State of the art of leadless pacing.

Despite undisputable benefits, conventional pacemaker therapy is associated with specific complications related to the subcutaneous device and the transvenous leads. Recently, two miniaturized leadless pacemakers, Nanostim™ (St. Jude Medical) and Micra™ (Medtronic), which can be completely implanted inside the right ventricle using steerable delivery systems, entered clinical application.

Perioperative use of β-blockers in cardiac and noncardiac surgery.

Clinical Question: Are β-blockers associated with lower rates of mortality and morbidity after cardiac or noncardiac surgery?

Bottom Line: In cardiac surgery, β-blockers are associated with a lower incidence of supraventricular tachycardias (SVTs) and ventricular arrhythmias. In noncardiac surgery, β-blockers are associated with a possible increase in mortality and strokes, a lower incidence of acute myocardial infarctions (AMIs) and SVTs, and an increase in bradycardia and hypotension. If tolerated, long-term β-blocker treatment should be continued perioperatively, whereas the decision to start a β-blocker should be individualized, weighing risks and benefits.

Impaired antioxidant HDL function is associated with premature myocardial infarction.

Background: There is growing evidence that the predictive value of HDL cholesterol levels for cardiovascular risk stratification is limited in patients with coronary artery disease (CAD). HDL function seems to be a more sensitive surrogate of cardiovascular risk estimation than simple serum levels. Therefore, we aimed to assess whether impaired antioxidant HDL function is involved in the development of premature acute myocardial infarction (AMI).

Iatrogenic left anterior descending artery stenosis early after aortic valve replacement presenting with T-wave-pseudonormalization - a case report.

Background: Both iatrogenic coronary artery stenosis early after aortic valve replacement and pseudonormalization of inverted T-waves in acute ischemia are rare but well-recognized findings which coincide in this case.

Case Presentation: 10 weeks after aortic valve replacement, a 58-year-old male patient was readmitted with recent onset of unstable angina pectoris. Electrocardiography showed inverted T-waves in leads V2-4 with pseudonormalization during episodes of typical chest pain.

Frequency of renal artery stenosis after renal denervation in patients with resistant arterial hypertension.

Catheter-based ablation of nerves in the adventitia of renal arteries (renal artery denervation [RAD]) using radiofrequency energy can reduce blood pressure (BP) in patients with resistant arterial hypertension (RAH). Occurrence of renal artery stenosis after RAD is still an important concern. We systematically investigated the renal artery anatomy using magnetic resonance imaging (MRI) or computed tomography (CT) angiography in a consecutive series of patients 6 months after RAD.

Individual-patient visit-by-visit office and ambulatory blood pressure measurements over 24months in patients undergoing renal denervation for hypertension.

Background: Renal denervation (RDN) is a promising treatment option in addition to medical antihypertensive treatment in patients suffering from resistant hypertension. Despite the growing interest in RDN, only few long-term results are published so far.

Methods: We systematically investigated the effects of RDN on ABPM in a consecutive series of patients with resistant hypertension out to 24 months.

Removal of active-fixation coronary sinus leads using a mechanical rotation extraction device.

Background: Active fixation coronary sinus (CS) leads are widely used in cardiac resynchronization therapy (CRT). Due to their low dislodgement rates they are an attractive option for implanters. However, extraction of active fixation leads is a complex procedure that bears potential fatal risks for patients.

Correlation of plasma and salivary oxytocin in healthy young men - experimental evidence.

Objectives: The neuroactive hormone oxytocin (OT) has significant influence on human behavior, and it has been measured peripherally in venous blood and in saliva in many behavioral neuroscience studies. Assessment of salivary hormone levels is popular due to non-invasiveness, but there is a controversy as to whether OT can be reliably measured in saliva and how possible time lags between plasma and salivary OT levels influence correlation.

Design And Methods: In order to shed light on the question whether salivary and plasma OT levels correlate, we designed an experiment where healthy young men had to look at a presentation of trustworthy faces on a computer screen (faces were taken from an established database in trust research).

Laparoscopic resection of gastrointestinal neuroendocrine tumors with special contribution of radionuclide imaging.

The surgical treatment of neuroendocrine tumors (NETs) draws on experience and guidelines more than on prospective randomized trials. The incidence of NET is increasing in all parts of the gastrointestinal tract. A variety of classifications introduced over the last decade may have led to difficulties in judging clinical relevance and determining the right surgical strategy.

Renal denervation in the treatment of resistant arterial hypertension.

Patients with resistant arterial hypertension have an increased risk of stroke, myocardial infarction, heart failure, and chronic kidney disease. In many cases, limitations of pharmacological treatment like intolerance and adherence to the antihypertensive medications are present in the clinical setting. In this context, new treatment options like trans-femoral sympathetic renal nerve denervation is, even after publication of the Symplicity HTN-3 trial, a promising new treatment option.

Perioperative beta-blockers for preventing surgery-related mortality and morbidity.

Background: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue.

Objectives: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia.

Quantitative EEG markers relate to Alzheimer's disease severity in the Prospective Dementia Registry Austria (PRODEM).

Objective: To investigate which single quantitative electro-encephalographic (QEEG) marker or which combination of markers correlates best with Alzheimer's disease (AD) severity as measured by the Mini-Mental State Examination (MMSE).

Methods: We compared quantitative EEG markers for slowing (relative band powers), synchrony (coherence, canonical correlation, Granger causality) and complexity (auto-mutual information, Shannon/Tsallis entropy) in 118 AD patients from the multi-centric study PRODEM Austria. Signal spectra were determined using an indirect spectral estimator.

Late renal artery stenosis after percutaneous renal denervation.

: Renal denervation has been adopted as an additional treatment option to pharmacological antihypertensive therapy in patients with resistant hypertension. However, concerns have been raised with regard to the possible occurrence of renal artery stenosis.Our patient developed renal artery stenosis late after renal denervation, as magnetic resonance angiography 6 months after the procedure had showed no stenosis.

Endometriosis patients in the postmenopausal period: pre- and postmenopausal factors influencing postmenopausal health.

Objective: To evaluate patients' health status and the course of endometriosis from the premenopausal to the postmenopausal period and evaluate influencing factors that may be relevant.

Methods: Questionnaire completed by 35 postmenopausal women in whom endometriosis had been histologically confirmed premenopausally. Correlation and regression analyses were carried out to identify factors relevant to their postmenopausal health status.

Quantitative EEG in Alzheimer's disease: cognitive state, resting state and association with disease severity.

Background: Quantitative electroencephalogram (qEEG) recorded during cognitive tasks has been shown to differentiate between patients with Alzheimer's disease (AD) and healthy individuals. However, the association between various qEEG markers recorded during mnestic paradigms and clinical measures of AD has not been studied in detail.

Objective: To evaluate if 'cognitive' qEEG is a useful diagnostic option, particularly if memory paradigms are used as cognitive stimulators.

Warmed, humidified carbon dioxide insufflation versus standard carbon dioxide in laparoscopic cholecystectomy: a double-blinded randomized controlled trial.

Background: During laparoscopic cholecystectomy (LCHE), the insufflation with warmed and humidified carbon dioxide (CO2) may reduce postoperative pain. The aim of the study was to evaluate the positive effects of heated and humidified carbon dioxide gas on patients with regard to postoperative pain after LCHE.

Patients And Methods: This is a prospective, randomized, double-blinded, controlled clinical trial.

Effects of renal denervation on ambulatory blood pressure measurements in patients with resistant arterial hypertension.

Background: The sympathetic nervous system is an important factor in hypertension. In patients suffering from resistant hypertension, transfemoral renal sympathetic denervation (RDN) reduces office blood pressure (BP) values.

Hypothesis: Ambulatory BP measurement (ABPM) is a better predictor than office BP of cardiovascular morbidity and mortality.

Exercise-induced vasospastic angina after left atrial catheter ablation: a case report.

Introduction: Left atrial catheter ablation (LACA) is routinely used in the management of recurrent atrial fibrillation.

Case Presentation: We report a patient suffering from vasospastic angina 2 months after a LACA procedure. Typical clinical symptoms, ST-segment changes during exercise test and successful treatment with nicorandil led to the diagnosis.

Allen-Masters syndrome: do the classic risk factors also apply in patients with endometriosis?

Aim: To evaluate whether the classic risk factors for Allen-Masters syndrome, such as body mass index (BMI) and spontaneous births, are in fact responsible for the condition in patients with endometriosis.

Methods: A total of 26 women who underwent a laparoscopic procedure due to chronic pelvic pain, Allen-Masters syndrome and endometriosis from 2009-2011 were enrolled in this study from an endometriosis competence center specializing in minimally invasive surgery. This was a retrospective cohort study (Canadian Task Force classification II-2).

Transverse musculocutaneous gracilis flap for treatment of capsular contracture in tertiary breast reconstruction.

Capsular contracture is a common complication associated with implant-based breast reconstruction and augmentation leading to pain, displacement, and rupture. After capsulectomy and implant exchange, the problem often reappears. We performed 52 deepithelialized free transverse musculocutaneous gracilis (TMG) flaps in 33 patients for tertiary breast reconstruction or augmentation of small- and medium-sized breasts.

Enzian classification: does it correlate with clinical symptoms and the rASRM score?

Objective: To assess the extent to which the Enzian classification correlates with the revised American Society for Reproductive Medicine (rASRM) score and clinical symptoms in women with deeply infiltrating endometriosis.

Design: Retrospective cohort study (Canadian Task Force classification II-2).

Setting: Endometriosis competence center specializing in minimally invasive surgery.