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Abstract Introduction There are several prognostic scores for the assessment of risk of atrial fibrillation (AF) recurrence post ablation procedure. However, the use of these complex scores is difficult and the validation on different populations brought divergent results. Our goal was to compare the performance of these risk scores as the basis for the development of a new, simplified score based only on few universally predictive variables. Methods All cryoballoon‐based AF ablations performed in a single‐center over a 10‐year period were prospectively analyzed with regard to AF recurrence. This served to analyze the performance of APPLE, CAAP‐AF, SCALE‐CryoAF, MB‐LATER, CHADS2, and CHA2DS2‐VASc risk scores. Results A total of 597 patients, mostly (78.1%) with paroxysmal AF were studied. Analyzed risk scores performed poorer than in the original publications because some risk factors were not predictive of AF recurrence. A simplified score named 0‐1‐2 PL, composed of just two universally predictive variables, AF type (1 point for Persistent AF) and LA dimension (1 point for LA size >45 mm) was developed. The 0‐1‐2 PL score stratified patients into low risk (0 points), intermediate risk (1 point), and high risk categories (2 points) which were related to a 2‐year risk of AF recurrence of 21%, 37%, and 55%, respectively. This score had C‐statistics (0.620) higher/comparable to other investigated much more complex scores. Conclusion The assessment of risk of AF recurrence at the pre‐ablation stage can be simplified without compromising accuracy. This could help to popularize risk assessment and standardization of AF management.

Since the cryoballoon was introduced into clinical practice, approximately half a million patients have undergone a pulmonary vein isolation (PVI) using this tool throughout the world. This single-shot technique makes the pulmonary vein isolation procedure easier and has the potential to expand access to the interventional treatment of atrial fibrillation (AF), eventually leading to a reduction of the AF-related disease burden. Several studies and metanalyses have assessed the acute and long-term efficacy of cryoballoon-based PVI. The reported success rate of PV isolation during the procedure is about 98%. Despite this, the long-term effectiveness of the procedure (AF free survival) assessed at 1 year after the ablation is in the range of 70–82%. The AF-free survival rate significantly depends on the clinical characteristics of the studied group and the presence of risk factors, especially the type of AF (paroxysmal vs. persistent), LA size and the presence of heart failure. For a safe and effective procedure the electrophysiologist should be aware of all minute details of the procedure including several tricks developed by the most experienced operators and the pre-procedural and post-procedural management recommendations. Detailed knowledge of complications of cryoballoon (CB)-based ablation is mandatory. This review concentrates on the practical aspects and recommendations for a cryoballoon ablation procedure. The review is based on the authors’ experience, including 800 procedures performed over 11 years with a low complication rate, and is presented within the context of the literature.

Introduction : Coronary artery disease is nowadays responsible for approximately 15% of hospitalizations in Poland. Minimally invasive coronary artery bypass (MIDCAB) represents an attractive alternative to a sternotomy, and at the same time provides better life quality and facilitates quick rehabilitation. Aim : To evaluate whether MIDCAB can be performed with similar early and mid-term results as off-pump coronary artery bypass (OPCAB) and therefore can be considered as a safe stage in hybrid revascularization. Material and methods : In a retrospective cohort study, we analyzed 73 consecutive patients who underwent coronary artery bypass grafting (left internal mammary artery to left anterior descending artery) between 2013 and 2016 in the Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow. Thirty-eight (52.1%) MIDCAB and 35 (47.9%) OPCAB patients were enrolled. Results : Short-term results did not significantly differ between groups and similar 30-day mortality was observed (MIDCAB 2.6% vs. OPCAB 2.9%, p = 1). The median follow-up period was 21 months. There were no statistical differences in terms of overall survival or cardiac mortality between groups (94.7% vs. 88.6%, p = 0.42; 2.6% vs. 2.9%, p = 1, respectively). The rate of hospitalization due to cardiac causes was similar in both groups (7.9% vs. 5.1%, p = 1) and there were no differences in current exacerbation of angina or heart failure, with median NYHA class I and CCS class I in both groups. Conclusions : Despite higher technical difficulty, MIDCAB procedures can be performed with similar safety results as OPCAB procedures. No differences in terms of mortality, repeat revascularization or recurrent angina are observed.

The authors made an attempt to verify if a coconut can be used as a model of human skull to determine the homicide weapon. During our experiment 27 strike attempts were performed with the use of 9 different tools. Among them there were authentic murder weapons and instruments which had been used in similar experiments conducted on human skulls in 1955. Depending on the size of an area in contact with a coconut, weapons caused dents corresponding to the shape of a weapon, irregular fractures or long linear cracks. Our results have shown that coconut can be used as an inexpensive screening model of human skull, but only to determine fractures made by tools with small striking surface.

Background Age remains a significant and unmodifiable risk factor for cardiovascular diseases, and an increasing number of patients older than 80 years of age undergo Coronary Artery Bypass Grafting (CABG). Old age is also an independent risk factor for postoperative complications. The aim of this study is to describe the population of patients 80 years of age or older who underwent CABG procedure and to assess the mortality rate and risk factors for in-hospital mortality. Methods A retrospective case-series study analyzing 388 consecutive patients aged 80 years of age or older who underwent isolated CABG procedure between 2010 and 2014 in the Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow. Results In-hospital mortality stood at 7%, compared to 3.4% for all isolated CABG procedures at our Institution. In an univariate logistic regression analysis, risk factors for in-hospital mortality were as follows: NYHA class (p = 0.005, OR 1.95, 95% CI [1.23–3.1]), prolonged mechanical ventilation (p

Objectives: In recent years, many studies emphasized the role of arterial rigidity in the development of cardiovascular diseases. Pulse pressure in an easy-obtained, reproducible marker of arterial stiffness and an independent cardiovascular risk factor. On the other hand it was observed that sodium restriction could improve large elastic artery compliance. The aim of the study was to investigate the relation between salt intake and pulse pressure in high salt intake population. Methods: The study group included 303 subjects recruited from the general population of Southern Poland. Ambulatory blood pressure (ABP) monitors (SpaceLabs 90207) were programmed to obtain measurements each 15 min. during the day and each 30 min. nighttime. Based on the ABP data, we calculated pulse pressure (PP) over 24h, daytime and nighttime. Sodium intake was assessed based on 24h urinary sodium excretion. Database management and statistical analysis were performed with SAS software. Results: The study group included 136 men and 167 women, with 165 hypertensive individuals, 105 of them on antihypertensive treatment, mean age = 47.1 ± 15.7 yrs. While adjusting for age, sex, body mass index, 24h blood pressure, antihypertensive treatment, and life style, we observed positive relation between sodium intake and 24h PP ([beta±SE]: 0.016 ± 0.006, p = 0.0075), daytime PP ([beta±SE]: 0.011 ± 0.005, p = 0.029) and non-significant trend regarding nighttime PP ([beta±SE]: 0.009 ± 0.005, p = 0.094). Conclusion: In our high salt intake population, sodium intake was positively related to calculated pulse pressure over 24-hour and daytime.