[Preparing for a pandemic].

On 16 March 2020 the government of Bavaria declared a state of emergency due to the coronavirus disease 2019 (COVID-19) pandemic. This confronted all clinics with completely new and difficult challenges. In accordance with the official requirements, pandemic officers were appointed at the Kempten Clinic and a clinical management team was established.

Myocardial Minimal Damage After Rapid Ventricular Pacing - the prospective randomized multicentre MyDate-Trial.

Therapy of choice for the primary and secondary prevention of sudden cardiac death is the implantation of an implantable cardioverter defibrillator (ICD). Whereas appropriate and inappropriate ICD shocks lead to myocardial microdamage, this is not known for antitachycardia pacing (ATP). In total, 150 ICD recipients (66 ± 12 years, 81.

Editorial Commentary: On Mentors and "Peeling Onions": Scoliosis Results in Inferior Outcomes Following Hip Gluteus Medius Tendon Repair.

Scoliosis results in improved but inferior outcomes following gluteus medius repair. The hip is affected by lumbo-pelvic position and gravity, and the disorder is predominant in women and perhaps also related to pelvic morphology. Numerous opportunities for future study exist.

[Temporary Pacemakers - Step by Step].

Symptomatic bradycardia is usually caused by abnormalities of atrioventricular conduction or sinus node dysfunction. Reversible and irreversible causes must be considered.Temporary pacemakers are used in the emergency treatment in case of severe bradyarrhythmia.

Pacemaker Implantation Associated Myocardial Micro-Damage: A Randomised Comparison between Active and Passive Fixation Leads.

Fixation of the pacemaker leads during pacemaker implantation leads to an increase of cardiac Troponin T (cTnT) that can be interpreted as a sign of minimal myocardial damage. This trial evaluates whether the mechanism type of lead fixation influences the magnitude of cTnT release. Patients having a de-novo cardiac pacemaker implantation or a lead revision were centrally randomized to receive either a ventricular lead with an active (screw) or passive (tine) fixation mechanism.

Takotsubo Syndrome After Cardiopulmonary Resuscitation During Emergency Cesarean Delivery.

Background: Takotsubo syndrome is a rare, stress-related, and reversible form of acute heart failure primarily affecting postmenopausal women. It is characterized by left ventricular dysfunction with a classic apical and midventricular wall motion abnormality (apical ballooning).

Case: A 28-year-old woman, gravida 2 para 1, at 30 4/7 weeks of gestation was admitted with fetal bradycardia, a fully dilated cervix, and breech presentation.

Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO Study): results from a large multicenter prospective randomized trial.

Background: Cryoablation has emerged as an alternative to radiofrequency catheter ablation (RFCA) for the treatment of atrioventricular (AV) nodal reentrant tachycardia (AVNRT). The purpose of this prospective randomized study was to test whether cryoablation is as effective as RFCA during both short-term and long-term follow-up with a lower risk of permanent AV block.

Methods And Results: A total of 509 patients underwent slow pathway cryoablation (n=251) or RFCA (n=258).

Very late relapse of atrial fibrillation after pulmonary vein isolation: incidence and results of repeat ablation.

Background: There are few data about the incidence of very late (>12 months) arrhythmia relapse after pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF) and about the success rate of repeat ablation procedures in this population.

Methods: All patients treated with PVI for paroxysmal AF were screened in the institution's electrophysiology database. Follow-up data at 1, 3, 6, and 12 months and yearly thereafter including repetitive (7 days or 1 day) Holter electrocardiograms were assessed as well as the technique and success rate of repeat ablations.

The modified anterior line: an alternative linear lesion in perimitral flutter.

Introduction: Ablation of left atrial flutter (LAF) is often limited by the need for technically demanding linear lesions. We evaluated the safety and efficacy of a new modified anterior line (MAL), connecting the anterior/anterolateral mitral annulus with the left superior pulmonary vein for ablation of perimitral flutter.

Methods And Results: MAL was performed in 65 patients (15 females, age 63.

Serial contrast-enhanced cardiac magnetic resonance imaging demonstrates regression of hyperenhancement within the coronary artery wall in patients after acute myocardial infarction.

Objectives: Our aim was to determine whether serial contrast-enhanced cardiac magnetic resonance (CE-CMR) is useful for the characterization of tissue signal changes within the coronary vessel wall in patients after acute myocardial infarction (AMI).

Background: Inflammation plays a key role in the development of AMI. CE-CMR of the vessel wall has been found useful for the characterization of inflammatory tissue signal changes in patients with carotid artery stenosis, giant cell arteritis, or Takayasu's arteritis; however, it has never been serially performed in the coronary artery wall in patients with acute and chronic myocardial infarction using a gadolinium-based contrast medium and compared with systemic markers of inflammation.

Electrogram-guided substrate ablation with or without pulmonary vein isolation in patients with persistent atrial fibrillation.

Aims: Ablation of complex fractionated atrial electrograms (CFAEs) is a new approach for the treatment of atrial fibrillation (AF). The purpose of the study was to assess the efficacy of CFAE ablation as a stand-alone strategy in patients with persistent AF and to compare it with a combined approach of CFAE ablation and pulmonary vein isolation (PVI).

Methods And Results: The study included 77 consecutive patients with persistent AF who underwent radiofrequency (RF) ablation of CFAE as a sole ablation procedure (CFAE group, n = 23 patients) or a combined approach of CFAE ablation and PVI (CFAE plus PVI group, n = 54 patients).

Radiofrequency ablation of complex fractionated atrial electrograms (CFAE): preferential sites of acute termination and regularization in paroxysmal and persistent atrial fibrillation.

Introduction: Complex fractionated atrial electrograms (CFAE) have been described as a new target for ablation of atrial fibrillation (AF). This prospective study evaluates the acute effects of CFAE ablation in patients with paroxysmal or persistent AF and analyzes the preferential anatomic sites where these effects occur.

Methods And Results: Ablation of CFAE was performed in 66 symptomatic patients (mean age of 58 +/- 12 years) with paroxysmal (n = 36) or persistent AF (n = 30).

The superior-medial shoulder arthroscopy portal is safe.

Purpose: The superior-medial (SM) shoulder arthroscopic portal (Neviaser portal) is the portal anatomically closest to the suprascapular nerve, and any potential benefits of this portal would be mitigated if risk of suprascapular nerve injury were significant. The purpose of this study is to determine the safety of the SM arthroscopic shoulder portal. We hypothesize that the SM shoulder arthroscopic portal is safe.

Effects of circumferential or segmental pulmonary vein ablation for paroxysmal atrial fibrillation on cardiac autonomic function.

Background: Circumferential and segmental pulmonary vein ablations are two established treatment strategies for ablation of atrial fibrillation. Both techniques require the application of radiofrequency current at anatomical sites that are close to autonomic ganglia. However, the effects of current pulmonary vein ablation techniques on cardiac autonomic function are unknown.

Long-term follow-up of patients supplied with single-chamber or dual-chamber cardioverter defibrillators.

Introduction: In patients who have an indication for an implantable cardioverter defibrillator (ICD) a dual-chamber device is indicated in the case of concomitant significant sinus node disease or atrioventricular block. It is a matter of debate whether dual-chamber ICD may be beneficial for patients with preserved sinus and atrioventricular nodal function as data from prospective randomized trials are limited. Mid- or long-term follow-up data are unavailable.

Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: incidence, electrophysiological characteristics, and results of radiofrequency ablation.

Aims: To investigate the incidence, electrophysiological properties, and ablation results for left atrial (LA) tachycardia as a sequel to the circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF).

Methods And Results: Sixty-seven patients with AF underwent CPVA. Sustained LA tachycardia developed in 21/67 (31%) patients and in 16/21 symptomatic patients 55 LA tachycardias (3.

Phrenic nerve injury after catheter ablation: should we worry about this complication?

Introduction: Phrenic nerve injury (PNI) is a complication that can occur with catheter ablation.

Methods: Data from 17 patients with PNI following different catheter ablation techniques were reviewed. PNI was defined as decreased motility (transient) or paralysis (persistent) of the hemi-diaphragm on fluoroscopy or chest X-ray.

Freedom from atrial tachyarrhythmias after catheter ablation of atrial fibrillation: a randomized comparison between 2 current ablation strategies.

Background: Data on the comparative value of the circumferential pulmonary vein and the segmental pulmonary vein ablation for interventional treatment of atrial fibrillation are limited. We hypothesized that the circumferential pulmonary vein ablation approach was superior to the segmental pulmonary vein ablation approach.

Methods And Results: One hundred patients with highly symptomatic atrial fibrillation were randomly assigned to undergo either circumferential (n=50) or segmental pulmonary vein ablation (n=50).

Catheter ablation of left atrial focal tachycardia guided by electroanatomic mapping and new insights into interatrial electrical conduction.

Background: Experience in catheter ablation of left atrial (LA) focal tachycardia and information about interatrial electrical connections during LA focal tachycardia are limited.

Objectives: The purpose of this study was to describe our experience in electroanatomic mapping-guided catheter ablation of LA focal tachycardia and to investigate interatrial electrical connections during LA focal tachycardias.

Methods: Thirty-three patients undergoing catheter ablation for LA focal tachycardia guided by electroanatomic mapping were reported.

Acute and long-term results of slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia--an analysis of the predictive factors for arrhythmia recurrence.

Background: Predictors of atrioventricular nodal reentrant tachycardia (AVNRT) recurrence after radiofrequency ablation including the importance of residual slow pathway conduction are not known. The aim of this study was to report the acute and long-term results of slow pathway ablation in a large series of consecutive patients with AVNRT and to analyze the potential predictors of arrhythmia recurrence with a particular emphasis on the residual slow pathway conduction after ablation.

Methods: The study included 506 consecutive patients with AVNRT (mean age 52.

Transvenous cryoablation versus radiofrequency ablation of the slow pathway for the treatment of atrioventricular nodal re-entrant tachycardia: a prospective randomized pilot study.

Aims: This is a prospective, randomized study comparing transvenous cryoablation with radiofrequency (RF) ablation of atrioventricular nodal re-entrant tachycardia (AVNRT).

Methods And Results: In this pilot trial, 200 patients with AVNRT were randomized to undergo cryoablation or RF ablation of the slow pathway. A 7 Fr 4-mm-tip cryocatheter (Cryocath) was used for cryomapping and cryoablation.

LocaLisa catheter navigation reduces fluoroscopy time and dosage in ablation of atrial flutter: a prospective randomized study.

Introduction: Catheter ablation has become a well-established therapy for isthmus-dependent right atrial flutter (AFL). Recently, mapping and ablation of AFL have been performed using sophisticated three-dimensional mapping systems, such as electroanatomic and noncontact mapping systems. The LocaLisa system enables nonfluoroscopic navigation of intracardiac electrode catheters based on impedance changes related to catheter movements in transthoracic current fields.

Pulmonary vein internal electrical activity does not contribute to the maintenance of atrial fibrillation.

Whether the electrical activity generated in the pulmonary veins (PVs) during atrial fibrillation (AF) contributes to the maintenance of arrhythmia is not known. The study population consisted of 22 patients (mean age 58 +/- 9.5 years, 16 men) with persistent (12 patients) or intermittent (10 patients) AF.

Do airport metal detectors interfere with implantable pacemakers or cardioverter-defibrillators?

Objectives: The aim of this study was to determine whether airport metal detector gates (AMDGs) interfere with pacemakers (PMs) or implantable cardioverter-defibrillators (ICDs).

Background: It is currently unknown whether AMDGs interfere with implanted PMs or ICDs.

Methods: A total of 348 consecutive patients (200 PM and 148 ICD recipients) have been tested for the occurrence of electromagnetic interference (EMI) within the electromagnetic field of a worldwide-used airport metal detector.