@phdthesis{Muensterer2022, author = {M{\"u}nsterer, Sascha Ottmar}, title = {Prognostische Wertigkeit der Herzfrequenz in Abh{\"a}ngigkeit von implantierten Devices bei akuter Herzinsuffizienz: Ergebnisse des prospektiven AHF-Registers W{\"u}rzburg}, doi = {10.25972/OPUS-28775}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-287755}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Aims This study investigated, whether an activated R-mode, a surrogate of chronotropic incompetence in patients carrying a cardiovascular implantable electronic device (CIED), is associated with worse prognosis during and after an episode of acutely decompensated heart failure (AHF). Methods and Results Six hundred and twenty-three patients participating in an ongoing prospective cohort study that phenotypes and follows patients admitted for AHF were studied. We compared CIED carriers with R-mode stimulation (n=37) to CIED carriers not in R-mode (n=64) and patients without CIEDs (n=511). Mean heart rate on admission was significantly lower in R-mode patients vs. patients with CIED but without R-mode or patients withour CIED. In-hospital mortality was similar across groups, but age- and sex-adjusted 12-month mortality risk was higher in R-mode group. These effects persisted after multivariable adjustment for comorbidity burden. Conclusion In patients admitted for AHF, R-mode stimulation was associated with a significantly increased 12-month mortality risk. Our findings suggest that chronotropic incompetence per se mediates an adverse outcome and may not be adequately treated through accelerometer-based R-mode stimulation during and after an episode of AHF.}, language = {de} } @phdthesis{Muensterer2022, author = {M{\"u}nsterer, Sascha Ottmar}, title = {Prognostische Wertigkeit der Herzfrequenz in Abh{\"a}ngigkeit von implantierten Devices bei akuter Herzinsuffizienz: Ergebnisse des prospektiven AHF-Registers W{\"u}rzburg}, doi = {10.25972/OPUS-33029}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-330293}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Aims This study investigated, whether an activated R-mode, a surrogate of chronotropic incompetence in patients carrying a cardiovascular implantable electronic device (CIED), is associated with worse prognosis during and after an episode of acutely decompensated heart failure (AHF). Methods and Results Six hundred and twenty-three patients participating in an ongoing prospective cohort study that phenotypes and follows patients admitted for AHF were studied. We compared CIED carriers with R-mode stimulation (n=37) to CIED carriers not in R-mode (n=64) and patients without CIEDs (n=511). Mean heart rate on admission was significantly lower in R-mode patients vs. patients with CIED but without R-mode or patients withour CIED. In-hospital mortality was similar across groups, but age- and sex-adjusted 12-month mortality risk was higher in R-mode group. These effects persisted after multivariable adjustment for comorbidity burden. Conclusion In patients admitted for AHF, R-mode stimulation was associated with a significantly increased 12-month mortality risk. Our findings suggest that chronotropic incompetence per se mediates an adverse outcome and may not be adequately treated through accelerometer-based R-mode stimulation during and after an episode of AHF.}, subject = {Herzschrittmacher}, language = {de} }