The global population aged over 65 years is forecast to double to 1.5 billion people by 2050.1 Ischaemic heart disease is the leading cause of death worldwide, with the greatest mortality burden afflicting older adults.2 International treatment guidelines recommend coronary angiography with subsequent revascularization if indicated in higher-risk patients following non-ST-elevation acute coronary syndrome (NSTEACS),3 yet evidence-based recommendations […]

Diabetes is a common comorbidity among patients with chronic or acute coronary syndrome, and patients with diabetes have a more aggressive form of atherosclerosis and more extensive coronary artery disease (CAD).1,2 In addition, diabetes is a major determinant of adverse clinical events after myocardial revascularization.3,4 In daily clinical practice, patients with diabetes frequently undergo percutaneous coronary intervention […]

For patients with heart failure and a reduced left ventricular ejection fraction (LVEF) who are thought to have iron deficiency, intravenous (i.v.) administration of iron increases haemoglobin, improves symptoms, reduces hospitalizations for heart failure, and might also reduce cardiovascular mortality.1 However, uncertainty exists about which blood markers best reflect iron deficiency and the response to i.v. […]

Patients with long atrial high-rate episodes (AHRE) ≥ 24 hours and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared to no anticoagulation in these patients. This secondary prespecified analysis of NOAH-AFNET 6 examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared to placebo in patients with AHRE […]

This Focus Issue on heart failure and cardiomyopathies contains the State of the Art Review article entitled ‘Mavacamten: a first-in-class myosin inhibitor for obstructive hypertrophic cardiomyopathy’.1 Eugene Braunwald from the Brigham and Women’s Hospital in Boston, MA, USA, and colleagues remind us that mavacamten is a first-in-class, targeted, cardiac-specific myosin inhibitor approved by the US […]

For many patients with terminal/advanced cardiac failure, heart transplantation is the most effective, durable treatment option, and offers the best prospects for a high quality of life. The number of potentially life-saving donated human organs is far fewer than the population who could benefit from a new heart, resulting in increasing numbers of patients awaiting […]

Calcific aortic valve stenosis (CAVS) is a frequent condition associated with significant morbidity. In Western countries, severe CAVS is present in ∼3–5% of individuals >70 years old. The number of individuals with an indication for aortic valve replacement is expected to double by 2050, leading to a significant health and economic burden on society.There is […]

Sudden cardiac death (SCD) accounts for ∼50% of total cardiovascular mortality and 10–20% of all deaths.1 Most of the SCDs (70–80%) are caused by coronary artery disease (CAD), whereas non-ischaemic myocardial diseases account for approximately one-fifth of the cases, and the minority is caused by other cardiac conditions (e.g. primary arrhythmia syndromes, valve diseases, or myocarditis).2,3 Although […]

Non-magnetic resonance imaging (MRI) conditional devices, leads, and abandoned leads traditionally represent a contraindication to MRI. Patients with MRI-conditional devices can safely undergo MRI if pre-defined device manufacturer steps are followed and met prior to and after performing MRI. Bhuva et al.4 provided data in support of a new contemporary approach in which patients with […]

Early delivery of high-quality cardiopulmonary resuscitation (CPR) and rapid defibrillation strengthen the initial links of the chain of survival and can help improve out-of-hospital cardiac arrest (OHCA) outcomes. However, health inequalities exist in OHCA survival at regional and global levels, which reduces the chances of survival, with disproportionately lower CPR delivery rates seen in areas […]

Perioperative myocardial injury evidenced by cardiac biomarker elevation is common after cardiac surgery.1,2 The fourth universal definition of myocardial infarction (UDMI)2 defines perioperative or Type 5 myocardial infarction as an elevation of cardiac troponin (cTn) of 10× the 99th percentile upper reference limit (URL) combined with (i) new pathological Q waves on electrocardiogram (ECG), (ii) flow-limiting angiographic […]

The coronavirus disease 2019 (COVID-19) pandemic has led to major disruption in most aspects of human activity, including clinical trials. Normal social and professional interactions were severely limited, particularly during ‘lockdowns’. Attempting to mitigate the effects of the pandemic on clinical trials for conditions other than COVID-19, regulatory authorities, including the European Medicines Agency (EMA) […]

The advent of the subcutaneous implantable cardioverter defibrillator (S-ICD) in clinical practice was meant to provide the well-established traditional transvenous implantable cardioverter defibrillator (TV-ICD) with potentially advantageous solutions. Among them were an easier implantation technique, a simpler algorithm for life-threatening event detection only, and no need for placement of ICD components in the heart and […]

There is currently no consensus on whether atrial fibrillation (AF) patients at low risk for stroke (one non-sex-related CHA2DS2-VASc point) should be treated with an oral anticoagulant. We conducted a multi-country cohort study in Sweden, Denmark, Norway, and Scotland. In total, 59 076 patients diagnosed with AF at low stroke risk were included. We assessed the […]

Atrial fibrillation (AF) has heterogeneous patterns of presentation concerning symptoms, duration of episodes, AF burden, and the tendency to progress towards the terminal step of permanent AF. AF is associated with a risk of stroke/thromboembolism traditionally considered dependent on patient-level risk factors rather than AF type, AF burden, or other characterizations. However, the time spent […]

March 2, 2022 – An international study led by a researcher from Tel Aviv University offers a novel technology that can assist many patients implanted with bioprosthetic heart valve by avoiding additional complicated replacement surgery. Many heart patients implanted with such valves are forced to replace it ten years later due to calcification of valve tissue. The […]

First published: 27 January 2022 Guideline-recommended therapies for heart failure (HF), particularly for HF with reduced ejection fraction, reduce morbidity and mortality.1 Yet observational data show geographic variation in their application in clinical practice.2–6 This disconnect between the development and the implementation of new healthcare technologies, the so-called ‘second translational gap’,7 calls for new initiatives which may […]

European Heart Journal, ehab912,  Published: 09 February 2022 Since the earliest documented accounts of ventricular fibrillation (VF) >3000 years ago,1 the mechanisms responsible have been the source of ongoing debate. During the early part of the last century, both focal and re-entrant mechanisms were proposed, and more recently the re-entry mechanisms have polarized into the multiple […]

European Heart Journal, ehab884,  Published: 03 January 2022 Since last year’s report in the European Heart Journal, we have witnessed substantial progress in all aspects of interventional cardiology. Of note, the practice of interventional cardiology took place amidst successive waves of the COVID-19 pandemic, which continues to be a major burden for all healthcare professionals around […]

 The Lancet, Published:January 05, 2022DOI:-7500(21)00256-9 Most patients who have heart failure with a reduced ejection fraction, when left ventricular ejection fraction (LVEF) is 40% or lower, are diagnosed in hospital. This is despite previous presentations to primary care with symptoms. We aimed to test an artificial intelligence (AI) algorithm applied to a single-lead ECG, recorded […]

Cardiovascular Research, Volume 117, Issue 7, 15 June 2021, Pages 1732- 1745, Published: 14 May 2021 The cardiac autonomic nervous system (ANS) plays an integral role in normal cardiac physiology as well as in disease states that cause cardiac arrhythmias. The cardiac ANS, comprised of a complex neural hierarchy in a nested series of […]

European Heart Journal, ehab834,  Published: 07 December 2021 A proposed conceptual framework for understanding atrial disease. Subclinical atrial disease develops under the effect of stressors such as aging, cardio-metabolic risk factors and diseases, and genetic predisposition that activate pathogenic mechanisms, such as inflammation, endothelial and microvascular dysfunction, fibrosis, hypercoagulability and atrial stretch that in turn […]

European Heart Journal, Volume 42, Issue 40, 21 October 2021, Pages 4111–4122,  Published: 29 August 2021 Digital therapeutics is a new approach to facilitate the non-pharmacological treatment of hypertension using software programmes such as smartphone applications and/or device algorithms. Based on promising findings from a small pilot trial, the HERB Digital Hypertension 1 (HERB-DH1) pivotal […]

European Heart Journal, Volume 42, Issue 40, 21 October 2021, Pages 4126–4137,  Published: 16 July 2021 Persistence with direct oral anticoagulants (DOACs) has become a concern in non-valvular atrial fibrillation (NVAF) patients, but whether this affects prognosis is rarely studied. We investigated the persistence with oral anticoagulants (OACs) and its association with prognosis among a […]

EP Europace, Volume 23, Issue 10, October 2021, Pages 1612–1676,  Published: 25 April 2021 Non-vitamin K antagonist oral anticoagulants (NOACs) are considered by atrial fibrillation (AF) guidelines world-wide as the preferred choice of anticoagulants to prevent stroke in patients with AF.1–4 The term NOAC has been used for many years, is used by the current European […]

European Heart Journal, ehab703,  Published: 07 October 2021 The SYNTAX II study evaluated the impact of advances in percutaneous coronary intervention (PCI), integrated into a single revascularization strategy, on outcomes of patients with de novo three-vessel disease. The study employed decision-making utilizing the SYNTAX score II, use of coronary physiology, thin-strut biodegradable polymer drug-eluting stents, intravascular […]

European Heart Journal, ehab534,  Published: 04 September 2021 Up to 40% of patients undergoing investigation for angina pectoris have no evidence of significant epicardial coronary disease by either elective computed tomography coronary angiography or invasive cardiac catheterization. Myocardial ischaemia can be detected in a large proportion of these patients. There is a wide spectrum of […]

European Heart Journal, Volume 42, Issue 29, 1 August 2021, Pages 2816 2823, The aim of this study was to investigate the causal effects between atrial fibrillation (AF) and kidney function. We performed a bidirectional summary-level Mendelian randomization (MR) analysis implementing the results from a large-scale genome-wide association study for estimated glomerular filtration rate […]

European Heart Journal, ehab504,  Published: 02 August 2021 Data suggest that women have worse outcomes than men after coronary artery bypass grafting (CABG), but results have been inconsistent across studies. Due to the large differences in baseline characteristics between sexes, suboptimal risk adjustment due to low-quality data may be the reason for the observed differences. […]

Publish date: June 4, 2021 Of patients with symptomatic, obstructive hypertrophic cardiomyopathy treated with the investigational oral agent mavacamten, more than twice as many, compared with placebo, had a very large improvement from baseline in their summary quality of life score after 30 weeks of treatment in a pivotal trial with 194 patients evaluable for this […]

MAY 27, 2021 | DAVE FORNELL, EDITOR The photo gallery below shows the variety of radiological presentations of COVID-19 (SARS-CoV-2) in medical imaging, including computed tomography (CT), radiograph X-rays, ultrasound, echocardiograms and magnetic resonance imaging (MRI). The radiology images show examples of typical COVID pneumonia in the lungs and the numerous complications the virus causes in the body in multiple […]

May 15, 2021 DOI: 10.1056/NEJMoa2101897 Surgical occlusion of the left atrial appendage has been hypothesized to prevent ischemic stroke in patients with atrial fibrillation, but this has not been proved. The procedure can be performed during cardiac surgery undertaken for other reasons. We conducted a multicenter, randomized trial involving participants with atrial fibrillation and a […]

May 16, 2021 DOI: 10.1056/NEJMoa2104650 In patients with ST-elevation myocardial infarction (STEMI) who have multivessel disease, percutaneous coronary intervention (PCI) for nonculprit lesions (complete revascularization) is superior to treatment of the culprit lesion alone. However, whether complete revascularization that is guided by fractional flow reserve (FFR) is superior to an angiography-guided procedure is unclear. In […]

European Heart Journal, Volume 42, Issue 19, 14 May 2021, Pages 1825 1857, Published: 19 April 2021 The Valve Academic Research Consortium (VARC), founded in 2010, was intended to (i) identify appropriate clinical endpoints and (ii) standardize definitions of these endpoints for transcatheter and surgical aortic valve clinical trials. Rapid evolution of the field, […]

European Heart Journal – Cardiovascular Imaging, Volume 22, Issue 4, April 2021, Pages 418-426, Published: 18 November 2020 In a cohort of 237 women with breast cancer receiving doxorubicin with or without trastuzumab, 1151 echocardiograms were prospectively acquired over a median (Q1–Q3) of 7 (2–24) months. LV ejection fraction (LVEF) and 36 segmental strain […]

Originally published15 Mar 2021 Circulation: Arrhythmia and Electrophysiology. 2021;14   Atrial fibrillation (AF) recurrence following catheter ablation remains high. Recent studies have shown a relation between epicardial adipose tissue and AF. epicardial adipose tissue secretes several proinflammatory and anti-inflammatory adipokines that directly interact with the adjacent myocardium. The aim of the current study was […]

First published: 22 November 2020   To characterize adverse ventricular remodelling after withdrawing therapy in recovered dilated cardiomyopathy (DCM). TRED‐HF was a randomized controlled trial with a follow‐on single‐arm cross‐over phase that examined the safety and feasibility of therapy withdrawal in patients with recovered DCM over 6 months. The primary endpoint was relapse of heart failure […]

European Heart Journal, Volume 42, Issue 15, 14 April 2021, Pages 1453-1455    Published: 28 December 2020 The coronavirus disease-2019 (COVID-19) pandemic has had an unparalleled impact on cardiology training worldwide. In the next few sections, we highlight several foundational considerations for building a successful technology-enabled model in the new normal for cardiology training. […]

European Heart Journal, Volume 42, Issue 16, 21 April 2021, Pages 1543-1544, Published: 24 March 2021   The European Society of Cardiology Guidelines for the diagnosis and management of AF3 recommend (Class IA) rhythm control therapy for symptom and quality of life improvement in symptomatic patients with AF. However, for rhythm control, catheter ablation is […]

European Heart Journal – Digital Health, Volume 1, Issue 1, November 2020, Pages 62-70, Published: 23 November 2020 Increased complexity in cardiac surgery over the last decades necessitates more precise preoperative planning to minimize operating time, to limit the risk of complications during surgery and to aim for the best possible patient outcome. Novel, […]

Originally published19 Mar 2021 Stroke. 2021;52:1534–1544   The Tigertriever is a novel, radially adjustable, fully visible, stentriever that permits the operator to align radial expansion with target vessel diameters. This multicenter trial compared the Tigertriever’s effectiveness and safety compared with established stent retrievers. Single arm, prospective, multicenter trial comparing the Tigertriever to efficacy and […]