Welcome to the summer edition of European Journal of Arrhythmia & Electrophysiology. The COVID-19 pandemic is proving extremely challenging for patients with arrhythmia, as well as cardiologists and electrophysiologists. As new data continue to emerge on the impact of COVID-19 on arrhythmias, new management strategies are evolving.
This edition begins with a review by Guettler, Rajappan and Nicol of the association between atrial fibrillation and cognitive impairment, cognitive decline and dementia, which highlights the need for large randomised clinical trials to establish the impact of anticoagulation and rhythm control strategies on the risk of cognitive decline and dementia.
A growing body of evidence suggests that women derive more benefit from cardiac resynchronisation therapy (CRT) than men, despite being less likely than men to receive it. In a review article, Zweerink at al. explore the mechanisms for the sex difference in CRT outcomes and the importance of these differences in the development of improved strategies.
Despite their high fitness levels, elite athletes have a higher risk of sudden death compared with the rest of the population. Gray, Malhotra and Sharma review the structural and functional changes within the heart that are seen during adaptation to exercise, and discuss the importance of accurate interpretation of electrocardiograms in the pre-participation screening of athletes and recognition of ‘red flags’ of potential underlying pathology.
Ventricular arrhythmias and premature ventricular complexes may arise from papillary muscles, which present unique challenges in terms of catheter ablation. Raja et al. describe the characteristic electrocardiogram features of papillary muscle ventricular arrhythmias and discuss optimal ablation strategies.
Finally, case reports are an important addition to scientific journals as they can raise awareness of uncommon disease presentations and therapeutic techniques. Mahmood, Dhillon and Kabunga describe a case of idiopathic left posterior fascicular ventricular tachycardia, which was successfully treated by localised catheter ablation in the left ventricular septum at sites with the earliest retrograde-Purkinje potential.
The European Journal of Arrhythmia & Electrophysiology would like to thank all authors who contributed their expertise towards this edition. A special thanks goes to our Editorial Board for their continuing guidance. We are also grateful to all organisations and society partners for their ongoing support. We hope that these articles prove thought-provoking and useful. Please also take the opportunity to look at the videos on our website, touchCARDIO.com, which features a wealth of content from experts in electrophysiology. Finally, we hope you all stay safe and well during these difficult times.