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Background: Total knee arthroplasty (TKA) for poliomyelitis patients is controversial due to its higher complication rate compared with that of TKA for osteoarthritis. In this study we evaluated the results, at a minimum of 10 years, of a consecutive series of third-generation rotating hinge total knee arthroplasties (RHKs) in patients affected by poliomyelitis. Methods: We conducted a retrospective analysis of 14 patients (15 TKA) performed between January 2000 and October 2021 that underwent a third-generation rotating hinge arthroplasty (Nex Gen RHK Zimmer). The clinical results using the American Knee Society Score (AKSS) were evaluated at an average follow-up of 154 months (min 120–max 216 months). Result: Of the 15 cases, 2 were lost at follow-up and 1 was excluded by the final evaluation due to infection. Of the remaining 12 cases at the final follow-up, the average AKKS clinical score improved from 30.08 points preoperatively, to 78.83 points postoperatively, while the average AKKS function score improved from 29.17 points to 56.25 points. We report only one intraoperative complication consisting of a femoral fracture at the tip of the stem, and a case of patellar fracture occurred 3 months after the index procedure. The presence of radiolucent lines was sporadic, while radiosclerotic lines were commonly visible around the stem extension, predominantly at the tip. Conclusions: The third generation of rotating hinge knee replacement has proved to be effective in polio patients, improving clinical and functional scores, and no cases of mechanical failure occurred.

Background Population‐based data on heart failure (HF)‐related death in patients with atrial fibrillation (AF) are lacking. We assessed HF‐related death in people with AF in the United States over the past 21 years and examined differences by age, sex, race, ethnicity, urbanization, and census region. Methods and Results Data were extracted from the Centers for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research to determine trends in age‐adjusted mortality rates per 100 000 people, due to HF‐related death among subjects with AF aged ≥15 years. To calculate nationwide annual trends, we assessed the average annual percent change (AAPC) and annual percent change with relative 95% CIs using joinpoint regression. Between 1999 and 2020, 916 685 HF‐related deaths (396 205 men and 520 480 women) occurred among US adults having a concomitant AF. The overall age‐adjusted mortality rates increased (AAPC: +4.1% [95% CI, 3.8–4.4]; P65 years was observed. Conclusions A worrying increase in the HF‐related mortality rate among patients with AF has been observed in the United States over the past 2 decades.

Arrhythmogenic cardiomyopathy (ACM) is a rare cardiac disease, characterized by the progressive replacement of myocardial tissue with fibrous and fatty deposits. It can involve both the right and left ventricles. It is associated with the development of life-threatening arrhythmias and culminates in sudden cardiac death. Electrocardiography (ECG) has emerged as a pivotal tool, offering diagnostic insights and prognostic information. The specific ECG abnormalities observed in ACM not only contribute to early detection but also hold the key to the prediction of the likelihood of severe complications. The recognition of these nuanced ECG manifestations has become imperative for clinicians as it guides them in the formulation of tailored therapeutic strategies that address both the present symptoms and the potential future risks.

Background: At the same conditions of delivered power and contact force, open-irrigated radiofrequency ablation catheters are believed to create deeper lesions, while non-irrigated ones produce shallower lesions. This ex vivo study aims to directly compare the lesion dimensions and characteristics of an irrigated ablation catheter with a flexible tip and a non-irrigated solid-tip catheter. Methods: Radiofrequency lesions were induced on porcine myocardial slabs using both open-tip irrigated and non-irrigated standard 4 mm catheters at three power settings (20 W, 30 W, and 40 W), maintaining a fixed contact force of 10 gr. A lesion assessment was conducted including the lesion depth, depth at the maximum diameter, and lesion surface diameters, with the subsequent calculation of the lesion volume and area being undertaken. Results: Irrigated catheters produced lesions with significantly higher superficial widths at all power levels (3.8 vs. 4.4 mm at 20 W; 3.9 mm vs. 4.4 mm at 30 W; 3.8 mm vs. 4.5 mm at 40 W; p = 0.001, p = 0.019, p = 0.003, respectively). Non-irrigated catheters resulted in significantly higher superficial areas at all power levels (23 mm2 vs. 18 mm2 at 20 W; 25 mm2 vs. 19 mm2 at 30 W; 26 mm2 vs. 19 mm2 at 40 W; p = 0.001, p = 0.005, p = 0.001, respectively). Irrigated catheters showed significantly higher values of lesion maximum depth at 40 W (4.6 mm vs. 5.5 mm; p = 0.007), while non-irrigated catheters had a significantly higher calculated volume at 20 W (202 µL vs. 134 µL; p = 0.002). Conclusions: Radiofrequency ablation using an irrigated catheter with a flexible tip has the potential to generate smaller superficial lesion areas compared with those obtained using a non-irrigated catheter.

Background: This case report outlines the presentation of an emerging complication arising from left bundle branch area pacing (LBBAP). Case summary: A 43-year-old male with no history of cardiac problems experienced recurrent episodes of syncope with no prodromal symptoms. During monitoring in the emergency department, the patient underwent an episode of asystole, leading to LBBAP implantation. The procedure encountered technical challenges, resulting in an interventricular septal hematoma and subsequent ventricular arrhythmias. Despite initial concerns, conservative management led to resolution, demonstrated through echocardiographic follow-ups. Discussion: This report underscores the significance of ventricular arrhythmias as indicators of interventricular septal hematoma, providing insights into its diagnosis, management, and implications for LBBAP procedures.