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dc.contributor.advisor Zabel, Markus Prof. Dr.
dc.contributor.author Lercher, Hendrik
dc.date.accessioned 2016-11-03T09:54:16Z
dc.date.available 2016-11-29T23:50:06Z
dc.date.issued 2016-11-03
dc.identifier.uri http://hdl.handle.net/11858/00-1735-0000-002B-7C62-5
dc.language.iso deu de
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc 610 de
dc.title Multivariate Vorhersagbarkeit von ICD-Schocks und Mortalität bei Patienten nach einer ICD-Neuimplantation de
dc.title.alternative Risikostratifikation für maligne ventrikuläre Rhythmusstörungen de
dc.type doctoralThesis de
dc.title.translated Multivariate predictability of ICD shocks and mortality in patients after an ICD new implant de
dc.contributor.referee Paul, Thomas Prof. Dr.
dc.date.examination 2016-11-22
dc.description.abstracteng In this study, the importance of various parameters for the risk assessment in ICD patients discussed in the literature has been investigated. An inhomogeneous collective study was investigated, the basic distribution of which distributes the clinical daily life as best as possible. Only non-invasive markers were considered. These included a TWA test, a signaling ECG, a 24-hour long-term ECG, a digital 12-channel ECG and the collection of data from the pre-medical and medication history. These data were collected in 122 patients immediately before or after ICD implantation. The follow-up period was 592 (± 240) days. Of the (n =) 122 patients included, 11 (9%) died during the observation period. This corresponds to an annual mortality of 6.8%. In 10 patients (8.2%) an adequate shock was registered by the ICD. This corresponds to an annual risk of shock of 6.2%. By means of multivariate Cox analysis it was shown that apoplex, the number of VES in the Holter ECG, decreased (<114 ms) fQRS values ​​in the SAECG and the use of furosemide significantly correlated with increased morality. The number of VES in the Holter ECG as well as the nicotine abortion also correlate with adequate shock delivery, although here only one 90% significance level is reached. The DC category achieved the 95% significance level (p = 0.048) as the only marker for non-eventful survival in the multivariate calculation. In addition, a statistical trend can be observed for the occurrence of nsVT in the Holter ECG and the implantation indication (p = ns) with respect to the event-free survival. However, the TWA measurement, the SAECG and the digital 12-lead ECG do not appear to be able to add additional benefits in the risk assessment. The reason why the LVEF does not have any prognostic significance in this collective group remains ultimately unclear. On the basis of the results of this work, no method can be identified, which in itself has a special prediction potential. However, it appears that the significance of the long-term ECG, especially the presence of VES and nsVT, should be given particular attention in future studies. de
dc.contributor.coReferee Oppermann, Martin Prof. Dr.
dc.title.alternativeTranslated Risk assessment for malignant ventricular rhythm disturbances de
dc.subject.ger ICD de
dc.subject.ger plötzlicher Herztod de
dc.subject.ger T-Wellen-Alternans (TWA) de
dc.subject.ger Spätpotentialmessung (EKG) de
dc.subject.ger Langzeit-EKG de
dc.subject.ger Risikostratifikation de
dc.subject.ger Implantierbarer Kardioverter-Defibrillator (ICD) de
dc.subject.ger Herzrhythmusstörung de
dc.subject.ger ICD-Schock de
dc.subject.eng ICD de
dc.subject.eng sudden cardiac death de
dc.subject.eng SAECG de
dc.subject.eng T wave alternans de
dc.subject.eng Electrocardiography de
dc.subject.eng Implantable cardioverter defibrillator (ICD) de
dc.subject.eng risk assessment de
dc.subject.eng Signal-averaged electrocardiogram de
dc.subject.eng Holter monitor de
dc.subject.eng predicting adverse cardiac events de
dc.subject.eng ICD shock de
dc.identifier.urn urn:nbn:de:gbv:7-11858/00-1735-0000-002B-7C62-5-4
dc.affiliation.institute Medizinische Fakultät de
dc.subject.gokfull Medizin (PPN619874732) de
dc.subject.gokfull Kardiologie (PPN619875755) de
dc.subject.gokfull Diagnostik {Medizin} (PPN619875739) de
dc.description.embargoed 2016-11-29
dc.identifier.ppn 871706784

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