First results of the Modular ATP trial finally published in NEJM and presented as a LBCT at HRS 2024: nejm.org/doi/full/10.10…
Also check out this cool video to see how it works:
youtu.be/uMWM8XWNoz8
YouTube
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Reinoud Knops
62 posts
Reinoud Knops
@KnopsReinoud
Professor in Cardiac Electrophysiology. Amsterdam University Medical Center, The Netherlands. PhD in CRM technology
Amsterdam, The Netherlands Katılım Mayıs 2016
55 Takip Edilen460 Takipçiler
Reinoud Knops retweetledi
More than one million people receive a pacemaker yearly. Leadless versions are only available for 20% of these patients. But, thanks to an international consortium led by @AmsterdamUMC, an improved version will soon be available for all patients.
amsterdamumc.org/en/spotlight/l…
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Reinoud Knops retweetledi
Great LBCT presented by @KnopsReinoud! First results of the randomized PRAETORIAN DFT trial. Validation of the PRAETORIAN score #HRS2023 #EPeeps #NOLA
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@EJSMD In experienced centers we have seen the rate of high PRAETORIAN scores go down from 8% to 1%. With that rate it is a relative low logistic burden to bring patients back for DFT testing or repositioning. The PRAETORIAN score should be used to improve implant technique.
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In PRAETORIAN DFT, a PRAETORIAN score < 90 predicts 99% DFT success in prelim data.
In practical terms, how might we use this info in lab, prior to CXR score? Will some pts need to come back to lab for testing & possible revision after CXR is obtained?
@KnopsReinoud
#HRS2023
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Reinoud Knops retweetledi
EHJ issue 43 - 47 out now!
Our EHJ Focus Issue on arrhythmias wraps up novel risk factors for atrial fibrillation, conduction disturbances, sudden coronary death and device infection:
academic.oup.com/eurheartj/arti…
@escardio @ESC_Journals #EHJ #cardiotwitter #arrhythmia
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New publication in EHJ!!Important data for shared decisions making in (S-)ICD therapy. eur04.safelinks.protection.outlook.com/?url=http%3A%2…
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Reinoud Knops retweetledi
ICYMI - Appropriate Therapy in PRAETORIAN @KnopsReinoud @CardiacDevices_ ahajournals.org/doi/10.1161/CI…
Circulation@CircAHA
#OriginalResearch SimPub #AHA21: In this study from the #PRAETORIAN #RCT, no difference in shock efficacy was observed between subcutaneous ICD compared with transvenous ICD ow.ly/HXyr50GN3FY @KnopsReinoud @CardiacDevices #AHAJournals
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Reinoud Knops retweetledi
@KnopsReinoud enrolled the 1st European patient in MODULAR ATP Trial! Designed to evaluate communication between 2 CRM devices, #SICD & EMPOWER Modular Pacing System, the trial aims to potentially expand treatment options for patients who require an ICD: bit.ly/3Ir4zxC
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Appropriate therapy in the Praetorian trial now published in Circulation. #AmsterdamUMC Summary of results: SICD vs TV-ICD similar shock efficacy. TV-ICD: With ATP less shocks in discrete episodes but more storm episodes. ahajournals.org/doi/10.1161/CI…
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Reinoud Knops retweetledi
Attending #AHA21? @KnopsReinoud will discuss antitachycardia pacing and new findings from the PRAETORIAN trial. Join us on Sunday, November 14 at 5:27pm ET.
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@drsuneet Since the start of the DETERMINE Trial in 2008, MRI has become much more routine. Perhaps enrollment will be easier nowadays. Still an important unanswered question!
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Tried that...St Jude DETERMINE trial. Had to be stopped due to low enrollment.
Reinoud Knops@KnopsReinoud
@drsuneet Guidelines follow the evidence. Perhaps we need a new SCD prevention trial based on scar volume on MRI. Any device company interested in sponsoring such a trial?
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@naderjo @BSC_EU_Heart @boersma_lucas I hope your comments will stimulate BSC to invest more in SICD development. Also looking forward to a mini-SICD for low BMI patients.
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@KnopsReinoud @BSC_EU_Heart @boersma_lucas I believe in patients being obese and of huge thoracic skeletal circumference a longer lead would be very helpful. Had two cases where the length just would not suffice despite being as deep as possible.
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T8: How has your patient population changed in the last 10 years and have you expanded the patients you implant in? Why? #UseHeart @KnopsReinoud @boersma_lucas
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@naderjo @BSC_EU_Heart @boersma_lucas In obese patients you have to ‘dig’ a little deeper to reach the fascia. In my experience: As long as you follow the fascia on the chest wall the SICD lead will accommodate all body sizes. Tip for BSC: pediatric lead!
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@BSC_EU_Heart @KnopsReinoud @boersma_lucas What do you think about obese patients? IMO they aren’t good candidates for S-ICD unless we have longer leads availabe?
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@naderjo @VKutyifa @BSC_EU_Heart @boersma_lucas Sorry for the confusion. I indeed mean conversion testing for efficacy. DFT= Threshold testing. We do that for scientific purposes.
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T7: As an S-ICD implant expert, what practical hints do you recommend for a successful procedure? #UseHeart @boersma_lucas @KnopsReinoud
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@drsuneet Guidelines follow the evidence. Perhaps we need a new SCD prevention trial based on scar volume on MRI. Any device company interested in sponsoring such a trial?
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Issue in US comes down to clinical guidelines and coverage and reimbursement stipulations.
Reinoud Knops@KnopsReinoud
@VKutyifa EF is the parameter with the most evidence. However I do think we should be more and more looking for scar tissue in relation to prognosis. Every patient needs an MRI!!! #UseHeart @DrRoderickTung @drsuneet
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Enjoyed my first ever Twitter chat session with @boersma_lucas on SCD prevention and S-ICD. Thanks for @VKutyifa and @LindsayLuvDavis for being so active with their questions 😀
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@BSC_EU_Heart @boersma_lucas A12: Smaller device. Even less complications with better implant techniques: possibly leading to expansion of primary prevention indications due to a better risk-benefit ratio with S-ICD than with the TV-ICD #UseHeart
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@BSC_EU_Heart A11: Subanalysis on appropriate therapy, ATP and mortality, a more in-depth analysis on complications and a QoL subanalysis, which will be important to patients. Long term follow-up (8yrs): we anticipate the complication curves to further diverge #UseHeart
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T11: @KnopsReinoud, what can we expect next from PRAETORIAN? #UseHeart
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@BSC_EU_Heart @boersma_lucas A10: That 12% of patients received appropriate ATP and it was only successful in terminating 55% of the arrhythmias, and 7% of the patients received inappropriate ATP bursts #UseHeart
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T10: What surprised you the most in the latest PRAETORIAN & UNTOUCHED extensive datasets? #UseHeart @KnopsReinoud @boersma_lucas
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@VKutyifa @BSC_EU_Heart @boersma_lucas We still perform DFT-tests for scientific purposes. In my opinion with a low Praetorian-DFT score a test is NOT necessary. Certainly not if the initial DFT was okay. #UseHeart
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@BSC_EU_Heart @boersma_lucas @KnopsReinoud Are you still performing conversion testing for all your S-ICD patients? Why? Why not?
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