Highlights Failure to target and deliver durable radiofrequency lesions to all functionally critical areas has been identified as an important cause of ventricular tachycardia recurrence and is particularly challenging in deep midmyocardial or very extensive substrate where point-by-point radiofrequency ablation becomes impractical. Alternative approaches have been described to: improve radiofrequency energy delivery to the tissue […]

Welcome to the latest issue of Heart International. This edition includes a range of articles on topics showcasing the latest advances in our understanding and treatment of cardiovascular disease. We begin with focus on the hereditary cardiac disorder, hypertrophic cardiomyopathy, which previously had a limited treatment options. However, with the approval of the myosin inhibitor, […]

The prevalence of aortic stenosis (AS) has grown over the last few decades, as life expectancy has increased. AS is the most common valvular disease in the developed world and is found in up to 9.8% of individuals aged ≥75.1–3 The wide range of ages, and the wide variability in the general health status in the […]

A significant proportion of patients with atrial fibrillation (AF) who have a high stroke risk are currently being treated with oral anticoagulation (OAC), including direct oral anticoagulants (DOACs) and vitamin K inhibitors (VKAs).1 It is well known that the increased risk of thromboembolic stroke in patients with AF is primarily due to left atrial appendage (LAA) […]

The American Diabetes Association (ADA) defines prediabetes as glycated haemoglobin (HbA1c) 5.7–6.4% or fasting plasma glucose (FPG) 100–125 mg/dL or 5.6–6.9 mmol/L.1 Patients with prediabetes have up to a 70% chance of developing diabetes and a two-fold higher risk of cardiovascular disease than normoglycaemic patients. Studies show results varying from no association to a strong association […]

Palliative care (PC) is recommended as a standard of practice for all patients with heart failure (HF) and is supported by evidence of improved patient outcomes (e.g. reduction in symptoms refractory to cardiovascular therapies and improved shared decision-making).1 PC also addresses the persistent disparity in care experienced by patients from disenfranchised groups.2 PC is often a consultative […]

Hypertrophic cardiomyopathy (HCM) is a genetic cardiovascular disease affecting 1 in 500 individuals worldwide.1 The disease pathogenesis of HCM is characterized by hypertrophy and myocyte disarray, along with muscle fibrosis on histopathology and intramural hyperplasia of the coronary arteries.2 HCM is diagnosed in patients with left ventricular hypertrophy having a maximum left ventricular wall thickness ≥15 mm […]

Bradycardia, renal failure, atrioventricular nodal blockade, shock and hyperkalemia (BRASH) syndrome is a rare, often unrecognized but potentially life-threatening clinical entity that is characterized by the pentad of symptoms after which it is named. BRASH syndrome is seen most commonly in the setting of atrioventricular nodal-blocking medications such as beta-blockers and calcium channel blockers.1,2 The synergistic interplay of […]

The systemic amyloidoses are a group of heterogenous diseases, which are characterized by the deposition of insoluble amyloid fibrils within the extracellular matrix of multiple organs throughout the body. Amyloid fibrils are formed from the misfolding of amyloid precursor proteins (APPs) into insoluble, beta-pleated sheets that are resistant to proteolysis. They are histologically characterized by […]