CURRENT OPINION IN CARDIOLOGY

Surgical and multimodal approaches to right-sided cardiac tumours
Patel SK, Dhingra NK and Cusimano RJ
Cardiac tumours present significant clinical challenges due to their wide differential, complex anatomical and physiological implications, as well as the potential for widespread invasion in the case of malignancies. This review synthesizes recent findings surrounding the diagnosis and management of specifically right-sided cardiac tumours, with a particular focus on surgical resection and reconstructive techniques.
Treatment options to break the cycle of recurrent pericarditis
Raisinghani AB and Luis SA
This review provides a contemporary, evidence-based update on the pathophysiological mechanisms and rapidly evolving therapeutic options for recurrent pericarditis.
Robotic mitral valve surgery: evolving history, techniques, and training paths
Hasan I, Amabile A and Tam DY
Over the past 25 years, robotic-assisted mitral valve surgery has gained significant recognition because of its potential to minimize patient trauma and improve clinical outcomes. This field has evolved from early efforts in minimally invasive mitral procedures to more refined and technically sophisticated approaches, driven by the need for smaller incisions and reduced recovery times.
New therapies to treat cardiac amyloidosis
Nguyen O, Kamna D and Masri A
Review advancements in therapies for transthyretin (ATTR-CM) and immunoglobulin light chain (AL-CM) cardiac amyloidosis.
Editorial introductions
Cardiac sarcoidosis; update for the heart failure specialist
Birnie DH
This review presents contemporary data on epidemiology, common presentations, investigations and diagnostic algorithms, treatment and prognosis. It particularly focuses on topics of most relevance to heart failure specialists, including what left ventricle (LV) function changes can be expected after treatment and outcomes to all standard and advanced heart failure therapies.
Ablation options for sub-epicardially located ventricular substrates responsible for ventricular tachycardia: where is it all headed?
Sperling JS and Santangeli P
Patients with nonischemic and ischemic cardiomyopathy (NICM and ICM) exhibit re-entrant tachycardias related to scar tissue in subepicardial, in addition to typical subendocardial locations. Control of ventricular arrhythmias related to these targets has remained elusive despite advances in mapping and ablation technology.
Electrographic flow mapping of atrial fibrillation
Castellano S and Kong MH
A low ceiling of efficacy exists for the treatment of persistent atrial fibrillation via pulmonary vein isolation without adjunctive ablations, which is likely because they do not target an individual patient's specific underlying disease mechanisms. Electrographic flow (EGF) mapping is the first system that reliably displays wavefront propagation through the atria. It is a promising tool for localizing sources of atrial fibrillation, guiding targeted ablation, and visualizing conduction through the atrial substrate.
Rethinking atherosclerotic cardiovascular disease prevention in the era of expanding therapies: could plaque stabilization reduce the need for lifelong treatments and polypharmacy?
Bruun K and Mortensen MB
This review examines current evidence on pharmacologically induced plaque stabilization in the context of a growing range of new therapies. It explores the potential for a paradigm shift in atherosclerotic cardiovascular disease (ASCVD) prevention, where treatments may not need to be lifelong to achieve lasting benefits.
The management of new-onset atrial fibrillation in critical illness: an update on current therapeutic options
Wang Z, Li J and Sun Y
New-onset atrial fibrillation (NOAF) is the most prevalent arrhythmia among critically ill patients, correlating with heightened morbidity and mortality rates. Current evidence for managing NOAF in this patient population is limited.
Beyond the Agatston calcium score: role of calcium density and other calcified plaque markers for cardiovascular disease prediction
Razavi AC, Whelton SP, Blumenthal RS, Blaha MJ and Dzaye O
To review the current evidence and highlight future strategies regarding consideration of coronary artery calcium (CAC) density in cardiovascular disease (CVD) risk stratification.
Advancements in automated external and wearable cardiac defibrillators
Aldaas OM and Birgersdotter-Green U
Survival statistics for out-of-hospital cardiac arrests remain unsatisfactory. Prompt defibrillation of shockable rhythms, such as ventricular fibrillation and pulseless ventricular tachycardia, is crucial for improving survival. Automated external defibrillators (AEDs) and wearable cardiac defibrillators (WCDs) seek to improve the survival rates following out-of-hospital cardiac arrests. We aim to review the indications, utility, advancements, and limitations of AEDs and WCDs, as well as their role in contemporary and future clinical practice.
Cardiac selectivity in pulsed field ablation
Meng F, Jin S and Liu N
This review examines the selective cardiac injury induced by pulsed electric fields during atrial fibrillation ablation. It consolidates findings from both preclinical and clinical studies on cardiac selectivity and explores the potential mechanisms behind this selectivity.
Genetics, manifestations, and management of catecholaminergic polymorphic ventricular tachycardia
Desai S, Moore OM and Wehrens XHT
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a devastating heritable channelopathy that can lead to sudden cardiac death in children and young adults. This review aims to explore genetics, the cardiac and extracardiac manifestations of mutations associated with CPVT, and the challenges involved with managing phenotypically variable variants.
Coronary artery injury in pulsed field ablation
Higuchi S and Gerstenfeld EP
Although pulsed field ablation (PFA) has emerged as an innovative nonthermal catheter ablation modality, recent reports raise concerns about its potential impact on nearby coronary arteries. This review provides a comprehensive overview of the current understanding and future directions regarding the effects of PFA on or near coronary arteries.
Cardiovascular disease in South Asian immigrants facing adverse socioeconomic circumstances: challenges and opportunities for enhanced management
Pappalettere CC, Llagostera M, Vime-Jubany J and Cainzos-Achirica M
To describe the challenges that health professionals often face when attempting to provide optimal primary and secondary prevention care of atherosclerotic cardiovascular disease (ASCVD) to South Asian immigrant patients who face adverse socioeconomic factors, such as many of the South Asian men and women who live in Catalonia, and to present a number of constructive approaches that can help minimize those barriers.
Promoting gender diversity and ergonomic equity in the cardiac surgery operating room
Altin E, Majeed H, Verma R, Paterson E and Yanagawa B
The operating room (OR) infrastructure and equipment such as gloves, were historically designed at a time when most surgeons were male. Today, there are increasing numbers of females in the OR and we should ensure that there is not a disproportionate risk of ergonomic stress and risk of work-related injuries. This review provides a perspective on the representation of female cardiac surgeons globally and examines the unique ergonomic challenges they may face.
When should the tricuspid valve be repaired during mitral valve repair?
An KR, Nwajei E and Chu MWA
Management of tricuspid regurgitation and annular dilation during mitral valve repair remains controversial. We review the latest evidence on indications to repair the tricuspid valve during mitral valve repair and discuss surgical strategies and complications.
Is it feasible to treat atrial fibrillation at the time of minimally invasive coronary artery bypass grafting?
Waterford SD and Ad N
Coronary artery bypass grafting remains the most common operation performed by cardiac surgeons. As a result, a cardiac surgeon with a typical practice will most commonly encounter atrial fibrillation when performing coronary artery bypass grafting. In this review, we first emphasize the importance of treating atrial fibrillation in patients undergoing coronary bypass grafting. We review benefits of concomitant surgical ablation and its importance relative to complete coronary revascularization. We then discuss options to treat atrial fibrillation in a more minimally invasive manner in these patients, while still preserving treatment efficacy.
Lipoprotein(a) is a highly atherogenic lipoprotein: pathophysiological basis and clinical implications
Björnson E, Adiels M, Borén J and Packard CJ
Lipoprotein(a) has been identified as a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis. However, as reviewed here, there is ongoing debate as to the key pathogenic features of Lp(a) particles and the degree of Lp(a) atherogenicity relative to low-density lipoprotein (LDL).
Current trends and challenges in infective endocarditis
Patel SK, Hassan SMA, Côté M, Leis B and Yanagawa B
Infective endocarditis (IE) is a complex disease with increasing global incidence. This review explores recent trends in IE infection patterns, including healthcare-associated IE (HAIE), drug-use-associated IE (DUA-IE), multidrug-resistant organisms (MDROs), and challenges in managing prosthetic valve and device-related infections.