Progress in cardiovascular diseases最新文献

{"title":"Pulsed field ablation: The basics relating to effectiveness, durability, and safety","authors":"Sara Vázquez-Calvo,&nbsp;Deepti Ranganathan,&nbsp;Atul Verma","doi":"10.1016/j.pcad.2025.05.007","DOIUrl":"10.1016/j.pcad.2025.05.007","url":null,"abstract":"<div><div><span>Pulsed field ablation (PFA) represents an innovative energy delivery approach for cardiac arrhythmia treatment, characterized by a favorable safety profile and effective </span>myocardial lesion<span><span> formation. It has demonstrated high acute pulmonary vein isolation<span> rates with a reduced incidence of injury to adjacent </span></span>anatomical structures<span>. Nonetheless, procedure-specific complications such as haemolysis, intravascular gas formation, and coronary vasospasm<span> have been observed and warrant further evaluation. Clinical evidence supports efficacy comparable to conventional thermal ablation in terms of arrhythmia recurrence. Ongoing advancements in catheter engineering, pulse modulation, and multimodal energy strategies aim to enhance lesion durability and transmurality. These developments position PFA as a promising technology in the field of cardiac ablation.</span></span></span></div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 38-48"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac implantable electronic devices in pediatric and congenital populations","authors":"Douglas Y. Mah,&nbsp;John K. Triedman","doi":"10.1016/j.pcad.2025.05.005","DOIUrl":"10.1016/j.pcad.2025.05.005","url":null,"abstract":"<div><div><span><span>Pediatric patients and children and adults with congenital heart disease often will require implantation of cardiac implantable electronic devices (CIEDs) for management of a variety of cardiac rhythm pathologies. The safe and effective use of CIEDs in these patients requires an awareness of important differences between this special population and the adult populations for whom these devices were primarily developed and in whom they have been most thoroughly studied. These include issues of body size and growth, anticipated lifespan, anatomical issues related to implantation and the </span>epidemiology of underlying rhythm issues. In this paper, we discuss these issues in the context of the current state of the art in </span>pediatric and congenital heart disease patients with respect to implant and lead extraction strategies, physiological cardiac pacing and resynchronization, ICD indications and use of transvenous and subcutaneous devices, and the use of implantable monitoring devices.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 121-129"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword","authors":"Evan L. O'Keefe ,&nbsp;James H. O'Keefe ,&nbsp;Hussam Abuissa ,&nbsp;Mark Metzinger ,&nbsp;Ellen Murray ,&nbsp;Grant Franco ,&nbsp;Carl J. Lavie ,&nbsp;William S. Harris","doi":"10.1016/j.pcad.2024.11.003","DOIUrl":"10.1016/j.pcad.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid<span><span> (EPA) and docosahexaenoic acid (DHA), on risk of </span>atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.</span></div></div><div><h3>Patients and methods</h3><div><span>A PubMed<span> search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, </span></span>vagal tone<span>. We summarized findings from randomized clinical trials<span> (RCTs), epidemiology studies, and meta-analyses evaluating effects/associations of DHA + EPA on risk of AF. Also, vagal tone was explored as a mediator between omega-3 and risk of AF.</span></span></div></div><div><h3>Results</h3><div><span>Meta-analyses of 8 RCTs and 17 prospective cohort studies comprised of 83,112 and 54,799 individuals, respectively, investigated the link between omega-3 intake and incident AF. The RCTs reported that treatment with DHA and/or EPA was associated with a 24 % increased relative risk of AF (absolute risk 4.0 % vs 3.3 %; relative risk [RR] 1.24, 95 % confidence interval [CI] 1.11–1.38, </span><em>p</em><span> = 0.0002). This was dose-dependent; DHA + EPA doses of ∼1000 mg/d increased AF risk ∼12 %, whereas 1800 to 4000 mg/d increased AF risk by ∼50 %. In contrast, observational studies focused on DHA + EPA blood levels or dietary intake have generally reported that higher omega-3 levels/consumption are associated with lower AF risk. Maximal AF risk reduction.</span></div><div>(12 %) occurred at ∼650 mg/d of dietary DHA + EPA. Other studies have indicated that omega-3 fatty acids can dose-dependently increase vagal tone, which could explain the biphasic relationship between DHA + EPA and AF risk. Experimental studies show that low-level vagal stimulation decreases risk of AF, whereas high-level vagal stimulation increases risk of AF.</div></div><div><h3>Conclusion</h3><div>Higher consumption of dietary omega-3 is associated with decreased AF risk. In contrast, pharmaceutical dosing of omega-3 increases AF in a dose-dependent manner, which may be mediated by vagal tone.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 3-9"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter ablation as first line therapy for atrial fibrillation","authors":"Maham F. Karatela,&nbsp;Hugh Calkins","doi":"10.1016/j.pcad.2025.07.009","DOIUrl":"10.1016/j.pcad.2025.07.009","url":null,"abstract":"<div><div>The treatment for atrial fibrillation has evolved significantly over time. Previously, medication management was the mainstay of treatment. As we have developed more robust technologies and modalities for catheter ablation, these treatment recommendations have changed. Catheter ablation is a safe and effective strategy for treating atrial fibrillation that is now considered first-line therapy in some patient populations. In this review, we discuss historical perspectives regarding the treatment and management of atrial fibrillation. We review the literature on studies investigating catheter ablation as first-line therapy, including the impact of catheter ablation on arrhythmia recurrence, cardiovascular outcomes, and healthcare utilization. Finally, we discuss future directions for the management of atrial fibrillation as the technology for catheter ablation continues to grow and progress.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 33-37"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadless pacing: Technology, techniques, and emerging options","authors":"Wissam Mekary,&nbsp;Colby Shanafelt,&nbsp;Elsa Hebbo,&nbsp;Mikhael F. El-Chami","doi":"10.1016/j.pcad.2025.07.002","DOIUrl":"10.1016/j.pcad.2025.07.002","url":null,"abstract":"<div><div>Leadless pacemakers offer several advantages over transvenous pacemakers. They mainly reduce lead and pocket related complications which result in a reduction of re-intervention and infection rates (Graphical abstract). However, leadless pacemakers are not without drawbacks. Implantation of leadless pacemakers present a higher risk of pericardial perforation compared to its transvenous counterpart. Also, the leadless pacing technology is relatively new, and little is known about the best approach to manage these devices at the time of an upgrade or when the battery is at end of life. A modular approach for leadless pacing is emerging as a logical way to minimize the amount of hardware in the heart while preserving the ability to upgrade a single chamber device to a dual chamber (Graphical abstract). This review aims to present an overview of the different leadless pacemakers, indications for implantation, guidance on extraction while highlighting the advances made in the field.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 103-112"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fat, fib, and forgetfulness: The interplay between adiposity, atrial fibrillation, and dementia","authors":"Tyson S. Burnham ,&nbsp;Ravi Ranjan ,&nbsp;Klitos Konstantinidis ,&nbsp;Benjamin A. Steinberg ,&nbsp;T. Jared Bunch","doi":"10.1016/j.pcad.2025.07.006","DOIUrl":"10.1016/j.pcad.2025.07.006","url":null,"abstract":"<div><div>Atrial Fibrillation, dementia, and obesity are prevalent and interconnected pathologic states with significant morbidity and mortality and increasing global incidence. This review examines the current literature regarding the known and hypothesized relationships between these three conditions, their risk factors, and treatment strategies. We aim to highlight a stepwise and potentially causative interplay between them. As all three states become increasingly common in clinical practice, a detailed understanding of their multifactorial and multimodal relationship becomes critical for effective multidisciplinary care. Appropriate treatment of each is likely to reduce the burden of all three.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 10-17"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of ventricular tachycardia in patients with advanced heart failure","authors":"Ioan Liuba,&nbsp;Jakub Sroubek,&nbsp;Pasquale Santangeli","doi":"10.1016/j.pcad.2025.04.006","DOIUrl":"10.1016/j.pcad.2025.04.006","url":null,"abstract":"<div><div><span><span>Ventricular arrhythmias (VAs) are highly prevalent in patients with advanced heart failure (AHF), a condition characterized by severe </span>signs and symptoms<span><span> despite conventional HF therapy. The management of VAs in this setting remains challenging. Antiarrhythmic drug therapy options are limited and only </span>amiodarone<span> has demonstrated effectiveness in suppressing VA, albeit this agent is associated with a substantial risk of cardiac and noncardiac adverse effects<span>. Catheter ablation is effective for the reduction of VAs in patients with AHF. Identification of patients at high risk for periprocedural </span></span></span></span>hemodynamic<span> decompensation has important implications in terms of procedural planning and improving patient safety and procedural outcomes. Herein, we review the current state of scientific evidence for the management of VA in patients with AHF.</span></div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 90-102"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates on inherited arrhythmia syndromes (Brugada syndrome, long QT syndrome, CPVT, ARVC)","authors":"Benjamin M. Moore,&nbsp;Thomas M. Roston,&nbsp;Zachary Laksman,&nbsp;Andrew D. Krahn","doi":"10.1016/j.pcad.2025.06.002","DOIUrl":"10.1016/j.pcad.2025.06.002","url":null,"abstract":"<div><div>The inherited arrhythmia (IA) syndromes are a group of rare and complex conditions that may predispose individuals to ventricular arrhythmias and sudden cardiac death. Our understanding of the genetic architecture underlying these syndromes has evolved, with recent reappraisals of variant pathogenicity and quantification of polygenic influences. The IA population includes an increasing proportion of low-risk patients, often identified via familial screening; avoiding over-treatment in these patients is an important consideration. Conversely, high-risk patients have an expanding armamentarium of targeted therapeutic interventions available beyond the ICD, with many emerging novel therapies. Refined risk stratification in the intermediate risk group is critical, utilising novel risk factors, genotype and multiparametric risk scores. Artificial intelligence will almost certainly play a role in diagnosis and risk stratification moving forward. Durable phenotype correction with gene therapy (or precision ablation) is an ultimate goal. This review will focus on updates in pathophysiology, diagnosis, risk stratification and management of Brugada syndrome, long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and arrhythmogenic right ventricular cardiomyopathy.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 130-143"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of conduction system pacing and gaps in understanding","authors":"Srinath Yeshwant,&nbsp;Gaurav A. Upadhyay","doi":"10.1016/j.pcad.2025.06.006","DOIUrl":"10.1016/j.pcad.2025.06.006","url":null,"abstract":"<div><div>The field of cardiac pacing has changed dramatically since the first pacemakers were implanted in the 1950s.<span><span>¹</span></span><span><span> Over the ensuing decades, advancements in pacing technology have yielded longer battery life, smaller devices, sturdier leads, and more sophisticated pacemaker programming. Cardiac resynchronization therapy (CRT) represented a significant revolution in pacing approach, with the goal of correcting interventricular dyssynchrony through biventricular pacing. More recently, conduction system pacing (CSP) has emerged as a means to deliver even more physiological activation through direct engagement of the conduction system. The enthusiasm for CSP, driven primarily by investigator-initiated studies, has led to a rapid evolution in our understanding of conduction system physiology and represents a contemporary paradigm shift in our approach to treating patients with </span>bradyarrhythmias and heart failure. The goal of this review is to provide a brief overview of the progression of CSP over time and to highlight key gaps in our understanding that need to be resolved prior to moving forward (Graphical Abstract).</span></div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"91 ","pages":"Pages 113-120"},"PeriodicalIF":7.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The culture of healthy living in communities","authors":"Ross Arena ,&nbsp;Grenita Hall","doi":"10.1016/j.pcad.2025.03.015","DOIUrl":"10.1016/j.pcad.2025.03.015","url":null,"abstract":"<div><div>What defines a group of individuals as part of a community is broadly interpreted and depends on the context of the group being categorized. For this review, community may be defined as “as a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings”. A given community will possess unique cultural attributes, defined by the American Psychological Association as “the values, beliefs, language, rituals, traditions, and other behaviors that are passed from one generation to another within any social group”. Unhealthy lifestyle behaviors drive the unacceptably high incidence and prevalence of chronic disease in the United States. Despite well intentioned efforts, society appears to be failing at altering the trajectory of unhealthy lifestyle behaviors, from an individual to population level. Perhaps our oftentimes one size fits all approach to health behavior messaging and counseling is a critical shortcoming. The fact that being more physically active, not smoking and consuming a healthier diet is of great benefit to human physiology and therefore human health outcomes is clear. However, human health behaviors or decisions to make a change in behavior are not driven by physiology but rather a complexly interacting milieu of factors - cultural drivers unique to a community amongst them. Herein, we discuss several community settings where there are opportunities to promote a culture of health living. This review will focus on settings that embody the definitions of community and culture described previously.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"90 ","pages":"Pages 32-37"},"PeriodicalIF":5.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}