Purpose Radiofrequency catheter ablation (RFCA) for electrical storm (ES) has become a widely used therapeutic method. Its effectiveness in comparison to other forms of ES treatment is however uncertain. Methods This single-centre retrospective study investigated the long-term clinical outcome after RFCA for ES and compared long-time effects of ablation to other forms of treatment. The study population consisted of 70 consecutive patients hospitalised between January 2010 and June 2015 due to ES. Patients were recruited for the study if the following criteria were fulfilled: first ES caused by ventricular tachycardia (VT) or ventricular fibrillation (VF), implanted cardioverter defibril-lator or cardiac resynchronisation therapy device and left ven-tricular ejection fraction < 50%. The follow-up data on VT/ES recurrence was obtained from pacemaker/implanted cardioverter defibrillator memory. Data on all-cause mortality was collected during outpatient visits or by telephone contact. Results Of the 70 patients enrolled, 28 (40%) were treated with RFCA (group A) and 42 (60%) received other forms of treatment for ES (group B). During a mean (±SD) 864 (629) days of follow-up, death occurred in 4 (14.3%) patients in the ablation group and in 16 (38.1%) patients treated with other methods [p = 0.03]. There was no significant between-group difference in VT/VF and ES recurrence. Statistical analysis revealed that the presence of cardiac resynchronisation therapy device during ES, stroke and/or transient ischaemic attack and lower baseline hematocrit level were the multivariate pre-dictors of all-cause mortality. Conclusions In patients treated with RFCA for ES, all-cause mortality was significantly lower compared to the group treated with other methods.

In captive adult Zambian mole-rats 14 different sounds (13 true vocalizations) have been recorded during different behavioural contexts. The sound analysis revealed that all sounds occurred in a low and middle frequency range with main energy below 10 kHz. The majority of calls contained components of 1.6-2 kHz, 0.63-0.8 kHz, and/or 5-6.3 kHz. The vocalization range thus matched well the hearing range as established in other studies. The frequency content of courtship calls in two species of Zambian Cryptomys was compared with that in naked mole-rats (Heterocephalus glaber) and blind mole-rats (Spalax ehrenbergi) as described in the literature. The frequency range of maximum sound energy is negatively correlated with the body weight and coincides with the frequencies of best hearing in the respective species. In general, the vocalization range in subterranean mammals is shifted towards low frequencies which are best propagated in underground burrows.

Pharmacological therapy of neurocardiogenic syncope is often limited by the relatively low response rate to such treatment. In particular, response to beta-blocker treatment has been reported to average 50%. Therefore, a two-step protocol, with metoprolol being the drug of first choice, was developed and prospectively evaluated in consecutive patients with a history of repeated syncopal attacks and a positive tilt table test indicative of neurocardiogenic syncope. Patients not responding to the beta-blocker were switched to the alpha-adrenoceptoragonist midodrine. Acute drug efficacy was assessed by repeated tilt table testing. The incidence of syncope recurrence rate was determined during a 7-month follow-up. In 16 of 30 (53%) patients, metoprolol was primarily effective; this was also the case in 7 of 11 patients receiving midodrine. Thus, the overall efficacy rate could be increased to 77% by the treatment protocol (P = 0.009, as compared to beta-blocker treatment alone). During follow-up, only 1 of 27 patients (4%) had a syncopal event. Thus, the two-step treatment protocol presented in this study proved to be safe and to improve significantly patients clinical symptoms, as well as results of repeated tilt table testing as compared to beta-blocker treatment alone.

A patient with ischemic cardiomyopathy presented with burning pain of his body surface with consecutive orthostatic intolerance and recurrent syncopes. A diagnosis of acute autonomic dysfunction was made and the patient was treated with midodrine, resulting in restoration of orthostatic tolerance after 6 weeks of therapy.