Impacts of environmental change on biodiversity and vegetation dynamics in Siberia.

Biological diversity is the basis for, and an indicator of biosphere integrity. Together with climate change, its loss is one of the two most important planetary boundaries. A halt in biodiversity loss is one of the UN Sustainable Development Goals. Current changes in biodiversity in the vast landmass of Siberia are at an initial stage of inventory, even though the Siberian environment is experiencing rapid climate change, weather extremes and transformation of land use and management. Biodiversity changes affect traditional land use by Indigenous People and multiple ecosystem services with implications for local and national economies. Here we review and analyse a large number of scientific publications, which are little known outside Russia, and we provide insights into Siberian biodiversity issues for the wider international research community. Case studies are presented on biodiversity changes for insect pests, fish, amphibians and reptiles, birds, mammals and steppe vegetation, and we discuss their causes and consequences.

Comparative Safety and Efficacy of Left Atrial Appendage Occlusion with the Watchman Device and Amplatzer Cardiac Plug: Results of the Russian National Registry.

PURPOSE: This multicenter, prospective registry evaluated the comparative safety and efficacy of left atrial appendage occlusion (LAAO) using the Watchman device (WD) and the Amplatzer Cardiac Plug (ACP) in patients with nonvalvular atrial fibrillation (NVAF) in real-world clinical practice in Russia. METHODS: The study included data from 200 consecutive NVAF patients (66.8 ± 7.8 years, 44.5% female, median CHA2DS2VASc 4, median HAS-BLED 3) who had undergone LAAO implantation using WD (n = 108) or ACP (n = 92) from September 2015 to December 2017 in 5 medical centers in Russia. The primary safety endpoint was the procedure-related major adverse events, and the primary efficacy endpoint was the composite of thromboembolic events, device thrombosis, hemorrhagic events, and unexplained death during the 12-month follow-up. RESULTS: Successful LAAO was performed in all 92 (100%) patients with ACP and 105 (97.2%) with WD (p = 0.053). At 12 months, primary safety endpoint occurred in 6.5% of patients in the ACP group with no events in the WD group (6.5% vs. 0%, p = 0.008). During the 12-month follow-up, the primary efficacy endpoint has occurred in 8.3% of patients in the WD group (n = 9) and 1.1% of patients in the ACP group (n = 1) (p = 0.016). CONCLUSIONS: In this multicenter prospective registry, LAA closure with the WD was associated with significantly higher thromboembolic events rate in NVAF patients. Patients, receiving the ACP, had more procedure-related major adverse events. However, further multicenter studies are necessary to evaluate these findings.

Outcome of anatomic ganglionated plexi ablation to treat paroxysmal atrial fibrillation: a 3-year follow-up study.

AIMS: A new strategy for anatomically based ganglionated plexi (GP) ablation for the treatment of paroxysmal atrial fibrillation (AF) has been proposed recently. We aimed to assess the long-term outcome of patients undergoing anatomic GP ablation for paroxysmal AF, in comparison with circumferential pulmonary vein (PV) isolation. METHODS AND RESULTS: The study population consisted of 70 patients (mean age 56.6 ± 10.9 years; 41 males) with paroxysmal AF and no history of structural heart disease: 35 subjects underwent anatomic GP ablation, while 35 consecutive patients had circumferential PV isolation (CPVI) (control group). The groups were not different in demographic and clinical parameters. Anatomic GP ablation required more ablation points (85.6 ± 5.5 vs. 74.4 ± 6.2, P < 0.05) and equal duration of total procedure and fluoroscopy times. During a mean follow-up period of 36.3 ± 2.3 months, freedom from any atrial tachyarrhythmia without antiarrhythmics was achieved in 34.3% patients after anatomic GP ablation and 65.7% patients after CPVI (log-rank test P = 0.008). Early arrhythmia recurrences and anatomic GP ablation were independent predictors of late recurrence [HR 6.44 (CI 95%; 3.14-13.18; P < 0.001) and HR 2.08 (CI 95%; 1.03-4.22; P = 0.04), respectively]. Six patients in the group of GP ablation underwent subsequent CPVI, plus peri-mitral flutter ablation in two of them, with no further arrhythmia episodes in five patients. CONCLUSION: Anatomic GP ablation yields a significantly lower success rate over the long-term follow-up period, when compared with CPVI. Recurrences include AF and macro re-entrant atrial tachycardias.

Additional left atrial septal line does not improve outcome of patients undergoing ablation for long-standing persistent atrial fibrillation.

OBJECTIVE: Additional septal linear ablation in patients undergoing ablation of long-standing persistent atrial fibrillation (AF) could be beneficial due to additional extensive atrial tissue ablation and incidental ablation of sites with complex fractionated electrograms. We assessed the long-term outcome of patients after ablation of long-standing persistent AF with an additional left atrial (LA) septal line. METHODS: Thirty-four patients were included.The patients were randomized into two groups and underwent pulmonary vein (PV) isolation with roof line, mitral isthmus line and coronary sinus ablation. In group I an additional LA septal line was created. RESULTS: AF converted into atrial tachycardia in 2 patients during septal ablation in group I. In group 2 AF terminated via atrial tachycardia in 3 patients (P = ns). During a mean follow-up of 620 +/- 119 days, 7 (41%) and 8 (47%) patients from group 1 and group 2 were free from recurrences (P = ns). Redo procedures were performed in 5 patients of group 1 and in 5 patients of group 2. For a follow-up of 349 +/- 273 days after the last ablation, Cox's F-test showed a trend of more recurrences in group 1 (P = 0.07). CONCLUSIONS: In patients with long-standing AF, an additional LA septal linear ablation is not associated with a significantly higher AF termination rate. A septal linear lesion might increase the risk of septal reentrant tachycardias, and is associated with a trend towards a worse outcome.

Atypical atrial flutter in a patient with atrial septal defect without previous surgery: the role of septal defect as a part of the arrhythmia substrate.

This case report describes an atypical right atrial septal flutter in a patient with a non-corrected atrial septal defect. The unique feature of this case report is that reentrant tachycardia with a cycle around the atrial septal defect was non-scar related. The slow conduction around this atrial septal defect was probably formed by right atrial dilatation and intra-cardiac haemodynamic alterations.