Background Diagnosing paroxysmal cardiac arrhythmias early poses a challenge, yet it holds paramount significance. Certain patients hold strong beliefs regarding the moon’s impact on cardiac arrhythmias. This study aims to examine the potential correlation. Methods In our emergency room, each patient presentation is assigned an ’admission diagnosis’. An analysis was conducted on admission diagnoses from 2012 to 2020 (pre-COVID pandemic). The frequency of rhythmological diagnoses was investigated, both collectively and separately, as well as categorized by underlying pathomechanism, in relation to the lunar phase and the moon’s proximity to Earth at the time of admission. Moreover, the impact of gender, age, and weight was evaluated. Results 58,230 patient presentations were recorded, with 16.9% coded with rhythmological diagnoses. No significant differences were found in the distribution of cardiac arrhythmias concerning lunar phases or moon-earth distance. Gender, age, and weight did not influence this distribution, except in a small group of underweight patients (<55kg), where a statistical difference was observed with greater moon distance. To verify this results, we investigated all existing holter monitoring of underweight patients presenting to the ER between 2017 and 2020. In 195 24-hour holter recordings a uniform burden of supraventricular extrasystoles and atrial fibrillation/flutter irrespective of the moon’s distance from Earth was observed. Conclusion Contrary to patient beliefs, moon does not seem to affect the presentations with rhythmological complaints and diagnoses in our single-center analysis, irrespective of age, gender, or arrhythmia type. The moon cannot aid in diagnosing paroxysmal arrhythmias .

In this case report, we describe a 74-year-old woman with paroxysmal tachycardias. During the electrophysiological study, a change in the QRS morphology and peculiar features of the diseased AV node complicated the diagnosis. A rare left atriofascicular accessory pathway as the sole anterograde connection between atria und ventricles was revealed, underscoring the importance of meticulous electrophysiological assessment.

The coronary sinus musculature connects to the right and the left atrium, forming electrical interatrial bridges and can be a critical part of various left atrial and biatrial flutter circuits. We herein present a rare case of a macroreentrant tachycardia around the coronary sinus using interatrial connections at its orifice and the inferolateral left atrium and the adjacent left atrial myocardium.