The aim of the study was the evaluation of myorelaxant action of bee venom (BV) ointment compared to placebo. Parallel group, randomized double blinded trial was performed. Experimental group patients were applying BV for 14 days, locally over masseter muscles, during 3-minute massage. Placebo group patients used vaseline for massage. Muscle tension was measured twice (TON1 and TON2) in rest muscle tonus (RMT) and maximal muscle contraction (MMC) on both sides, right and left, with Easy Train Myo EMG (Schwa-medico, Version 3.1). Reduction of muscle tonus was statistically relevant in BV group and irrelevant in placebo group. VAS scale reduction was statistically relevant in both groups: BV and placebo. Physiotherapy is an effective method for myofascial pain treatment, but 0,0005% BV ointment gets better relief in muscle tension reduction and analgesic effect. This trial is registered with Clinicaltrials.govNCT02101632.

The aim of the study was to compare in-hospital and long-term prognosis in patients with acute coronary syndromes (ACS) and de novo vs. pre-existing atrial fibrillation (AF). Atrial fibrillation increases the risk of serious adverse events including death in patients with ACS. However, it is unclear whether de novo and pre-existing AF portend a different risk. We analysed the incidence, clinical characteristics, and in-hospital and long-term outcomes in patients with AF and ACS based on combined data from Polish Registry of Acute Coronary Syndrome (PL-ACS) (n = 581 843) and SILICARD (n = 852 063) databases. Atrial fibrillation at admission was diagnosed in of 6.16% patients [de novo: 1129 (2.46%); pre-existing: 1691 (3.7%)]. Groups were compared (N = 1023 vs. 1023) after matching for relevant clinical factors. De novo and pre-existing AF differed in in-hospital diuretic (52% vs. 58%; P = 0.008) and aldosterone inhibitor (27.5% vs. 32.5%; P = 0.02) use, Thrombolysis In Myocardial Infarction (TIMI) flow before percutaneous coronary intervention (P = 0.016), and diuretic (52.1% vs. 58%; P = 0.008) and oral anticoagulant (27.5% vs. 32.5%; P = 0.018) use at discharge. In-hospital mortality in the de novo AF group was significantly higher (13.1% vs. 8.31%; P = 0.0005). Post-discharge 12-month survival was similar between groups (14.5% vs. 15.3%, P = 0.63). Long-term re-hospitalization due to heart failure (22.7% vs. 17.2%; P < 0.005) and medical contact due to AF (48.4% vs. 26.1%, P < 0.0001) rates were higher in the group with pre-existing AF, without the difference of stroke or myocardial infarction occurrence. De novo AF accounts for 40% of all AF cases in ACS patients and is an unfavourable in-hospital prognostic factor. The occurrence of de novo AF during ACS should require special attention and caution in the treatment of these patients.

Background: The population of patients with implanted cardioverter–defibrillators (ICDs) and cardiac resynchronization therapy devices (CRT–Ds) is constantly growing. The use of remote-monitoring (RM) techniques in this group can significantly improve clinical outcomes, but there are limited data about the impact of RM on healthcare costs from a payer’s perspective. Aim: The aim of the study was to assess the impact on costs for the healthcare system of RM in patients with ICDs or CRT-Ds. Methods: We examined a cohort of 842 patients with ICDs or CRT–Ds. The group was divided into two groups based on RM (or no RM, NRM), matched according to important clinical characteristics. The subjects were followed for a maximum of 3 years after implantation (mean follow-up 2.11 ± 0.83 years). The overall costs for the healthcare provider in the follow-up were defined as the primary endpoint. The secondary endpoint was the use of different types of medical contact events: hospitalization and number of in-clinic and general practitioner visits (without the number of remote transmissions). Results: In the 3-year follow-up, the reduction in the costs of treatment for National Health Care in the RM group was 33.5% (median value, p < 0.001). In patients with implanted CRT-Ds, the reduction reached 42,7% (p = 0.011) and with ICDs was 31,3% (p = 0.007). We observed no significant reduction in the median hospitalization costs in the 3-year follow-up in the RM group (p = NS), despite 25% drop in the mean value. Costs of outpatient visits were slightly higher in the RM group (p=NS). In the follow-up period, there was no reduction in the number of medical contacts events (p=NS). Conclusions: Remote monitoring in patients with implanted ICD or CRT-D devices reduces the cost for national healthcare provider. Background: The population of patients with implanted cardioverter–defibrillators (ICDs) and cardiac resynchronization therapy devices (CRT–Ds) is constantly growing. The use of remote-monitoring (RM) techniques in this group can significantly improve clinical outcomes, but there are limited data about the impact of RM on healthcare costs from a payer’s perspective. Aim: The aim of the study was to assess the impact on costs for the healthcare system of RM in patients with ICDs or CRT-Ds. Methods: We examined a cohort of 842 patients with ICDs or CRT–Ds. The group was divided into two groups based on RM (or no RM, NRM), matched according to important clinical characteristics. The subjects were followed for a maximum of 3 years after implantation (mean follow-up 2.11 ± 0.83 years). The overall costs for the healthcare provider in the follow-up were defined as the primary endpoint. The secondary endpoint was the use of different types of medical contact events: hospitalization and number of in-clinic and general practitioner visits (without the number of remote transmissions). Results: In the 3-year follow-up, the reduction in the costs of treatment for National Health Care in the RM group was 33.5% (median value, p < 0.001). In patients with implanted CRT-Ds, the reduction reached 42,7% (p = 0.011) and with ICDs was 31,3% (p = 0.007). We observed no significant reduction in the median hospitalization costs in the 3-year follow-up in the RM group (p = NS), despite 25% drop in the mean value. Costs of outpatient visits were slightly higher in the RM group (p=NS). In the follow-up period, there was no reduction in the number of medical contacts events (p=NS). Conclusions: Remote monitoring in patients with implanted ICD or CRT-D devices reduces the cost for national healthcare provider.

Epicardial pulsed field ablation (PFA) of ganglionated plexi (GPs) is being explored as a potential treatment for atrial fibrillation. Initial work using open-chest access with a monopolar ablation device has been completed. This study describes the early development work for a device that can be used with subxiphoid access and deliver bipolar ablation pulses. Electric field computational models have been used for the initial guidance on pulse parameters. An in vivo assessment of these ablation parameters has been performed in an open-chest canine study, while subxiphoid access and navigation of the device has been demonstrated in a porcine model. Results from this acute study have demonstrated the promising potential of this approach.

This multicenter European survey systematically evaluated the impact of using contact force-sensing catheters (CFSCs) on fluoroscopy and procedure time in interventional electrophysiology. Data from 25 participating centers were collected and analyzed, also considering important confounders. With the use of CFSCs, fluoroscopy time was reduced for right- and left-sided atrial ablations (median −6.4 to −9.6 min, p < 0.001 for both groups), whereas no such effect could be found for ventricular ablations. Moreover, the use of CFSCs was associated with an increase in procedure time for right-sided atrial and ventricular ablations (median +26.0 and +44.0 min, respectively, p < 0.001 for both groups), but not for left-sided atrial ablations. These findings were confirmed independent of career level and operator volume, except for very highly experienced electrophysiologists, in whom the effect was blunted. In the subset of pulmonary vein isolations (PVIs), CFSCs were shown to reduce both fluoroscopy and procedure time. In conclusion, the use of CFSCs was associated with a reduced fluoroscopy time for atrial ablations and an increased procedure time for right atrial and ventricular ablations. These effects were virtually independent of the operator experience and caseload. When considering only PVIs as an important subset, CFSCs were shown to reduce both fluoroscopy and procedure time.