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International Waterway E60 (IWW E60) is a sea-shore route running from Gibraltar to the North along European coast up to St. Petersburg then through the Baltic-White Sea Channel, then along the White Sea coast to Arkhangelsk. From the German-Polish border, along the Polish, Russian and Lithuanian coast to the Lithuanian-Latvian border, the route is 610 km-long and runs along 32 Polish municipalities and 4 Lithuanian regions. Determining the role of IWW E60 is important in the context of economic growth of municipalities and coastal regions, especially through the development of local seaports. Operations of the multifunctional port have a wide economic and social impact. Mutual interaction of functions can be observed on the example of fisheries, where in the port area fishing functions intermingle with the processing, tourism, storage and distribution function. The main socioeconomic benefits of E60 waterway development include the increase in employment, economic activity, generation of added value and improvement of transport infrastructure. In addition, ports influence attractiveness of the regions and create impulse for new jobs in the tourism industry. Until now there have been no attempts to make E60 route navigable or only on short sections, usually between two neighbouring ports. Despite the significant cross-border importance of this connection, no directions for its optimal development were defined. What is more, the route is not used. In connection with this, steps were taken to thoroughly investigate the problem and determine the possibility of its development as part of inland waterways network.

Introduction: Hybrid ablation (HABL) of atrial fibrillation combining endoscopic, minimally invasive, closed chest epicardial ablation with endocardial CARTO-guided accuracy was introduced to overcome the limitations of current therapeutic options for patients with persistent (PSAF) and longstanding persistent atrial fibrillation (LSPAF). The purpose of this study was to evaluate the procedural safety and feasibility as well as effectiveness of HABL in patients with PSAF and LSPAF 1 year after the procedure.Material and Methods: The study is a single-center, prospective clinical registry. From 07/2009 to 12.2014, 90 patients with PSAF (n = 39) and LSPAF (n = 51), at the mean age of 54.8 ±9.8, in mean EHRA class 2.6, underwent HABL. 64.4% of patients had a history of prior cardioversion or catheter ablation. Thirteen patients had LVEF less than 35%. Mean AF duration was 4.5 ±3.7 years. Patients were scheduled for 3-, 6- and 12-month follow-up with 7-day Holter monitoring.Results: At 6 months after the procedure 78% (54/69) of patients were in SR. At 12 months after the procedure 86% (59/69) were in SR and 62.3% (43/69) in SR and off class I/III antiarrhythmic drugs (AADs). Only 1% (1/69) of patients required a repeat ablation for atrial flutter. A significant decrease in LA dimension and an increase in LVEF were noted.Conclusions: A combination of epicardial and endocardial RF ablation should be considered as a treatment option for patients with persistent and long-standing persistent atrial fibrillation as it is safe and effective in restoring sinus rhythm. [ABSTRACT FROM AUTHOR]

Background and Aim: Transcatheter aortic valve implantation (TAVI) has proven to be a valuable alternative to conventional surgical aortic valve replacement in high-risk and surgically inoperable patients who suffer from severe symptomatic aortic stenosis. With the second generation of TAVI devices improvements in both handling and performance are highly demanded. This brief clinical communication reports the first Polish experience with the second generation of transfemoral TAVI device--Symetis Acurate Neo., Methods: From November 19th 2014 until February 18th 2015 nine (n = 9) patients with severe symptomatic aortic stenosis have been operated on using the Symetis Acurate Neo. Patients were subject to seven-day evaluation and 30-day phone follow-up., Results: The procedure was safely and successfully performed in all patients. A SMALL (S) valve (21-23 mm equivalent) was used in two patients, MEDIUM valve (M; 23-25 mm equivalent) in five patients, and a LARGE valve (L; 25-26 mm equivalent) in two patients. In three cases post-release balloon dilatation was required. There were no intraoperative complications and no major adverse events (as per VARC classification) during initial hospitalisation, including conduction or rhythm disturbances. In all cases, the mean gradient on the prosthetic valves was 7.8 mm Hg (10.2 mm Hg on the "S" valves). Rapid improvement in patients' functional class was noted. Perivalvular leak was evaluated as "mild" in three cases, "trace" in one, and "not existing" in five., Conclusions: This initial experience with the Symetis Acurate Neo demonstrates its good safety profile and excellent haemodynamics. Low radial stress of the valve results in minimal incidence of atrioventricular rhythm disturbances, and a sealing crown for nearly non-existent paravalvular leak.