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Biomedical subjects

Mogens Møller

Publications and source records attributed to Mogens Møller.

7 recordsLinked to original sources
PubMed2005

Twins with implanted pacemakers: Is there an increased mortality risk for the co-twin? A follow-up study based on the Danish Twin Registry and the Danish Pacemaker Register.

BACKGROUND: The main indications for implanting a cardiac pacemaker are either acquired atrio-ventricular block (AVB) or sick sinus syndrome (SSS). In general, the exact aetiology of these conditions is unknown. Genetic factors may play a role. Untreated AVB is associated with increased mortality but SSS seems to have a good prognosis. The present study was designed to assess whether first-degree relatives of these patients have an increased mortality risk. METHODS: We investigated the survival pattern of the co-twins of twins who have had a cardiac pacemaker implanted, by linking two nationwide registries in Denmark: the Danish Pacemaker Register and the Danish Twin Registry. For each "pacemaker-twin" four control-twins matched with respect to age, sex, and zygosity were selected among the twins who were alive at the time of the pacemaker implantation. A total of 159 twins with a pacemaker treated bradycardia of unknown aetiology were identified of which 73 had AVB and 64 had SSS. A total of 622 matched control-twins could be identified. The survival from age six of the co-twins of the "pacemaker-twins" was compared with that of the co-twins of the control-twins. The follow-up period ended January 1st, 2000. FINDINGS: The survival curves for the co-twins of the "pacemaker-twins" were virtually identical to those of the co-twins of the control-twins. This finding was consistent for both AVB and SSS and for monozygotic as well as dizygotic twins. CONCLUSION: No increased mortality risk could be demonstrated for first-degree relatives--including monozygotic twins--of patients with a cardiac pacemaker implanted due to either acquired AVB or SSS.

Aged↗
PubMed2002

Risk of severe cardiac arrhythmia in male utility workers: a nationwide danish cohort study.

To address concern about the potential cardiovascular effects of occupational exposure to electromagnetic fields in the 50- to 60-Hz frequency band, the authors launched an epidemiologic study of the incidence of severe cardiac arrhythmia, as indicated by the need for a pacemaker, in a nationwide cohort of Danish utility workers. The cohort of 24,056 men employed at utility companies between 1900 and 1993 was linked to the nationwide, population-based Danish Pacemaker Register, and the numbers of persons who had undergone pacemaker implantation between 1982 and 2000 were compared with corresponding numbers in the general population. In addition, the data on the utility workers were fitted to a multiplicative Poisson regression model in relation to estimated levels of exposure to 50-Hz electromagnetic fields. Overall, based on 135 men with pacemakers (140 expected), there was no increased risk of severe cardiac arrhythmia among the utility employees; the risk estimate was 0.96 (95% confidence interval: 0.81, 1.14). No clear dose-response pattern emerged with increasing levels of exposure to electromagnetic fields or with duration of employment. These results are largely reassuring, since they do not support the hypothesis of a link between occupational exposure to electromagnetic fields and an excess risk of severe cardiovascular arrhythmia leading to permanent implantation of a pacemaker.

Adolescent↗
PubMed2002

QT interval dynamics predict mortality in high-risk patients after myocardial infarction.

OBJECTIVE: The purpose of this study was to evaluate the prognostic properties of the QT/RR relationship in survivors of myocardial infarction with severe left ventricular dysfunction. DESIGN: The QT/RR interval slope was assessed from 24-h electrocardiographic recordings obtained from 241 patients representative of survivors of an acute myocardial infarction with an ejection fraction < or =35%. During a median follow-up of 752 days, 63 patients died. RESULTS: In a multivariate analysis QT/RR at night-time was an independent predictor of all-cause mortality. A linear all-cause mortality predictor score was calculated from age, ejection fraction, QRS duration and QT/RR night, allowing identification of a high-risk one-third of the patients with a relative risk of death at 4.0. CONCLUSION: This study demonstrates independent prognostic information of night-time QT/RR dynamics in patients at high risk after myocardial infarction. A linear predictor score calculated from age, ejection fraction, QRS duration and QT/RR night identifies a high-risk one-third of the patients with a 1-year mortality of 36% vs 9% in the remaining patients.

Adrenergic beta-Antagonists↗
PubMed2002

Improvement of risk-stratification by use of a new combination of Holter variables in survivors of myocardial infarction.

OBJECTIVE: Holter monitoring is one option in risk-stratification after acute myocardial infarction (MI). Measurements of heart rate variability (HRV), ventricular tachycardia (VT) and ST-segment elevation (ST upward arrow ) have been useful in predicting clinical outcome. We investigated if a combination of different Holter variables could optimize risk-stratification. DESIGN: One hundred and twenty-one men < 70 years old with a first MI were studied. Holter monitoring for 24 h was started 11 +/- 5 days after MI and analysed for HRV, VT and ST. Follow-up was 10-12 years with cardiac death as endpoint. RESULTS: Thirty-six patients were positive for > or = 1 Holter variable (HRV in 15, VT in 16, ST in 10). At follow-up 22 cardiac deaths had occurred. The prognostic sensitivity of individual Holter variables ranged from 23 to 36%, but increased to 64% if combined. The cardiac death rate in Holter positive patients (39%) was significantly higher than in Holter negative patients (9%) (p < 0.0001). CONCLUSION: By combining measurements of HRV, VT and ST the prognostic importance of Holter monitoring can be significantly improved. The patients can be stratified in a low-risk group with an annual mortality < 1% vs a high-risk group with a cardiac death rate around 40% over the following decade.

Aged↗
PubMed2002

Cancer risk among pacemaker recipients in Denmark, 1982-1996.

To address concerns about the potential carcinogenicity of pacemakers, we launched the first epidemiologic study of cancer incidence among pacemaker recipients. A nationwide cohort of 16,357 pacemaker recipients in Denmark from 1982 through 1996 was identified. The Danish Cancer Registry was used to identify all incident cancers within the cohort, with almost 75,000 person-years of observation. The cohort had a slight excess of cancer overall (SIR = 1.19, 95% confidence interval [95% CI, 1.1-1.2]). This was largely caused by an elevated SIR for multiple myeloma among men (SIR = 1.78,95% CI, 1.1-2.8), which increased to 2.60 (95% CI, 0.9-5.7) 5-9 years after implantation, and to a similarly increased SIR for kidney cancer among women (SIR = 2.05, 95% CI, 1.3-3.0), which increased to 3.39 (95% CI, 1.6-6.2) after a latency period of 5-9 years. An excess of urinary bladder cancer was also seen after 10 years. No excess risk was observed for breast cancer or sarcomas, although the SIRs for sarcomas tended to increase over time, based on small numbers. Our results are largely reassuring but, as pacemakers become more common and are implanted at earlier ages and as survival following implantation improves, the excesses of bladder cancer, multiple myeloma among men, and kidney cancer among women with long-term followup warrant further investigation.

Aged↗