (HE) (TO, Osypka AG, Rheinfelden, Germany). CRT simulation in heart failure P (n=75, age 62±11 years) was evaluated by focused bipolar TLAP and/or TLVP with ventricular constant voltage stimulus output and different pacing mode. Results: Focused electrical pacing field between CE and HE (n=28) allowed low threshold TLAP with 8.0±2.6 mA CT at 9.9 ms stimulus duration (SD) which was lower than 9.2±4.5 mA FT at 9.9 ms SD. Focused electrical pacing field between HE and HE (n=21) allowed low threshold TLAP with 8.1±2.2 mA CT at 9.9 ms SD which was lower than 9.8±5.0 mA FT at 9.9 ms SD. SVT initiation by programmed AAI TLAP was possible in 23 P and not possible in 26 P. CRT simulation was evaluated with TLAP and TLVP with VAT, D00 and V00 pacing mode and 95.5±10.9 V TLVP CT at 4.0 ms SD. Conclusions: Programmed focused AAI TLAP allowed initiation of SVT with very low CT and high FT and focused electrical pacing field between CE-HE and HE-HE. CRT simulation with focused TLAP and/or TLVP with VAT, D00 and V00 pacing mode may be a useful technique to detect responders to CRT.
    No preview · Article · Sep 2012 · Biomedizinische Technik/Biomedical Engineering
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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.
    Full-text · Article · Feb 2011 · European Heart Journal
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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
    No preview · Chapter · Jan 2010
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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
    Preview · Chapter · Jan 2010
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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.
    No preview · Article · Apr 2007 · Biomedizinische Technik
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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.
    Full-text · Article · Feb 2007 · Biomedizinische Technik
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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.
    Full-text · Article · Dec 2005 · Europace
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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.
    No preview · Article · Jun 2004 · Medical Microbiology and Immunology
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    M. Heinke · H. Kuhnert · R. Surber · G. Dannberg · F. Kuthe · H. R. Figulla

    Preview · Article · Oct 2003 · Europace
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    Preview · Article · Oct 2003 · Europace
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    Preview · Article · Oct 2003 · Europace
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    Preview · Article · Jan 2003 · Europace

Publication Stats

147 Citations
59.37 Total Impact Points

Institutions

  • 2013
    • Universitätsklinikum Jena
      Jena, Thuringia, Germany
  • 1987-2007
    • Friedrich Schiller University Jena
      • • Clinic of Internal Medicine I
      • • Department of Anaesthesiology and Intensive Care Medicine
      • • Clinic of Internal Medicine II
      • • Section of Cardiology
      Jena, Thuringia, Germany