N. Doll - Academia.edu (original) (raw)

Papers by N. Doll

Research paper thumbnail of DGTHG-Zertifizierung zur Herzschrittmacher-, ICD- und CRT-Therapie

Herzschrittmachertherapie & Elektrophysiologie

Die ärztliche Qualifikation zur Durchführung von Eingriffen mit kardialen Rhythmusimplantaten sow... more Die ärztliche Qualifikation zur Durchführung von Eingriffen mit kardialen Rhythmusimplantaten sowie der entsprechenden prä- und postoperativen Therapie, einschließlich der Nachuntersuchungen, ist bisher kaum definiert. Basierend auf dem interdisziplinär erarbeiteten und in 2008 publizierten Strukturpapier wurde von der Arbeitsgruppe Elektrophysiologische Chirurgie der Deutschen Gesellschaft für Thorax-, Herz- und Gefäßchirurgie (DGTHG) ein Zertifikat mit 3 Modulen erarbeitet, das Kriterien und Anforderungen für diesen Bereich nachvollziehbar definiert. Die ersten Prüfungen zur Erlangung des Zertifikats werden noch in 2013 erfolgen; eine zeitlich begrenzte Übergangsregelung ist bis zum 01. April 2014 vorgesehen. Weitere Details sind auf der Homepage der DGTHG zu finden.

Research paper thumbnail of Chirurgische Verfahren zur kurativen Therapie von Vorhofflimmern: Auch für idiopathisches Vorhofflimmern?

Herzschrittmachertherapie und Elektrophysiologie, 2002

Summary The development of simple, safe and curative strategies for the treatment of atrial fib... more Summary The development of simple, safe and curative strategies for the treatment of atrial fibrillation will remain one of the major challenges for invasive electophysiologists during the upcoming years. Our growing pathophysiological understanding of the arrhythmia itself has developed from surgical therapeutic strategies like the MAZE procedure and from intraoperative mapping-studies. Despite being highly effective the MAZE concept has never

Research paper thumbnail of Histological findings induced by different energy sources in experimental atrial ablation in sheep

Interactive cardiovascular and thoracic surgery, 2005

The aim of this study was a detailed comparative investigation of acute cardiac alterations induc... more The aim of this study was a detailed comparative investigation of acute cardiac alterations induced by different energy sources and approaches in a sheep model. Experiments were performed on 39 sheep. Circular lesions were created endo- or epicardially in the left atrium and at the pulmonary veins using different energy sources: cryo, microwave, laser and unipolar or bipolar radiofrequency (RF). Electrophysiological examinations were performed immediately post treatment and 2 h after ablation to prove conduction block. Altered areas of the atria and pulmonary veins were investigated histopathologically. Endocardial ablation resulted in transmural lesions, confirmed by electrophysiological examinations. However, endocardial microwave and laser induced intensive thrombus formation, whereas radiofrequency and cryoablation induced more circumscribed necrosis and led to little endocardial thrombi. Epicardial cryoablation and microwave energy were not successful in acute phase in 8 of 9 a...

Research paper thumbnail of Influence of operative strategy for Debakey Type I Aortic Dissection-Analysis of the GERAADA Registry

The Thoracic and Cardiovascular Surgeon, 2011

Research paper thumbnail of Is solitary left ventricular pacing using coronary vein lead a save treatment in patients following tricuspid valve replacement or reconstruction

The Thoracic and Cardiovascular Surgeon, 2011

Research paper thumbnail of Single patch repair of complete atrioventricular septal defect in neonates within the first three months of age suffering from therapy refractory heart failure. Is it feasible?

The Thoracic and Cardiovascular Surgeon, 2011

Research paper thumbnail of Impact of Diabetes Mellitus on Cardiac Surgery Outcome

The Thoracic and Cardiovascular Surgeon, 2003

Diabetes mellitus is an established independent risk factor related to significant morbidity and ... more Diabetes mellitus is an established independent risk factor related to significant morbidity and mortality after cardiac surgical procedures. Data on 16,184 patients undergoing cardiac surgery with and without cardiopulmonary bypass between April 1996 and August 2001 were prospectively evaluated. Diabetes mellitus as a patient related risk factor was subjected to univariate analysis to identify potential associations to 28 intra- and postoperative outcome variables. Outcome variables having a significant association with diabetes mellitus (p < 0.05) were then subjected to a stepwise logistic regression model to identify the influence of diabetes mellitus as compared to additional 30 different patient related risk factors and treatment variables. Diabetes mellitus was defined as glucose intolerance treated either dietary, with oral hypoglycemics or with insulin. Overall prevalence of diabetes mellitus was 33.3 %. Compared to non-diabetic patients the group with diabetes mellitus was older (p < 0.0001) and had a significantly lower ejection fraction (p < 0.0001). 15 outcome variables having a significant association with diabetes mellitus were identified. Furthermore, diabetes mellitus could be identified as an independent predictor for 7 postoperative outcome variables (prolonged ICU-stay, sternal instability and/or infection, sternal revision and refixation respiratory insufficiency, postoperative delirium, perioperative stroke, renal dysfunction, postoperative reintubation). Diabetes mellitus is a significant independent predictor for several postoperative outcome variables after cardiac surgery associated with higher postoperative morbidity and prolonged hospital stay.

Research paper thumbnail of The German Competence Network on Atrial Fibrillation (AFNET)

Herz Kardiovaskuläre Erkrankungen, 2008

The German Competence Network on Atrial Fibrillation (AFNET) is an interdisciplinary national res... more The German Competence Network on Atrial Fibrillation (AFNET) is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF) since 2003. The AFNET aims at improving treatment of atrial fibrillation (AF), the most frequent sustained arrhythmia of the heart. The AFNET has established a nationwide patient registry on manifestation, diagnostics, and therapy of AF in Germany. The data analyzed to date demonstrate that patients with AF are likely to have multiple comorbidities (hypertension, valvular heart disease, coronary artery disease, diabetes mellitus) and an advanced age. Regarding oral anticoagulation, guideline adherence is very high. Basic research has identified specific changes in atrial tissue during AF-induced remodeling providing the rationale for novel therapeutic interventions. Clinical trials are being carried out to optimize pharmacological and nonpharmacological treatments. The ANTIPAF trial is designed to prove that angiotensin II receptor blockers reduce the incidence of paroxysmal AF. The Flec-SL trial tests the efficacy of a short-term treatment with antiarrhythmic drugs after cardioversion. The Gap-AF trial investigates the impact of complete pulmonary vein (PV) isolation versus incomplete circumferential PV ablation on AF recurrences. The effect of preventive pacing on the recurrence of paroxysmal AF is studied in the BACE-PACE trial.

Research paper thumbnail of Die chirurgische Behandlung des therapierefrakt�ren Vorhofflimmerns

Zeitschrift f�r Kardiologie, 2003

Research paper thumbnail of Das Kompetenznetz Vorhofflimmern (AFNET)

Medizinische Klinik, 2006

The Atrial Fibrillation Competence Network is an interdisciplinary national research network fund... more The Atrial Fibrillation Competence Network is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF). The aim of the network--founded in 2003--is to improve the treatment of atrial fibrillation, the most common clinically important arrhythmia of the heart. A decentralized patient registry has been established. This registry, which comprises the manifestation, diagnostics and therapy of atrial fibrillation in Germany, is being used as a data basis for epidemiologic clinical studies. Epidemiologic projects are being conducted to study, e.g., the prevalence of atrial fibrillation as well as the occurrence of complications. Four multicenter clinical trials have been started to optimize pharmacological treatments (ANTIPAF trial, Flec-SL trial), preventive pacing (BACE-PACE trial) and catheter-based ablation (GAP-AF trial). Other clinical projects are being conducted to study the risk of neurologic complications and to develop new diagnostic imaging techniques. Experimental basic research projects are focusing on different aspects of atrial remodeling in order to find out in which way the molecular mechanisms can be manipulated by new methods of treatment. First results are presented.

Research paper thumbnail of DGTHG-Zertifizierung zur Herzschrittmacher-, ICD- und CRT-Therapie

Herzschrittmachertherapie & Elektrophysiologie

Die ärztliche Qualifikation zur Durchführung von Eingriffen mit kardialen Rhythmusimplantaten sow... more Die ärztliche Qualifikation zur Durchführung von Eingriffen mit kardialen Rhythmusimplantaten sowie der entsprechenden prä- und postoperativen Therapie, einschließlich der Nachuntersuchungen, ist bisher kaum definiert. Basierend auf dem interdisziplinär erarbeiteten und in 2008 publizierten Strukturpapier wurde von der Arbeitsgruppe Elektrophysiologische Chirurgie der Deutschen Gesellschaft für Thorax-, Herz- und Gefäßchirurgie (DGTHG) ein Zertifikat mit 3 Modulen erarbeitet, das Kriterien und Anforderungen für diesen Bereich nachvollziehbar definiert. Die ersten Prüfungen zur Erlangung des Zertifikats werden noch in 2013 erfolgen; eine zeitlich begrenzte Übergangsregelung ist bis zum 01. April 2014 vorgesehen. Weitere Details sind auf der Homepage der DGTHG zu finden.

Research paper thumbnail of Chirurgische Verfahren zur kurativen Therapie von Vorhofflimmern: Auch für idiopathisches Vorhofflimmern?

Herzschrittmachertherapie und Elektrophysiologie, 2002

Summary The development of simple, safe and curative strategies for the treatment of atrial fib... more Summary The development of simple, safe and curative strategies for the treatment of atrial fibrillation will remain one of the major challenges for invasive electophysiologists during the upcoming years. Our growing pathophysiological understanding of the arrhythmia itself has developed from surgical therapeutic strategies like the MAZE procedure and from intraoperative mapping-studies. Despite being highly effective the MAZE concept has never

Research paper thumbnail of Histological findings induced by different energy sources in experimental atrial ablation in sheep

Interactive cardiovascular and thoracic surgery, 2005

The aim of this study was a detailed comparative investigation of acute cardiac alterations induc... more The aim of this study was a detailed comparative investigation of acute cardiac alterations induced by different energy sources and approaches in a sheep model. Experiments were performed on 39 sheep. Circular lesions were created endo- or epicardially in the left atrium and at the pulmonary veins using different energy sources: cryo, microwave, laser and unipolar or bipolar radiofrequency (RF). Electrophysiological examinations were performed immediately post treatment and 2 h after ablation to prove conduction block. Altered areas of the atria and pulmonary veins were investigated histopathologically. Endocardial ablation resulted in transmural lesions, confirmed by electrophysiological examinations. However, endocardial microwave and laser induced intensive thrombus formation, whereas radiofrequency and cryoablation induced more circumscribed necrosis and led to little endocardial thrombi. Epicardial cryoablation and microwave energy were not successful in acute phase in 8 of 9 a...

Research paper thumbnail of Influence of operative strategy for Debakey Type I Aortic Dissection-Analysis of the GERAADA Registry

The Thoracic and Cardiovascular Surgeon, 2011

Research paper thumbnail of Is solitary left ventricular pacing using coronary vein lead a save treatment in patients following tricuspid valve replacement or reconstruction

The Thoracic and Cardiovascular Surgeon, 2011

Research paper thumbnail of Single patch repair of complete atrioventricular septal defect in neonates within the first three months of age suffering from therapy refractory heart failure. Is it feasible?

The Thoracic and Cardiovascular Surgeon, 2011

Research paper thumbnail of Impact of Diabetes Mellitus on Cardiac Surgery Outcome

The Thoracic and Cardiovascular Surgeon, 2003

Diabetes mellitus is an established independent risk factor related to significant morbidity and ... more Diabetes mellitus is an established independent risk factor related to significant morbidity and mortality after cardiac surgical procedures. Data on 16,184 patients undergoing cardiac surgery with and without cardiopulmonary bypass between April 1996 and August 2001 were prospectively evaluated. Diabetes mellitus as a patient related risk factor was subjected to univariate analysis to identify potential associations to 28 intra- and postoperative outcome variables. Outcome variables having a significant association with diabetes mellitus (p < 0.05) were then subjected to a stepwise logistic regression model to identify the influence of diabetes mellitus as compared to additional 30 different patient related risk factors and treatment variables. Diabetes mellitus was defined as glucose intolerance treated either dietary, with oral hypoglycemics or with insulin. Overall prevalence of diabetes mellitus was 33.3 %. Compared to non-diabetic patients the group with diabetes mellitus was older (p < 0.0001) and had a significantly lower ejection fraction (p < 0.0001). 15 outcome variables having a significant association with diabetes mellitus were identified. Furthermore, diabetes mellitus could be identified as an independent predictor for 7 postoperative outcome variables (prolonged ICU-stay, sternal instability and/or infection, sternal revision and refixation respiratory insufficiency, postoperative delirium, perioperative stroke, renal dysfunction, postoperative reintubation). Diabetes mellitus is a significant independent predictor for several postoperative outcome variables after cardiac surgery associated with higher postoperative morbidity and prolonged hospital stay.

Research paper thumbnail of The German Competence Network on Atrial Fibrillation (AFNET)

Herz Kardiovaskuläre Erkrankungen, 2008

The German Competence Network on Atrial Fibrillation (AFNET) is an interdisciplinary national res... more The German Competence Network on Atrial Fibrillation (AFNET) is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF) since 2003. The AFNET aims at improving treatment of atrial fibrillation (AF), the most frequent sustained arrhythmia of the heart. The AFNET has established a nationwide patient registry on manifestation, diagnostics, and therapy of AF in Germany. The data analyzed to date demonstrate that patients with AF are likely to have multiple comorbidities (hypertension, valvular heart disease, coronary artery disease, diabetes mellitus) and an advanced age. Regarding oral anticoagulation, guideline adherence is very high. Basic research has identified specific changes in atrial tissue during AF-induced remodeling providing the rationale for novel therapeutic interventions. Clinical trials are being carried out to optimize pharmacological and nonpharmacological treatments. The ANTIPAF trial is designed to prove that angiotensin II receptor blockers reduce the incidence of paroxysmal AF. The Flec-SL trial tests the efficacy of a short-term treatment with antiarrhythmic drugs after cardioversion. The Gap-AF trial investigates the impact of complete pulmonary vein (PV) isolation versus incomplete circumferential PV ablation on AF recurrences. The effect of preventive pacing on the recurrence of paroxysmal AF is studied in the BACE-PACE trial.

Research paper thumbnail of Die chirurgische Behandlung des therapierefrakt�ren Vorhofflimmerns

Zeitschrift f�r Kardiologie, 2003

Research paper thumbnail of Das Kompetenznetz Vorhofflimmern (AFNET)

Medizinische Klinik, 2006

The Atrial Fibrillation Competence Network is an interdisciplinary national research network fund... more The Atrial Fibrillation Competence Network is an interdisciplinary national research network funded by the Federal Ministry of Education and Research (BMBF). The aim of the network--founded in 2003--is to improve the treatment of atrial fibrillation, the most common clinically important arrhythmia of the heart. A decentralized patient registry has been established. This registry, which comprises the manifestation, diagnostics and therapy of atrial fibrillation in Germany, is being used as a data basis for epidemiologic clinical studies. Epidemiologic projects are being conducted to study, e.g., the prevalence of atrial fibrillation as well as the occurrence of complications. Four multicenter clinical trials have been started to optimize pharmacological treatments (ANTIPAF trial, Flec-SL trial), preventive pacing (BACE-PACE trial) and catheter-based ablation (GAP-AF trial). Other clinical projects are being conducted to study the risk of neurologic complications and to develop new diagnostic imaging techniques. Experimental basic research projects are focusing on different aspects of atrial remodeling in order to find out in which way the molecular mechanisms can be manipulated by new methods of treatment. First results are presented.