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This article discusses the online edition of the “Deutsche Allgemeine Zeitung” (DAZ, German General Newspaper), an exceptional media product in Kazakhstan. This medium was chosen mainly for its very complex linguistic and cultural configuration. The linguistic forms are German, while the discourse and text traditions suggest a Russian influence due to the long hegemony of Russian as the language of culture and education in Kazakhstan. Additionally, the current sociocultural frame of reference is of genuine Kazakh origin. The central aim of this evidence-based media linguistic analysis was to describe the unique features in the language of this online medium, i.e. the multilingual aspects of language variation and aspects related to language and cultural contact. The methodology is based on a linguistic concept of saliency and used interrater reliability in the linguistic assessment. The study showed that the online version and the print version differ not only on a technical level, but also in their journalistic and linguistic design. The digital version is marked by livelier, more idiomatic, and more colorful texts than the print version. These differences can likely not just be attributed to the greater range of options provided by the new medium, but possibly also to the larger share of contributions by authors from Germany in the online version compared to the print version. In the written practices examined in this article it could be shown that authors from Kazakhstan generally used ‘multiliteracy’ form that also generated emergent forms.

Die vorliegende evidenzbasierte Studie stellt auf Basis eines Forschungs- und Dokumentationsprojekts aktuelle ungarndeutsche Kontaktvarietäten fränkischer Provenienz aus Südungarn vor und erschließt charakteristische Prozesse, Muster und Resultate intensiven deutsch-ungarischen Kontakt- bzw. Interaktionsgeschehens. Es werden u. a. spezifische Zwischenformen und Verbindungen aus den verfügbaren Kodes der Sprecher aufgedeckt: Mittels der Beschreibung zahlreicher overter und coverter Transferenzprozesse, Kode-Umschaltungen, bilingualer Dopplungen etc. konnte das Profil einer gleichsam „postfränkischen“ Dialektausprägung, also einer spezifischen sprachlich-kommunikativen „Grenzgänger-Varietät“, herausgearbeitet werden. Es wurde klar, dass bei den ermittelten Kontaktphänomenen prototypisch drei Klassen eine Rolle spielen: (a) interlinguale Transfers/Übernahmen, (b) zwischensprachliche Kopien und (c) Sprachalternierungen. Die ersten beiden Manifestationsarten fasst der Aufsatz unter Hybridität zusammen, während Typ (c) als Synkretismus betrachtet wird. Dabei wurde auch deutlich, dass sich in der kommunikativen Welt von Ungarndeutschen zunehmend Erosionserscheinungen zeigen: Die Wortfluency lässt nach und eine langsame Restrukturierung des Systems setzt ein, die augenscheinlich in den semantischen und morphologischen Domänen anfängt. Dies führt sukzessiv zu einer Abnahme der Funktionsvitalität ungarndeutscher Dialektvarietäten.

This article is based on the understanding that figurative linguistic signs are in general a common research topic in the media language but represent a desideratum especially with regard to the German-speaking press abroad. Against this background, some of the figurative and formulaic related observations as well as the results of a current research project are thematised and discussed. The primary goal is a focused evidence-based analysis – more precisely: a theory-based qualitative exploration – of special features of figurative language use in three German-language minority newspapers from Russia, Kazakhstan and Hungary. In addition, manifestations of culturality are developed in the analysed media discourse, which is characterised by multilingualism and interculturality or rather transculturality. The approach is not normative and error-analytical, but descriptive and primarily contact- or intercultural-oriented. Among other things, it was found that the empirical database provided only relatively few figurative phrases. The findings include that other textual mechanisms prevail and due to the multilingual settings the text producers adopt fixed syntactic schemes from the contact languages. On the producer side, a German-based figurative language is generally used, but it is congruent with the figurativity of the respective contact language (in the present case: Russian, Kazakh and Hungarian), including Russian/Kazakh/Hungarian-oriented framings. In this context, the dominant feature is constituted of (virulent or latent) language contact-related phenomena with some dynamics: primarily transference formations of different kinds. At the same time, it cannot be ignored that the language and text (types) competence and especially the figurative competence of the text producers in the area of conceptual-writing skills vary widely and are often not comparable to those of federal German journalists.

Die Studie arbeitete zentrale sprachliche Profilmerkmale der Deutschen Allgemeinen Zeitung (DAZ) in Kasachstan heraus und lieferte dabei auch einen Beitrag zur Erschließung von Manifestationen der Kulturalität im analysierten interkulturellen Mediendiskurs. Der verwendete Ansatz war – im Denkrahmen der interkulturellen Linguistik – deskriptiv und vorrangig variations- bzw. kontaktorientiert. Die Besonderheit der Zeitung besteht vor allem darin, dass ihre Sprache praktisch monolingual deutsch ist, während ihr kulturelles Umfeld eine kasachisch-russische Prägung aufweist. Die daraus resultierende konkrete Sprachverwendung in der DAZ wurde unter Nutzung des Salienz-Konzeptes betrachtet. Im ausgewerteten Korpus des Jahrgangs 2017 wurden sprachbezogene Salienzen auf nahezu allen Ebenen herausgearbeitet, allen voran in Lexik und Phraseologie, Grammatik, Stil, Grafie sowie Typografie. Die eruierten Verwendungsbesonderheiten resultieren aus drei Prozessen typologisch unterschiedlicher Art: (1) aus prototypischen Sprachkontaktmechanismen, also aus Transfers oder Nachahmungen von Elementen, Strukturen und Modellen der Kontaktsprachen Russisch und Kasachisch; (2) aus Verfremdungsprozessen, z. B. Kontrastverschiebungen oder -übertreibungen, die sich aus einer unsicheren Beherrschung der Zielsprache Deutsch, etwa durch Übergeneralisierung des Sprachsystems, ergeben; (3) aus Normverletzungen aufgrund von Unachtsamkeit, d. h. Flüchtigkeitsfehler bzw. problematische oder grenzwertige Formulierungen, die selbst bei Textproduzenten mit exzellenter (nativer) Sprachbeherrschung vorkommen. Es ist nachgewiesen worden, dass quantitativ die mehrsprachigkeits-, kontakt- und/oder kompetenzbedingten Auffälligkeiten überwiegen, wobei sich der sprachliche Kontakteinfluss des Russischen als größer erwies als der des Kasachischen. Auf dieser Basis konnte der Beitrag die DAZ als eine mehrfach kulturasymmetrische Grenzgänger-Zeitung mit einer spezifischen Form von Mehrschriftlichkeit erfassen und beschreiben.

Die Germanistik als wissenschaftliches Fach sieht gegenwärtig im Hinblick auf Profil, Inhalte und Methoden natürlich nicht mehr so aus, wie sie im disziplinenbildenden 19. Jhd. konzipiert und etabliert wurde. Sie hat eine wechselvolle Fachgeschichte durchlaufen und steht derzeit vor großen Herausforderungen. In diesem Kontext hat der Beitrag vor, eine neue oder zumindest differenziertere Standortbestimmung der Germanistik und ihrer Erscheinungsformen zu erarbeiten. So stellt er einige Überlegungen zu aktuellen Grundsatzfragen bezüglich der Fachtypologie, der Konzeptualisierung, der Verortung und der Perspektiven der Germanistik (in ihren mannigfaltigen Ausprägungen) an und diskutiert diese in ihrem mehrsprachigen und multikulturellen Referenzrahmen. Vor diesem Hintergrund werden Elemente der Konturen und Leistungen einer speziell ostmitteleuropäischen Germanistik herausgearbeitet.

Introduction: Reel syndrome resulting in lead dislodgement is a rare, but well-known complication of cardiac device implantation. Therefore, it has to be considered in case of device dysfunction. Case description: We present the case of a 64-year-old male patient who visited our ward following an ICD shock. He had heart failure with reduced ejection fraction, and had a CRT-D device implanted 2 years before. The 12-lead ECG showed a septal pacemaker rhythm. Device interrogation verified adequate ICD therapy, with left ventricular sensing and capture failure. Chest X-ray showed optimal right atrial and defibrillator lead position. The left ventricular lead was not present near the heart. Our patient reported that he regularly manipulated the area around the device. During the pacemaker system revision, the diagnosis of isolated coronary sinus lead Reel syndrome was verified. We removed the old lead and implanted a new one in a good position in a lateral vein. Discussion: Thorough patient education and regular check-ups for patients living with permanent pacemakers and implantable cardioverter defibrillators are essential. Migration of the device can occur in some rare cases, leading to lead dislodgement. We can reduce the risk of these complications by appropriately anchoring leads and generators.

We present the case of a 52-year-old female patient on optimal medical therapy (OMT) for heart failure with severely reduced ejection fraction. She was diagnosed with dextrocardia and congenital corrected transposition of the great arteries (ccTGA) by echocardiography. Despite 3 months of OMT and a persisting NYHA II functional state, she was referred for primary prevention ICD implantation. At admission echocardiography revealed a hypertrophic systemic ventricle with an ejection fraction of 27%. Cardiac CT confirmed ccTGA, dextrocardia, a normal extracardiac and epicardial venous system. Coronary artery disease was excluded. Our team opted for left-sided VDD-ICD implantation in case of a need for AV-synchronous pacing and to enhance arrhythmia discrimination. An active fixation shock lead was placed in the mid-septal region of the functional right ventricle. The defibrillation threshold test (DFT) was successful at 20 J. No periprocedural complications were observed. At the 12-month ambulatory visit, device interrogation showed good function, no detected arrhythmias, and no antitachycardia therapy was delivered. Preoperative imaging is essential prior to any invasive cardiac procedure in patients with congenital heart disease. Performing a DFT test at adult congenital heart disease patients may be reasonable.

Abstract Background Cryoballoon ablation is a commonly used approach to treat patients with atrial fibrillation (AF). Objectives Report on the safety and efficacy of cryoballoon ablation for the treatment of AF in the largest global cohort of cryoablated patients prospectively studied within a single registry. Methods The Cryo AF Global Registry is a prospective, multi‐center registry. Patients with paroxysmal AF (PAF) or persistent AF (PsAF) were treated with the cryoballoon catheter according to routine practices at 93 sites across 36 countries. Primary efficacy endpoints included freedom from AF and freedom from AF/atrial flutter (AFL)/atrial tachycardia (AT) ≥30 seconds. The primary safety endpoint was serious device‐ or procedure‐related adverse events over 12 month follow‐up. Results During this evaluation window, 2922 subjects completed an index cryoballoon procedure, and 1440 completed 12 month follow‐up. The cohort was 61 ± 12 years of age, 36.3% female, and 78.7% PAF. Serious device‐ and procedure‐related adverse event rates were 1.5% and 3.4%, respectively. Freedom from AF/AFL/AT after the 90 day blanking period was 86.4% (95% CI: 84.3%‐88.3%) in patients with PAF and 70.9% (95% CI: 64.6%‐76.4%) in patients with PsAF. Freedom from AF/AFL/AT in first‐line PAF and PsAF was 90.0% (95% CI: 86.4%‐92.7%) and 72.9% (95% CI: 58.6%‐83.0%) at 12 months, respectively. Conclusions The Cryo Global AF Registry is the largest evaluation to demonstrate cryoablation is an efficient, safe, and effective treatment for patients with AF worldwide. Cryoablation was commonly used to treat patients prior to an AAD failure and may facilitate earlier therapy for patients on the AF disease continuum.

Background Heart failure (HF) and atrial fibrillation (AF) often coexist; yet, outcomes of ablation in patients with AF and concomitant HF are limited. This analysis assessed outcomes of cryoablation in patients with AF and HF. Methods and Results The Cryo AF Global Registry is a prospective, multicenter registry of patients with AF who were treated with cryoballoon ablation according to routine practice at 56 sites in 26 countries. Patients with baseline New York Heart Association class I to III (HF cohort) were compared with patients without HF. Freedom from atrial arrhythmia recurrence ≥30 seconds, safety, and health care utilization over 12‐month follow‐up were analyzed. A total of 1303 patients (318 HF) were included. Patients with HF commonly had preserved left ventricular ejection fraction (81.6%), were more often women (45.6% versus 33.6%) with persistent AF (25.8% versus 14.3%), and had a larger left atrial diameter (4.4±0.9 versus 4.0±0.7 cm). Serious procedure‐related complications occurred in 4.1% of patients with HF and 2.6% of patients without HF (P=0.188). Freedom from atrial arrhythmia recurrence was not different between cohorts with either paroxysmal AF (84.2% [95% CI, 78.6–88.4] versus 86.8% [95% CI, 84.2–89.0]) or persistent AF (69.6% [95% CI, 58.1–78.5] versus 71.8% [95% CI, 63.2–78.7]) (P=0.319). After ablation, a reduction in AF‐related symptoms and antiarrhythmic drug use was observed in both cohorts (HF and no‐HF), and freedom from repeat ablation was not different between cohorts. Persistent AF and HF predicted a post‐ablation cardiovascular rehospitalization (P=0.032 and P=0.001, respectively). Conclusions Cryoablation to treat patients with AF is similarly effective at 12 months in patients with and without HF. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02752737.

This randomized study aims to compare the left atrial (LA) lesion size, function, and tissue damage following pulmonary vein isolation (PVI) by high-power short-duration (HPSD) radiofrequency (RF) and second-generation cryoballoon (CB2) ablation. We enrolled 40 patients with paroxysmal atrial fibrillation who underwent PVI by HPSD RF (n = 21) or CB2 (n = 19). Every patient underwent LA CT angiography and transthoracic echocardiography (TTE) to assess the LA anatomy and function. Biomarker levels (hs-cTnT, hs-CRP, LDH) were compared pre- and post-procedurally. Pre- and post-ablation high-density mapping (HDM) was performed. The isolation area was defined under 0.2 mV bipolar voltage (low voltage area, LVA). We calculated the post-PVI LVA/LA surface ratio using LA CT-HDM merge images. At 3-month follow-up, TTE was performed to assess the changes in LA function. Post-ablation hs-cTnT level was significantly higher in the RF group (RF: 1249 ± 469 ng/L, CB2: 995 ± 280 ng/L, p = 0.024). Post-PVI hs-CRP (RF: 9.53 ± 10.30 mg/L, CB2: 12.36 ± 5.76 mg/L, p = 0.034) and LDH levels (RF: 349.9 ± 65.6 U/L, CB2: 451.6 ± 91.3 U/L, p < 0.001) were significantly higher following CB2 ablation. Post-PVI LVA/LA surface ratios were 8.37 ± 6.42% in the RF group and 13.58 ± 8.92% in the CB2 group (p = 0.022). LA function did not change significantly after the PVI procedure. Our data indicate that second-generation cryoballoon ablation produces a significantly larger LA lesion size compared to “point-by-point” HPSD radiofrequency. Both techniques preserve LA function. The myocardial component of tissue loss appears to be higher using HPSD radiofrequency ablation, with less collateral damage.

BackgroundPopulation‐based studies suggest that genetic factors contribute to sudden cardiac death (SCD). Methods and ResultsIn the first part of the present study (Diagnostic Data Influence on Disease Management and Relation of Genetic Polymorphisms to Ventricular Tachy‐arrhythmia in ICD Patients [DISCOVERY] trial) Cox regression was done to determine if 7 single‐nucleotide polymorphisms (SNPs) in 3 genes coding G‐protein subunits (GNB3, GNAQ, GNAS) were associated with ventricular tachyarrhythmia (VT) in 1145 patients receiving an implantable cardioverter‐defibrillator (ICD). In the second part of the study, SNPs significantly associated with VT were further investigated in 1335 subjects from the Oregon SUDS, a community‐based study analyzing causes of SCD. In the DISCOVERY trial, genotypes of 2 SNPs in the GNAS gene were nominally significant in the prospective screening and significantly associated with VT when viewed as recessive traits in post hoc analyses (TT vs CC/CT in c.393C>T: HR 1.42 [CI 1.11‐1.80], P=0.005; TT vs CC/CT in c.2273C>T: HR 1.57 [CI 1.18‐2.09], P=0.002). TT genotype in either SNP was associated with a HR of 1.58 (CI 1.26‐1.99) (P=0.0001). In the Oregon SUDS cohort significant evidence for association with SCD was observed for GNAS c.393C>T under the additive (P=0.039, OR=1.21 [CI 1.05‐1.45]) and recessive (P=0.01, OR=1.52 [CI 1.10‐2.13]) genetic models. ConclusionsGNAS harbors 2 SNPs that were associated with an increased risk for VT in ICD patients, of which 1 was successfully replicated in a community‐based population of SCD cases. To the best of our knowledge, this is the first example of a gene variant identified by ICD VT monitoring as a surrogate parameter for SCD and also confirmed in the general population. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00478933.

Background: One of the crucial points during in most approaches developed for ablation of atrial fibrillation (AF) is the ability to identify the pulmonary vein (PVs) and to accurately locate their ostia. Objectives: The purpose of this case series was to investigate a simplified method for fusion of the multislice computer tomography (CT) derived 3D dataset with the electroanatomical map in order to facilitate the mapping procedure. Methods: In 5 consecutive patients (4 male) referred for catheter ablation of symptomatic drug-refractory paroxysmal atrial fibrillation contrast enhanced computer tomography was performed before the procedure and imported into an electroanatomical mapping system (Carto XP) using CartoMerge Image Integration Module. During the procedure a multipolar mapping catheter (Quick Star DS, Biosense Webster, Diamond Bar, CA, USA) was introduced to the coronary sinus (CS) to align the CSCT shell to the proper position. The CS potentials provided information to identify the ostium of the CS to achieve a more accurate fusion of the images. No mapping points were taken in the left atrium. The feasibility of the method was characterized by the distance of mapping points. Mapping, registration and outcome data were compared with a cohort of patients undergoing MRI image integration. Result: The mean distance between the mapping points taken in the CS by the Quick Star catheter and the CS CT surface was suitable (mean±SD, 1.4±0.3 mm). Full electrical isolation of the pulmonary veins could be achieved in all patients. The mean procedure and fluoroscopy time were 39 ± 22 and 134 ±38 min respectively, significantly decreased as compared to the MRI cohort. Conclusions: Highly accurate CT image and the electroanatomical map (EAM) fusion can be obtained by the Carto 3D electromanatomical mapping system using CS as the key anatomical structure for registration. Using this technique the mapping time of the left atrium can be reduced.