Diagnostic Yield of Genetic Testing in Young Patients With Atrioventricular Block of Unknown Cause

BACKGROUND: The cause of atrioventricular block (AVB) remains unknown in approximately half of young patients with the diagnosis. Although variants in several genes associated with cardiac conduction diseases have been identified, the contribution of genetic variants in younger patients with AVB is unknown. METHODS AND RESULTS: Using the Danish Pacemaker and Implantable Cardioverter Defibrillator (ICD) Registry, we identified all patients younger than 50 years receiving a pacemaker because of AVB in Denmark in the period from January 1, 1996 to December 31, 2015. From medical records, we identified patients with unknown cause of AVB at time of pacemaker implantation. These patients were invited to a genetic screening using a panel of 102 genes associated with inherited cardiac diseases. We identified 471 living patients with AVB of unknown cause, of whom 226 (48%) accepted participation. Median age at the time of pacemaker implantation was 39 years (interquartile range, 32–45 years), and 123 (54%) were men. We found pathogenic or likely pathogenic variants in genes associated with or possibly associated with AVB in 12 patients (5%). Most variants were found in the LMNA gene (n=5). LMNA variant carriers all had a family history of either AVB and/or sudden cardiac death. CONCLUSIONS: In young patients with AVB of unknown cause, we found a possible genetic cause in 1 out of 20 participating patients. Variants in the LMNA gene were most common and associated with a family history of AVB and/or sudden cardiac death, suggesting that genetic testing should be a part of the diagnostic workup in these patients to stratify risk and screen family members

Nordiske forskningsperspektiver på arbejdsmiljø : Mening, indflydelse og samarbejde

Indflydelse, samarbejde og mening i arbejdet. De særlige træk ved det nordiske arbejdsmarked bygger på, at arbejdsgivere og fagbevægelse tidligt har anerkendt hinanden. Samarbejdet har været afsæt for de forskningsprojekter og forsøg med udvikling af arbejdsorganiseringen med en høj grad af indflydelse for medarbejderne. Den nordiske forskningstradition har opfattet medarbejderne som aktivt og kollektivt handlende og har fokuseret på sammenhængen mellem arbejdsopgaven og fællesskabet – i modsætning til de individuelle teoriers fokus på motivation og selvudvikling. Forfatterne ser et behov for at revitalisere den nordiske forskningstradition og bringe den i spil i forhold til ny teknologi og globalisering. Derigennem kan forskningen bidrage til et bæredygtigt arbejdsmarked, som er sundt, udviklende og produktivt, så nordiske virksomheder kan klare sig i den internationale konkurrence