Thomas Wichter - Academia.edu (original) (raw)
Papers by Thomas Wichter
Introduction Numerous reports on the inducibility of ventricular tachyarrhythmias (VT) in patient... more Introduction Numerous reports on the inducibility of ventricular tachyarrhythmias (VT) in patients with atypical right bundle branch block and right precordial ST-elevation (Brugada syndrome) are based on multicentre studies that have used different stimulation protocols. Therefore, we
RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin, 2002
The Thoracic and Cardiovascular Surgeon, 2005
We sought to examine our management and the outcomes of cardiothoracic procedures after heart and... more We sought to examine our management and the outcomes of cardiothoracic procedures after heart and heart lung transplantation. We performed a retrospective review of cardiothoracic surgical procedures carried out between 1990 and 2004 in patients who had previously undergone heart or heart-lung transplantation at our institution. Twenty-one out of 340 patients (6.2 %) were identified. Cardiothoracic surgery was performed 44.4 +/- 33 months (range 1 - 115 months) after transplantation. Predominant types of surgery were coronary artery bypass grafting due to allograft vasculopathy (n = 5), aortic surgery due to acute dissection (n = 3), biventricular assist device implantation due to acute rejection (n = 1), tricuspid valve repair (n = 1), multiple cardiac surgical procedures including coronary artery bypass grafting, retransplantation, and tricuspid valve replacement (n = 2), explantation of a functionless heterotopic transplanted heart (n = 1). Lung surgery was performed in six patients due to pneumonia (n = 2), primary lung carcinoma (n = 3), lung torsion following heart-lung transplantation (n = 1). All patients underwent either lobectomy or segmental lung resection. Single lung retransplantation (n = 2) after prior heart-lung transplantation due to bronchiolitis obliterans was performed. In one patient a pneumonectomy (n = 1) due to severe chronic rejection of the contralateral lung was performed. Six subsequent deaths after cardiothoracic procedures were recorded after 1, 4, 78, 163, 205, and 730 days, respectively. Causes of death were advanced carcinoma (n = 1), multi-organ failure due to sepsis (n = 2), sudden heart death (n = 2), and advanced heart failure (n = 1). Fifteen out of 21 patients having undergone cardiothoracic procedures (71.4 %) survived the observation period of 56.6 +/- 34 months (range 1 - 114). Reasons for cardiothoracic procedures after prior heart or heart-lung transplantation were allograft vasculopathy, aortic dissections years after transplantation, chronic rejection, and either lung infections or malignancies. Surgical repair can be performed with an acceptable operative risk and good long-term survival rates.
RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 2002
Intensivmedizin Und Notfallmedizin, 1991
European Heart Journal, 1995
Patients with third-degree atrioventricular block implanted with a dual-chamber pacemaker in DDD ... more Patients with third-degree atrioventricular block implanted with a dual-chamber pacemaker in DDD mode can develop pacemaker-mediated tachycardias if retrograde ventriculoatrial (VA) conduction is present. Programming a long post-VA refractory period to avoid tachycardia initiation can be contraindicated if these patients have a good atrial response from exercise testing and require a high maximum tracking rate to allow for a proper response to sensed atrial rhythms. We report a case of a patient in whom mapping and ablation of retrograde conduction during the pacemaker-mediated rhythm was the only solution to allow both the programming of a high tracking rate and the elimination of tachycardia induction.
Nuklearmedizin. Nuclear medicine, Jan 20, 2016
To investigate sex differences in myocardial perfusion especially in healthy individuals since fo... more To investigate sex differences in myocardial perfusion especially in healthy individuals since former studies are rare and findings are controversial. Participants, methods: 26 subjects were enrolled: 16 healthy women (age: 34 ±7 years) were compared with 10 healthy men (age: 34 ± 3 years; p = ns). Myocardial blood flow (MBF) and coronary vascular resistance (CVR) were quantified at rest, during adenosine infusion and cold-pressor-testing, using positron emission tomography and radioactive-labelled water (H215O-PET). Women showed higher MBF than men at rest (1.10 ± 0.18 vs. 0.85 ± 0.20 ml/min/ml; p = 0.003) and cold-stress (1.39 ± 0.38 vs. 1.06 ± 0.28 ml/min/ml; p = 0.026). Corrected for rate-pressure-product, baseline findings maintained significance (1.41 ± 0.33 vs. 1.16 ± 0.19 ml/min/ml; p = 0.024). CVR was lower in women at baseline (81 ± 14 vs. 107 ± 22 mmHg*ml(-1)*min*ml; p = 0.006) and during cold-pressor-testing (71 ± 17 vs. 91 ± 20 mmHg*ml(-1)*min*ml; p = 0.013). Under aden...
Dokumentationsverfahren in der Herzchirurgie III, 1998
Im Mittelpunkt der Aufgabenbereiche der Herzkatheterlabore steht die Diagnostik angeborener Herzf... more Im Mittelpunkt der Aufgabenbereiche der Herzkatheterlabore steht die Diagnostik angeborener Herzfehler, erworbener Herzklappenfehler, von Herzmuskelerkrankungen, von Erkrankungen der Herzkranzgefase und von peripheren Gefasen, die Vorbereitung von Patienten mit Herzinsuffizienz und nach Herztransplantation, die elektrophysiologische Diagnostik und die Therapie von Herzrhythmusstorungen mit Katheterverfahren (Katheterablation) und die postoperative Uberprufung von automatischen implantierten Kardioverter-Defibrillator-Systemen.
Deutsche Gesellschaft für Chirurgie, 1999
Zeitschrift für Kardiologie, 1993
The case of a 36-year-old woman with suspected idiopathic long QT syndrome is reported. Diagnosis... more The case of a 36-year-old woman with suspected idiopathic long QT syndrome is reported. Diagnosis was made late after syncopal attacks and several episodes of resuscitation had occurred. Although therapy with a beta-blocking agent was initiated and a cardioverter/defibrillator was implanted, the patient died, due to a hydrocephalus internus resulting in cerebral damage. Diagnostic and therapeutic problems in idiopathic long QT syndrome are discussed.
Zeitschrift für Kardiologie, 1995
So-called "Mahaim-pathways" represent a distinct subset of accessory pathways and the p... more So-called "Mahaim-pathways" represent a distinct subset of accessory pathways and the preexcitation syndromes with unique electrophysiologic properties. During sinus rhythm, preexcitation is minimal or absent whereas incremental atrial stimulation reveals preexcitation with a left bundle branch block like morphology. "Mahaim-fibers" exhibit long conduction times, decremental conduction properties by atrial extrastimuli or incremental atrial pacing, and conduction only in the anterograde direction. The typical atrioventricular reentrant tachycardia incorporating a "Mahaim-pathway" is a preexcited antidromic tachycardia with anterograde conduction over the accessory pathway and retrograde conduction over the AV node. "Mahaim-fibers" may be associated with dual AV node physiology or common atrioventricular accessory pathways. The original concept of "Mahaim-fibers" consisted of accessory pathways originating in the AV node and inserting...
Computers in Cardiology, 2005, 2005
Background: Irreversibly dysfunctional myocardium is electrically characterized by decreased ampl... more Background: Irreversibly dysfunctional myocardium is electrically characterized by decreased amplitudes and prolonged duration of local electrograms. We investigated whether ECGs from body surface correlate with epicardial electrograms. Methods: A 120-channel body surface potential mapping (BSPM) was performed in 24 patients before CABG. During CABG epicardial mapping was performed. For all BSPM leads the Qamplitude and QR-duration were measured and correlated to epicardial electrogram characteristics. Results: Q-wave-amplitude neighboring the area over the left scapula correlated well with epicardial amplitudes in scarred LAD. QR-duration caudal to V5,V6 correlated well with epicardial signal duration in scarred CxA, Qamplitude in paramedian epigastric region correlated with epicardial amplitudes in scarred RCA. Conclusion: Epicardial electrogram characteristics can be estimated from body surface in patients with chronic ischemia.
The Thoracic and Cardiovascular Surgeon, 2005
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2010
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2010
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2001
Introduction Numerous reports on the inducibility of ventricular tachyarrhythmias (VT) in patient... more Introduction Numerous reports on the inducibility of ventricular tachyarrhythmias (VT) in patients with atypical right bundle branch block and right precordial ST-elevation (Brugada syndrome) are based on multicentre studies that have used different stimulation protocols. Therefore, we
RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin, 2002
The Thoracic and Cardiovascular Surgeon, 2005
We sought to examine our management and the outcomes of cardiothoracic procedures after heart and... more We sought to examine our management and the outcomes of cardiothoracic procedures after heart and heart lung transplantation. We performed a retrospective review of cardiothoracic surgical procedures carried out between 1990 and 2004 in patients who had previously undergone heart or heart-lung transplantation at our institution. Twenty-one out of 340 patients (6.2 %) were identified. Cardiothoracic surgery was performed 44.4 +/- 33 months (range 1 - 115 months) after transplantation. Predominant types of surgery were coronary artery bypass grafting due to allograft vasculopathy (n = 5), aortic surgery due to acute dissection (n = 3), biventricular assist device implantation due to acute rejection (n = 1), tricuspid valve repair (n = 1), multiple cardiac surgical procedures including coronary artery bypass grafting, retransplantation, and tricuspid valve replacement (n = 2), explantation of a functionless heterotopic transplanted heart (n = 1). Lung surgery was performed in six patients due to pneumonia (n = 2), primary lung carcinoma (n = 3), lung torsion following heart-lung transplantation (n = 1). All patients underwent either lobectomy or segmental lung resection. Single lung retransplantation (n = 2) after prior heart-lung transplantation due to bronchiolitis obliterans was performed. In one patient a pneumonectomy (n = 1) due to severe chronic rejection of the contralateral lung was performed. Six subsequent deaths after cardiothoracic procedures were recorded after 1, 4, 78, 163, 205, and 730 days, respectively. Causes of death were advanced carcinoma (n = 1), multi-organ failure due to sepsis (n = 2), sudden heart death (n = 2), and advanced heart failure (n = 1). Fifteen out of 21 patients having undergone cardiothoracic procedures (71.4 %) survived the observation period of 56.6 +/- 34 months (range 1 - 114). Reasons for cardiothoracic procedures after prior heart or heart-lung transplantation were allograft vasculopathy, aortic dissections years after transplantation, chronic rejection, and either lung infections or malignancies. Surgical repair can be performed with an acceptable operative risk and good long-term survival rates.
RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 2002
Intensivmedizin Und Notfallmedizin, 1991
European Heart Journal, 1995
Patients with third-degree atrioventricular block implanted with a dual-chamber pacemaker in DDD ... more Patients with third-degree atrioventricular block implanted with a dual-chamber pacemaker in DDD mode can develop pacemaker-mediated tachycardias if retrograde ventriculoatrial (VA) conduction is present. Programming a long post-VA refractory period to avoid tachycardia initiation can be contraindicated if these patients have a good atrial response from exercise testing and require a high maximum tracking rate to allow for a proper response to sensed atrial rhythms. We report a case of a patient in whom mapping and ablation of retrograde conduction during the pacemaker-mediated rhythm was the only solution to allow both the programming of a high tracking rate and the elimination of tachycardia induction.
Nuklearmedizin. Nuclear medicine, Jan 20, 2016
To investigate sex differences in myocardial perfusion especially in healthy individuals since fo... more To investigate sex differences in myocardial perfusion especially in healthy individuals since former studies are rare and findings are controversial. Participants, methods: 26 subjects were enrolled: 16 healthy women (age: 34 ±7 years) were compared with 10 healthy men (age: 34 ± 3 years; p = ns). Myocardial blood flow (MBF) and coronary vascular resistance (CVR) were quantified at rest, during adenosine infusion and cold-pressor-testing, using positron emission tomography and radioactive-labelled water (H215O-PET). Women showed higher MBF than men at rest (1.10 ± 0.18 vs. 0.85 ± 0.20 ml/min/ml; p = 0.003) and cold-stress (1.39 ± 0.38 vs. 1.06 ± 0.28 ml/min/ml; p = 0.026). Corrected for rate-pressure-product, baseline findings maintained significance (1.41 ± 0.33 vs. 1.16 ± 0.19 ml/min/ml; p = 0.024). CVR was lower in women at baseline (81 ± 14 vs. 107 ± 22 mmHg*ml(-1)*min*ml; p = 0.006) and during cold-pressor-testing (71 ± 17 vs. 91 ± 20 mmHg*ml(-1)*min*ml; p = 0.013). Under aden...
Dokumentationsverfahren in der Herzchirurgie III, 1998
Im Mittelpunkt der Aufgabenbereiche der Herzkatheterlabore steht die Diagnostik angeborener Herzf... more Im Mittelpunkt der Aufgabenbereiche der Herzkatheterlabore steht die Diagnostik angeborener Herzfehler, erworbener Herzklappenfehler, von Herzmuskelerkrankungen, von Erkrankungen der Herzkranzgefase und von peripheren Gefasen, die Vorbereitung von Patienten mit Herzinsuffizienz und nach Herztransplantation, die elektrophysiologische Diagnostik und die Therapie von Herzrhythmusstorungen mit Katheterverfahren (Katheterablation) und die postoperative Uberprufung von automatischen implantierten Kardioverter-Defibrillator-Systemen.
Deutsche Gesellschaft für Chirurgie, 1999
Zeitschrift für Kardiologie, 1993
The case of a 36-year-old woman with suspected idiopathic long QT syndrome is reported. Diagnosis... more The case of a 36-year-old woman with suspected idiopathic long QT syndrome is reported. Diagnosis was made late after syncopal attacks and several episodes of resuscitation had occurred. Although therapy with a beta-blocking agent was initiated and a cardioverter/defibrillator was implanted, the patient died, due to a hydrocephalus internus resulting in cerebral damage. Diagnostic and therapeutic problems in idiopathic long QT syndrome are discussed.
Zeitschrift für Kardiologie, 1995
So-called "Mahaim-pathways" represent a distinct subset of accessory pathways and the p... more So-called "Mahaim-pathways" represent a distinct subset of accessory pathways and the preexcitation syndromes with unique electrophysiologic properties. During sinus rhythm, preexcitation is minimal or absent whereas incremental atrial stimulation reveals preexcitation with a left bundle branch block like morphology. "Mahaim-fibers" exhibit long conduction times, decremental conduction properties by atrial extrastimuli or incremental atrial pacing, and conduction only in the anterograde direction. The typical atrioventricular reentrant tachycardia incorporating a "Mahaim-pathway" is a preexcited antidromic tachycardia with anterograde conduction over the accessory pathway and retrograde conduction over the AV node. "Mahaim-fibers" may be associated with dual AV node physiology or common atrioventricular accessory pathways. The original concept of "Mahaim-fibers" consisted of accessory pathways originating in the AV node and inserting...
Computers in Cardiology, 2005, 2005
Background: Irreversibly dysfunctional myocardium is electrically characterized by decreased ampl... more Background: Irreversibly dysfunctional myocardium is electrically characterized by decreased amplitudes and prolonged duration of local electrograms. We investigated whether ECGs from body surface correlate with epicardial electrograms. Methods: A 120-channel body surface potential mapping (BSPM) was performed in 24 patients before CABG. During CABG epicardial mapping was performed. For all BSPM leads the Qamplitude and QR-duration were measured and correlated to epicardial electrogram characteristics. Results: Q-wave-amplitude neighboring the area over the left scapula correlated well with epicardial amplitudes in scarred LAD. QR-duration caudal to V5,V6 correlated well with epicardial signal duration in scarred CxA, Qamplitude in paramedian epigastric region correlated with epicardial amplitudes in scarred RCA. Conclusion: Epicardial electrogram characteristics can be estimated from body surface in patients with chronic ischemia.
The Thoracic and Cardiovascular Surgeon, 2005
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2010
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2010
RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2001