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Purpose Lens opacification is a common complication after pars plana vitrectomy (PPV) and knowing its progression would facilitate consulting patients. The purpose of this study was to evaluate a quantitative model for lens-status-monitoring after PPV with C3F8 gas. Our model was evaluated in rhegmatogenous retinal detachment (RRD) patients of various age and lens densitometry (LD). Methods Data between March 2018 and March 2020 were evaluated retrospectively. LD measurements of the PentacamHR® Nucleus Staging mode (PNS) were used to quantify lens opacification over time. A mixed-effect regression model was designed, to enable LD predictions at any time postoperatively. Calculations were based on patient’s age and baseline LD as dependent variables. Six patients were randomly excluded during model development, to be used for testing its power afterwards. Results 34 patients (male 19 [55.9%], female 15 [44.1%]) matched the inclusion criteria. Average age was 58.5 years (32–77;±4.3) and average follow-up was 7.2 months (3,4–23.1;±1,8). Mean baseline LD of the treated and fellow eye before surgery were 10.9% (8.7%-14.8%;±0.8) and 10.7% (8.5%-14.1%;±0.6), respectively. Using our prediction model, LD values for the six pre-selected patients closely match the observed data with an average deviation of 1.07%. Conclusions Evaluation of age and baseline LD using a mixed-effect regression model might predict cataract progression in RRD patients treated with PPV and C3F8-gas. Such a tool could be considered during cataract surgery consultation in these patients.

Aims Left ventricular (LV) endocardial pacing may address the limitations in the selection of an LV pacing site and provide improvements in cardiac resynchronization therapy (CRT) effectiveness. We report on the feasibility, the safety, and the short-term outcome of a leadless ultrasound-based technology for LV endocardial resynchronization in heart failure (HF) patients enroled into the Wireless Stimulation Endocardially for CRT (WiSE-CRT) study. Methods and results Seventeen HF patients were enroled and categorized as: (i) patients in whom attempted coronary sinus lead implantation for CRT had failed ( n = 7); (ii) patients with a previously implanted CRT device, not responding to CRT ( n = 2); and (iii) patients with previously implanted pacemakers or implantable cardioverter-defibrillator and meeting the standard indications for CRT ( n = 8). System implantation was achieved in 13 patients (76.5%); mean R-wave amplitude was 5.6 ± 3.2 mV and the mean pacing threshold was 1.6 ± 1.0 V, respectively. In one patient, no sufficient pacing thresholds were found; in three patients pericardial effusion occurred. Biventricular pacing was recorded in 83% and 92% of the patients at 1 month and 6 months, respectively. QRS duration was shorter during biventricular pacing compared with right ventricular pacing at 1 month (−41 ms; P = 0.0002) and 6 months (−42 ms; P = 0.0011), respectively. At the 6-month follow-up, two-thirds of the patients had at least one functional class change. Left ventricular ejection fraction significantly increased ( P < 0.01) by 6 points at the 6-month follow-up. Conclusion The feasibility of providing an endocardial stimulation for CRT with a leadless technology was successfully demonstrated. Despite the promising results for a novel technology, further study is required to definitively conclude the safety and the performance of the system. Clinical Trial Registration Information NCT01294527.

Catheter ablation is used extensively with curative intention in atrial fibrillation. Radiofrequency ablation has long been a standard of care, while cryoballoon technology has emerged as a feasible approach with promising results. Prospective multicenter registry data referring to both ablation technologies in AF ablation therapy are lacking.Between January 2007 and August 2011, a total of 3,775 consecutive patients with symptomatic paroxysmal AF who underwent PV ablation in their respective centers were enrolled. The cohort was divided into 2 groups according to the ablation energy source used: cryoballoon ablation (group 1, n = 905 [24.0%], median age 63 years, 64.3% men) and RF ablation (group 2, n = 2870 [76.0%], median age 63 years, 62.7% men). Comorbidities and baseline clinical characteristics were similar in both groups.Acute success rate was similar in both groups (97.5% in cryo vs 97.6% in RF; P = 0.81). Procedure times were similar, ablation and fluoroscopy times were higher in cryoballoon when compared to RF ablation. Overall complication rate was similar in cryo- (4.6%) and RF-ablation (4.6%; P = 1.0). Phrenic nerve palsy was more often in cryo versus RF ablation (2.1% in cryo vs 0.0% in RF; P0.001). Other complications were more common in RF compared to cryoablation (4.6% in RF vs 2.7% in cryo; P0.05).RF ablation is the most widespread ablation method in Germany, but use of cryoballoon increased significantly. Procedure times were similar, but ablation and fluoroscopy times were longer in cryoballoon ablation. No significant differences were found in terms of acute success and overall complication rate.

The surgical treatment of atrial fibrillation (AF) by Cox and other ablation methods shows a 50-90% conversion rate to sinus rhythm. However, to date no study has addressed the influence of ablation on the mortality rate.The perioperative and postoperative mortalities of 210 consecutive patients with permanent AF was investigated for up to two years after cardiac surgery with (n = 111) or without (n = 99) endocardial microwave ablation within the framework of a prospective register study. All patients were followed up.In the ablation group, one patient (0.9%) died perioperatively, seven died during the first year of follow up (6.3%), and nine in the second year of follow up (8.1%). In the control group, five patients died perioperatively (5.1%), 12 died in the first year of follow up (12.1%), and 22 in the second year of follow up (22.2%). During the two-year follow up period, significantly more patients died in the control group than in the ablation group (Log-Rank test: p = 0.0051).The results of this register study showed that among patients with permanent AF who underwent cardiac surgery with ablation, mortality was significantly lower than in those who underwent comparable surgery but without ablation. The marked difference in mortality was essentially based on the typical clinical consequences of AF (e.g. thromboembolic complications, cardiac arrhythmias and bleeding complications due to anticoagulation therapy), which occurred less often in the ablation group.