IF 1.6 4区医学

Herz Pub Date : 2026-02-01 Epub Date: 2025-12-09 DOI: 10.1007/s00059-025-05354-6

Anna Hohneck, Oliver Weingärtner

{"title":"[ESC guidelines on dyslipidemia update 2025 : New recommendations for the practice].","authors":"Anna Hohneck, Oliver Weingärtner","doi":"10.1007/s00059-025-05354-6","DOIUrl":"10.1007/s00059-025-05354-6","url":null,"abstract":"The 2025 update of the European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines on dyslipidemia introduce important innovations based on new evidence. The risk assessment is now conducted using the systematic coronary risk evaluation 2 (SCORE2) and SCORE2-OP (older persons), which enable improved stratification, particularly in older individuals. In addition, risk modifiers, such as family history, ethnicity, comorbidities and the biomarkers elevated highly sensitive C‑reactive protein (hs-CRP) or lipoprotein(a) (Lpa), have been introduced. Risk categories have been refined while low-density lipoprotein cholesterol (LDL-C) target values and the principle of stepwise treatment remain unchanged. A major focus is on the acute coronary syndrome: the immediate initiation of high-intensity statin treatment, mostly in combination with ezetimibe is recommended. Increasingly more important are elevated Lp(a) levels and special subgroups: in people with human immunodeficiency virus (HIV), statin treatment is recommended over the age of 40 years regardless of the LDL‑C as well as in high-risk patients undergoing anthracycline treatment. The use of dietary supplements and vitamins for prevention, however, are discouraged. The update reinforces the principle of risk-adapted LDL‑C target values, expands the treatment options and emphasizes the need for early, consistent lipid-lowering with practical recommendations.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"4-11"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145714101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[The 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease : A successful plea for psychocardiology]. [2025年ESC关于心理健康和心血管疾病的临床共识声明：对心理心脏病学的成功呼吁]。

IF 1.6 4区医学

Herz Pub Date : 2026-02-01 Epub Date: 2026-01-04 DOI: 10.1007/s00059-025-05357-3

Malte Meesmann, Karl-Heinz Ladwig

{"title":"[The 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease : A successful plea for psychocardiology].","authors":"Malte Meesmann, Karl-Heinz Ladwig","doi":"10.1007/s00059-025-05357-3","DOIUrl":"10.1007/s00059-025-05357-3","url":null,"abstract":"The negative impact of psychological factors on the development and course of cardiovascular disease is impressively documented in the European Society of Cardiology (ESC) 2025 Clinical Consensus Statement on mental health and cardiovascular disease (ESC-CCS-2025), which cites a total of 687 references. In particular, chronic stress, depression, anxiety disorders, and post-traumatic stress disorder can increase the cardiovascular risk by up to twofold, and these factors are often associated with an unhealthy lifestyle (smoking, unhealthy diet, physical inactivity, obesity). Conversely, due to their often existentially threatening nature, cardiovascular diseases can secondarily lead to significant psychological distress. Based on this broad body of evidence, readers are encouraged to apply this knowledge in clinical practice as directly and extensively as possible. As there are several barriers to implementing these recommendations, the ACTIVE principles propose guidance on how structures can be improved or newly created in order to enhance the diagnosis and treatment of psychological distress and mental disorders in patients with cardiovascular disease. To this end, establishment of a \"Psycho-Cardio team\" and expansion of a stepped-care model are recommended. The statement also emphasizes that caregiving relatives of patients may themselves experience severe emotional distress and often require support. Furthermore, the situation of patients with a primary, severe mental disorder is highlighted, as their cardiovascular care is frequently characterized by stigma and undertreatment. In our view, the ESC-CCS-2025 represents a milestone in psychocardiology, calling on all of us to translate this knowledge into practice and to create or expand effective structures of care.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"37-44"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Conduction system pacing (CSP) for every patient? : Should CSP replace classical right ventricular and biventricular stimulation?] [每个病人的传导系统起搏（CSP）？CSP是否应该取代经典的右心室和双心室刺激？］

IF 0.9 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-10-21 DOI: 10.1007/s00059-025-05347-5

Jörn Schmitt, Sergio Richter

{"title":"[Conduction system pacing (CSP) for every patient? : Should CSP replace classical right ventricular and biventricular stimulation?]","authors":"Jörn Schmitt, Sergio Richter","doi":"10.1007/s00059-025-05347-5","DOIUrl":"10.1007/s00059-025-05347-5","url":null,"abstract":"Direct stimulation of the conduction system (conduction system pacing, CSP) can be performed at multiple levels and for different indications. The most physiological option is direct stimulation of the bundle of His, which is technically simpler and possible at the level of the left bundle branch and with more stable electrical parameters. This stimulation results not only in \"nice\" ECG leads but, above all, in a homogeneous, synchronous, physiological contraction pattern, especially of the left ventricle. In many situations there is a direct competition with the established stimulation modalities of the right ventricle in isolated bradycardia and cardiac resynchronization therapy (CRT) in heart failure. A clear distinction and recommendation in the guidelines are not yet definitive, also due to pending and constantly accumulating data and an evolving portfolio of sheaths and leads from all manufacturers; however, overall there is a clear preference for CSP over right ventricular apical pacing, if possible but this still needs to be confirmed in comparison to CRT.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"438-445"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Deactivation of implantable cardioverter defibrillators (ICD) at the end of life]. [生命末期植入式心律转复除颤器（ICD）的失活]。

IF 1.6 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-09-25 DOI: 10.1007/s00059-025-05342-w

Karl-Heinz Ladwig, Bernd Lemke, Andreas Goette, Karoline Lukaschek

{"title":"[Deactivation of implantable cardioverter defibrillators (ICD) at the end of life].","authors":"Karl-Heinz Ladwig, Bernd Lemke, Andreas Goette, Karoline Lukaschek","doi":"10.1007/s00059-025-05342-w","DOIUrl":"10.1007/s00059-025-05342-w","url":null,"abstract":"Up to one third of patients with an implantable cardioverter defibrillator (ICD) experience shock discharges in the last 24 h before death, which no longer have any therapeutic benefit. Even in patients who have a living will (do not resuscitate, DNR, directive), the shock function of the ICD is activated in over 50% of those affected 24 h before death. A significant subgroup of ICD wearers must therefore experience painful, significantly stressful and unnecessary ICD shocks at the hour of their death. All available position papers on this topic call for patients to be informed about this issue in good time; however, in reality such a conversation almost never takes place. This paper outlines the legal basis that helps doctors to deactivate the ICD in the final stage of life and the specific conditions that must be met. This paper advocates repeatedly addressing the issue during the course of the illness and to involve relatives. The actual conversation about deactivation at the end of life should be proactively initiated by the responsible attending physician and should take the form of a structured, patient-centered dialogue in the spirit of good dialogue.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"453-459"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The extravascular implantable cardioverter-defibrillator: technology, evidence, and clinical perspectives. 血管外植入式心律转复除颤器：技术、证据和临床观点。

IF 0.9 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1007/s00059-025-05345-7

Eleonora Angelini, Karolin Albert, David Duncker

{"title":"The extravascular implantable cardioverter-defibrillator: technology, evidence, and clinical perspectives.","authors":"Eleonora Angelini, Karolin Albert, David Duncker","doi":"10.1007/s00059-025-05345-7","DOIUrl":"10.1007/s00059-025-05345-7","url":null,"abstract":"The extravascular implantable cardioverter-defibrillator (EV-ICD) offers a fully extravascular alternative to transvenous ICDs, combining substernal lead placement with defibrillation and limited pacing capabilities. Designed to mitigate intravascular complications while maintaining generator size and longevity comparable to conventional ICDs, the EV-ICD supports antitachycardia pacing, post-shock pacing, and temporary bradycardia management. Procedural experience demonstrates high implantation success, low rates of major complications, and effective arrhythmia termination. Early real-world data indicate that lead dislodgement, pneumothorax, and pocket infection are uncommon, and lead explantation is feasible when required. Antitachycardia pacing effectively terminates a substantial proportion of ventricular tachycardias, while inappropriate therapies have been reduced through optimized lead positioning and advanced detection algorithms. Patient selection should exclude, among others, those with permanent pacing needs, anatomical constraints, and prior radiotherapy or sternotomy. Future directions include optimization of lead design and exploration of alternative implantation sites, with ongoing evaluation of long-term device performance and safety. Current evidence supports the EV-ICD as a safe and effective option in selected patients, including younger populations or those with limited vascular access, although its definitive role in sudden cardiac death prevention requires further long-term study.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"417-426"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Timing of RAS blocker administration and long-term cardiovascular outcomes in STEMI patients. STEMI患者RAS受体阻滞剂给药时机与长期心血管预后

IF 1.6 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-06-16 DOI: 10.1007/s00059-025-05317-x

Tuğba Çetin, Mehmet Baran Karataş, Semih Eren, Şeyda Dereli, Gündüz Durmuş

{"title":"Timing of RAS blocker administration and long-term cardiovascular outcomes in STEMI patients.","authors":"Tuğba Çetin, Mehmet Baran Karataş, Semih Eren, Şeyda Dereli, Gündüz Durmuş","doi":"10.1007/s00059-025-05317-x","DOIUrl":"10.1007/s00059-025-05317-x","url":null,"abstract":"Background: Renin-angiotensin system (RAS) blockers constitute a cornerstone in the management of patients with cardiovascular disease. However, the relationship between the administration time of these drugs during the day and cardiovascular events is not yet fully elucidated. We aimed to examine the relationship between the administration time of RAS blockers during the day and long-term cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI).Methods: A total of 701 patients who were admitted to our hospital between 2018 and 2020 with STEMI and underwent primary percutaneous coronary intervention (PCI) were included in this single-center, retrospective, observational study. Primary endpoints were acute heart failure (AHF), nonfatal myocardial infarction, major adverse cardiovascular events (MACE), and long-term mortality. Patients were divided into two group according to the administration of RAS blockers in the morning (06:00-10:00) or evening (20:00-00:00).Results: The mean age of the patients was 57.5 ± 11.9 years and 75.9% were male. After discharge, 485 patients were taking RAS blockers in the morning and 216 patients were taking them in the evening. There was a significantly higher rate of AHF, nonfatal myocardial infarction, MACE, and death in the group taking RAS blockers in the morning compared to the group taking them in the evening (p < 0.01, p = 0.02, p < 0.01, p < 0.01, respectively).Conclusion: Routine administration of RAS blockers in the evening rather than in the morning led to a remarkable decrease in the occurrence of AHF, nonfatal myocardial infarction, MACE, and mortality.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"460-468"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[First cardioverter defibrillator (ICD) shock : Diagnostic and therapeutic procedure]. [首次心脏转复除颤器（ICD）休克：诊断和治疗程序]。

IF 1.6 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-09-11 DOI: 10.1007/s00059-025-05338-6

Thomas Kleemann, Ralf Zahn

{"title":"[First cardioverter defibrillator (ICD) shock : Diagnostic and therapeutic procedure].","authors":"Thomas Kleemann, Ralf Zahn","doi":"10.1007/s00059-025-05338-6","DOIUrl":"10.1007/s00059-025-05338-6","url":null,"abstract":"Patients with an implantable cardioverter defibrillator (ICD) who receive an appropriate ICD shock are known to subsequently have a worse prognosis. Despite the knowledge about the poorer prognosis, in the guidelines there are no clear instructions on how to proceed after the occurrence of an adequate ICD shock. The ToVAMI concept represents a treatment regimen for patients with first appropriate ICD shock after ventricular tachycardia (VT) or ventricular fibrillation (VF) and consists of three steps: 1) To = trigger optimization with the following triggers summarized under the acronym ICD-STEMi (ischemia, compliance, decompensation, stress, technical issue, electrolyte/endocrinological disorder and medication intoxication), 2) VA = ventricular arrhythmia treatment and 3) MI = medicinal and interventional prognostic heart failure treatment. The treatment after the first ICD shock consists not only of ablation or antiarrhythmic treatment but also encompasses a comprehensive suite of diagnostic and therapeutic measures, which require a systematic approach. The systematic application of this regimen can increase the detection rate of trigger factors for VT/VF and essentially contributes to an optimized medicinal and interventional prognostic heart failure treatment. Approximately 10% of patients have no clinical symptoms of worsening heart failure or ischemia during the first ICD shock, despite objective evidence of progressive heart failure or ischemia. In these patients, the first VT/VF shock is the sole warning signal for worsening of the cardiac status. This underscores the need for a systematic diagnostic work-up and treatment after the first ICD shock.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"446-452"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Subcutaneous defibrillator (S-ICD)]. 皮下除颤器（S-ICD）。

IF 0.9 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-10-07 DOI: 10.1007/s00059-025-05344-8

Jürgen Kuschyk, Fabian Fastenrath, Katherine Sattler, Ibrahim Akin, Daniel Duerschmied, Boris Rudic

{"title":"[Subcutaneous defibrillator (S-ICD)].","authors":"Jürgen Kuschyk, Fabian Fastenrath, Katherine Sattler, Ibrahim Akin, Daniel Duerschmied, Boris Rudic","doi":"10.1007/s00059-025-05344-8","DOIUrl":"10.1007/s00059-025-05344-8","url":null,"abstract":"Defibrillator treatment should adhere to the guidelines to effectively prevent sudden cardiac death while minimizing all complications. As an entirely extrathoracic system, the subcutaneous implantable cardioverter defibrillator (S-ICD) eliminates the need for intracardiac leads, thus reducing procedural and lead-related complications as well as systemic infections. The evidence across > 5000 participants in randomized trials and registries demonstrates approximately 98% shock conversion with low complication rates. The PRAETORIAN study demonstrated that the S‑ICD is not inferior to the transvenous ICD (TV-ICD), long-term and secondary analyses indicate fewer severe, particularly lead-related, complications with S‑ICD treatment. Studies such as UNTOUCHED, EFFORTLESS, and PAS confirm its shock effectiveness and safety profile in routine clinical care, while the ATLAS study reports significantly fewer perioperative lead-related complications in younger patients. The procedure has been streamlined and standardized, incorporating best practices such as preoperative vector screening, a two-incision technique, intermuscular/submuscular pocket creation, and dual-zone programming with morphology/high-pass filtering. In the absence of indications for bradypacing, cardiac resynchronization therapy (CRT) or antitachycardia pacing (ATP), the S‑ICD should be considered a routine option in the clinical routine, especially for younger patients, those prone to infections, those with limited venous access and individuals with hereditary arrhythmia syndromes.","PeriodicalId":12863,"journal":{"name":"Herz","volume":" ","pages":"427-437"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[New developments in cardiac device therapy]. [心脏装置治疗的新进展]。

IF 1.6 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-11-27 DOI: 10.1007/s00059-025-05346-6

Thomas Kleemann, David Duncker

引用次数: 0

[Contemporary management of endocarditis]. 当代心内膜炎的处理。

IF 1.6 4区医学

Herz Pub Date : 2025-12-01 Epub Date: 2025-10-29 DOI: 10.1007/s00059-025-05339-5

Suzanne de Waha, Mateo Marín-Cuartas, Madlen Uhlemann, Manuela de la Cuesta, Steffen Desch, Roland R Tilz, Michael A Borger

引用次数: 0

Herz最新文献