Background: Data on the prevalence and predictors for the development of pacing-dependency in patients with cardiovascular implantable electronic devices (CIEDs) are sparse. Methods: Pacing-dependency defined as an absence of intrinsic rhythm of ≥ 30 bpm was determined in 802 consecutive patients with CIEDs who visited the documented pacemaker or implantable cardioverter-defibrillator outpatient clinic for routine follow-up. Results: A total of 131 (16%) patients were found to be pacing-dependent 67 ± 70 months after CIED implant. Multivariate analysis revealed a significant association between pacing-dependency and the following clinical variables: second or third-degree atrioventricular (AV) block at implant (

Background Cardiac allograft vasculopathy (CAV) and nephrotoxicity affect long‐term survival after heart transplantation (HTX). Studies, mostly conducted in adults, showed a positive effect of everolimus (EVL) on these problems. We describe the effects of conversion of the immunosuppressive therapy to an everolimus including regime on CAV, renal function, and safety in heart transplanted children/adolescents. Methods This retrospective single‐center study included 36 participants (mean time after HTX 6.3 ± 4.7 years). Descriptive pre/post‐comparisons were performed with an observation period partially up to 4 years. Impact on CAV was assessed based on intravascular imaging and Stanford grading. Safety analysis included cytomegalovirus (CMV)‐infection and acute rejection. Results In terms of CAV (9 out of 36 patients) four showed no progression, three an improvement, one a worsening; one new diagnosis. The average CrCl showed a significant improvement 6, 12, and 24 months after conversion regarding all patients (n = 29). There was no acute rejection or CMV‐infection. Conclusion Conversion to an EVL‐based therapy after pediatric HTX is a safe immunosuppressive regime without increasing risk of acute rejection or CMV‐infection. There was some evidence of reduction in progression of CAV and a significant improvement of the renal function.

In comparison with other surgical procedures concerning the breast, the history of reduction mammaplasty is relatively short. Some authors have mistaken Paulos of Aegina for the pioneer in this field, although he occupied himself exclusively with gynaecomastia. Since some decades Hanns Schaller, the so-called "barber" of Augsburg, is considered to be the first surgeon to have performed a reduction mammaplasty by breast amputation in 1561. However, exact references have not been available so far. We found the original text containing the description of the procedure written by a contemporary in a rather unexpected place as well as some details about the surgeon. We conclude that Hanns Schaller was the first surgeon to undertake a reduction mammaplasty in an otherwise healthy woman in order to relieve her physical symptoms. Undoubtedly, his intentions were purely functional without any further aesthetic considerations.

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