Current Opinion in Cardiology最新文献

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Radiofrequency lesion formation prediction with contact force versus local impedance. 接触力与局部阻抗的射频损伤形成预测。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-10-09 DOI: 10.1097/HCO.0000000000001095
Ziad F Issa
{"title":"Radiofrequency lesion formation prediction with contact force versus local impedance.","authors":"Ziad F Issa","doi":"10.1097/HCO.0000000000001095","DOIUrl":"10.1097/HCO.0000000000001095","url":null,"abstract":"<p><strong>Purpose of review: </strong>Safe and effective radiofrequency (RF) myocardial ablation requires real-time monitoring of lesion formation. Here, we review conventional and novel approaches proposed to guide titration of RF energy application.</p><p><strong>Recent findings: </strong>Conventional monitoring modalities, such as ablation electrode temperature, generator impedance, and tissue electrophysiological properties have been of limited value in predicting efficacy and safety of ablation. Therefore, several input-driven indices have been proposed to improve the quality and durability of RF ablation lesion while maintaining safety. These metrics predominantly incorporate RF power output, duration of RF application, and firmness and stability of electrode-tissue contact. More recently, novel catheters have enabled measuring local impedance at the catheter-tissue interface, which has been found valuable for real-time monitoring of RF lesion formation.</p><p><strong>Summary: </strong>It is likely that using the combination of multiple metrics would be required to improve the quality and safety of RF lesions, but further investigation is still required.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41220741","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
2023 Update on equity, diversity, and inclusion in Canadian cardiac surgery. 2023加拿大心脏外科的公平性、多样性和包容性更新。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-11-07 DOI: 10.1097/HCO.0000000000001101
Lina A Elfaki, Rosalind Groenewoud, Akachukwu Nwakoby, Areeba Zubair, Raj Verma, Bobby Yanagawa
{"title":"2023 Update on equity, diversity, and inclusion in Canadian cardiac surgery.","authors":"Lina A Elfaki, Rosalind Groenewoud, Akachukwu Nwakoby, Areeba Zubair, Raj Verma, Bobby Yanagawa","doi":"10.1097/HCO.0000000000001101","DOIUrl":"10.1097/HCO.0000000000001101","url":null,"abstract":"<p><strong>Purpose of review: </strong>Despite efforts to diversify the medical field, cardiac surgery remains amongst the least diverse specialties. Specifically, the percentage of women and racial minorities has remained low in past few decades. This may impact prospective trainee recruitment and surgical care. This paper highlights recent efforts that aim to promote diversity and inclusion of the Canadian cardiac surgical workforce.</p><p><strong>Recent findings: </strong>Formal programs have been established to support students at different stages of training. In 2022, the Canadian Society for Cardiac Surgery has released an equity, diversity, and inclusion statement to summarize the current state and the strategic goals to accomplish a more just working environment. At the local level, the University of Toronto Next Surgeon high school pilot program, provided low-income, women, and racial minority students mentorship and experiential exposure to our field. Also, the University of Toronto, scholarships funded summer research with cardiac surgeons for women, as well as Black and Indigenous medical students.</p><p><strong>Summary: </strong>Tangible efforts that target high school, undergraduate, and medical students are underway to promote equity and diversity of cardiac surgeons in Canada. Future studies that evaluate the gaps and identify bottlenecks could better guide interventions at institutions across the country.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489194","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
Advances in cardiac pacing with leadless pacemakers and conduction system pacing. 无引线起搏器心脏起搏和传导系统起搏的进展。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-21 DOI: 10.1097/HCO.0000000000001092
Sulaiman Somani, Albert J Rogers
{"title":"Advances in cardiac pacing with leadless pacemakers and conduction system pacing.","authors":"Sulaiman Somani, Albert J Rogers","doi":"10.1097/HCO.0000000000001092","DOIUrl":"10.1097/HCO.0000000000001092","url":null,"abstract":"<p><strong>Purpose of review: </strong>The field of cardiac pacing has undergone significant evolution with the introduction and adoption of conduction system pacing (CSP) and leadless pacemakers (LLPMs). These innovations provide benefits over conventional pacing methods including avoiding lead related complications and achieving more physiological cardiac activation. This review critically assesses the latest advancements in CSP and LLPMs, including their benefits, challenges, and potential for future growth.</p><p><strong>Recent findings: </strong>CSP, especially of the left bundle branch area, enhances ventricular depolarization and cardiac mechanics. Recent studies show CSP to be favorable over traditional pacing in various patient populations, with an increase in its global adoption. Nevertheless, challenges related to lead placement and long-term maintenance persist. Meanwhile, LLPMs have emerged in response to complications from conventional pacemaker leads. Two main types, Aveir and Micra, have demonstrated improved outcomes and adoption over time. The incorporation of new technologies allows LLPMs to cater to broader patient groups, and their integration with CSP techniques offers exciting potential.</p><p><strong>Summary: </strong>The advancements in CSP and LLPMs present a transformative shift in cardiac pacing, with evidence pointing towards enhanced clinical outcomes and reduced complications. Future innovations and research are likely to further elevate the clinical impact of these technologies, ensuring improved patient care for those with conduction system disorders.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154163","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
Left atrial appendage closure: the journey today and tomorrow. 左心耳封堵术:今天和明天的旅程。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-10-20 DOI: 10.1097/HCO.0000000000001091
Marvin Louis Roy Lu, David Bowers De Lurgio
{"title":"Left atrial appendage closure: the journey today and tomorrow.","authors":"Marvin Louis Roy Lu, David Bowers De Lurgio","doi":"10.1097/HCO.0000000000001091","DOIUrl":"10.1097/HCO.0000000000001091","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to discuss the rationale behind the development of percutaneous LAAC devices as a treatment option for atrial fibrillation patients ineligible for long-term anticoagulation. The evolution of LAAC, from early experiences and challenges to risk mitigation and improved devices and techniques, will be examined. Furthermore, the review will explore our current understanding of the potential and limitations of LAAC in stroke prevention.</p><p><strong>Recent findings: </strong>Multiple trials confirm LAAC device safety and efficacy for stroke prevention, but peri-device leak and thrombus remain concerns postimplantation. Even small leaks pose increased stroke risk. While guidelines suggest short-term anticoagulation postimplant; real-world data show equivalent efficacy with dual antiplatelet regimen.</p><p><strong>Summary: </strong>LAAC device design has evolved and now serve as a viable option for stroke prevention in high-risk atrial fibrillation patients, offering protection in the absence of anticoagulation.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694177","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
Neurologic impact of atrial fibrillation. 心房颤动对神经系统的影响。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/HCO.0000000000001093
Daniel R Feldman, Emily P Zeitler
{"title":"Neurologic impact of atrial fibrillation.","authors":"Daniel R Feldman, Emily P Zeitler","doi":"10.1097/HCO.0000000000001093","DOIUrl":"10.1097/HCO.0000000000001093","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cognitive dysfunction is a complex condition that is becoming increasingly more prevalent. There has been growing acknowledgement that individuals with atrial fibrillation are at an increased risk of cognitive dysfunction beyond the association of age with both disorders. The purpose of this review is to explore the potential underlying mechanisms connecting atrial fibrillation and cognitive dysfunction and to examine the existing evidence for potential treatment options.</p><p><strong>Recent findings: </strong>Many mechanisms have been proposed for the association between cognitive dysfunction and atrial fibrillation. These include cerebral infarction (both micro and macro embolic events), cerebral microbleeds including those secondary to therapeutic anticoagulation, an increased inflammatory state, cerebral hypoperfusion, and a genetic predisposition to both diseases. Treatments designed to target each of these mechanisms have led to mixed results and there are no specific interventions that have definitively led to a reduction in the incidence of cognitive dysfunction.</p><p><strong>Summary: </strong>The relationship between cognitive dysfunction and atrial fibrillation remains poorly understood. Standard of care currently focuses on reducing risk factors, managing stroke risk, and maintaining sinus rhythm in appropriately selected patients. Further work needs to be conducted in this area to limit the progression of cognitive dysfunction in patients with atrial fibrillation.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184569","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
Perspectives on pulsed field ablation: how to judge endpoints. 脉冲场消融的视角:如何判断终点。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-11 DOI: 10.1097/HCO.0000000000001094
Valeria Anglesio, Atul Verma
{"title":"Perspectives on pulsed field ablation: how to judge endpoints.","authors":"Valeria Anglesio, Atul Verma","doi":"10.1097/HCO.0000000000001094","DOIUrl":"10.1097/HCO.0000000000001094","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights pulse field ablation's (PFA) significance in treating atrial fibrillation. PFA uses short-pulsed electrical fields, offering safety advantages over thermal methods. Multicenter studies' findings on PFA's safety, efficiency, and efficacy, compared with thermal techniques, are discussed.</p><p><strong>Recent findings: </strong>The review encompasses major PFA systems utilized in multicenter studies: penta-spline, circular, and lattice catheters. These studies affirm PFA's safety, with minimal complications like esophageal injury, phrenic nerve complications, and pulmonary vein stenosis. PFA also demonstrates procedural efficiency benefits because of rapid pulse delivery. However, PFA's efficacy appears on par with thermal ablation, showing similar rates of atrial arrhythmia recurrence during follow-up periods. The studies explore diverse postablation monitoring strategies, underscoring the necessity for standardized monitoring or consistent transformation of arrhythmia data.</p><p><strong>Summary: </strong>In conclusion, PFA marks a promising era for atrial fibrillation treatment with improved safety and efficiency. Efficacy is comparable to thermal methods, though technology advancements could alter this. PFA's potential as a safer and faster alternative positions it as a dominant atrial fibrillation ablation technology. Careful analysis and standardized monitoring are vital to assess PFA's potential and clinical implications.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609986","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
Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and apolipoprotein B for cardiovascular care. 用于心血管护理的低密度脂蛋白胆固醇、非高密度脂蛋白蛋白胆固醇和载脂蛋白B。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-11-06 DOI: 10.1097/HCO.0000000000001100
Selin Bilgic, Allan D Sniderman
{"title":"Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and apolipoprotein B for cardiovascular care.","authors":"Selin Bilgic, Allan D Sniderman","doi":"10.1097/HCO.0000000000001100","DOIUrl":"10.1097/HCO.0000000000001100","url":null,"abstract":"<p><strong>Purpose of review: </strong>Some experts and consensus groups continue to argue that apolipoprotein B (apoB) should not be introduced broadly into clinical care. But, too often, the present approach to clinical care is not succeeding. An important reason for this failure, we believe, is that the conventional approach limits what the expert clinician can accomplish and is too complex, confusing, and contradictory for primary care physicians to apply effectively in their practise.</p><p><strong>Recent findings: </strong>There are four major reasons that apoB should be measured routinely in clinical care. First, apoB is a more accurate marker of cardiovascular risk than LDL-C or non-HDL-C. Second, the measurement of apoB is standardized whereas the measurements of LDL-C and non-HDL-C are not. Third, with apoB and a conventional lipid panel, all the lipid phenotypes can be simply and accurately distinguished. This will improve the care of the expert. Fourth, apoB, as the single measure to evaluate the success of therapy, would simplify the process of care for primary care physicians.</p><p><strong>Summary: </strong>By introducing apoB broadly into clinical care, the process of care will be improved for both the expert and the primary care physician, and this will improve the outcomes of care.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489195","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
Reconsideration of the definition of blanking period and significance of early recurrences after catheter ablation of atrial fibrillation. 心房颤动导管消融术后空白期定义及早期复发意义的再思考。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-09-18 DOI: 10.1097/HCO.0000000000001096
Songnan Wen, Yu Liao, Tejas S Khurana, Rong Bai
{"title":"Reconsideration of the definition of blanking period and significance of early recurrences after catheter ablation of atrial fibrillation.","authors":"Songnan Wen, Yu Liao, Tejas S Khurana, Rong Bai","doi":"10.1097/HCO.0000000000001096","DOIUrl":"10.1097/HCO.0000000000001096","url":null,"abstract":"<p><strong>Purpose of review: </strong>Early recurrence of atrial tachyarrhythmia (ERAT) during blanking period (BP) is not uncommon after catheter ablation of AF. Current guidelines and consensus statements recommend conservative treatment of ERAT. This review summarized recent studies, underlying mechanism and clinical managements of ERAT, and proposed a reconsideration of the definition and clinical significance of BP.</p><p><strong>Recent findings: </strong>Recent studies have shown that the entity of ERAT in the very early phase of BP (i.e., first 4 weeks of the 3-month period) is different from those ERATs occurring late which is strongly associated with the late recurrence of atrial tachyarrhythmia. The optimal BP duration suggested by clinical observation ranges from 21 to 58 days. Using antiarrhythmic drugs and early electrical cardioversion are the effective management for ERAT, whereas re-ablation is a reasonable strategy although remains controversial.</p><p><strong>Summary: </strong>The definition of BP with a shorter duration, that is, 1 month instead of 3 months post AF ablation, is supported by the observations of latest clinical studies. Recurrent atrial tachyarrhythmia beyond the 1-month time frame is associated with higher risk of late recurrence and may warrant repeat ablation. A revisit to the guideline recommendation on management of ERAT is needed to change clinical practice.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141513","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
Cardiovascular disease prevention in women - the current state in 2023. 妇女心血管疾病预防——2023年的现状。
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2024-01-01 Epub Date: 2023-11-03 DOI: 10.1097/HCO.0000000000001099
Aarti Purohit, Yoo Jin Kim, Erin D Michos
{"title":"Cardiovascular disease prevention in women - the current state in 2023.","authors":"Aarti Purohit, Yoo Jin Kim, Erin D Michos","doi":"10.1097/HCO.0000000000001099","DOIUrl":"10.1097/HCO.0000000000001099","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality for women globally. The purpose of this review is to provide an updated overview of CVD prevention in women, focusing on what is currently understood about female-specific or female-predominant CVD risk factors and the importance of tailored strategies for risk assessment and medical interventions.</p><p><strong>Recent findings: </strong>Recent studies have demonstrated the need to account for risk factors specific to women in current risk assessment models for CVD, including early menarche, polycystic ovary syndrome, adverse pregnancy outcomes, early menopause, and chronic inflammatory conditions. Incorporation of these findings has led to advancements in sex-specific guidelines, diagnostic tools, and treatment approaches that have led to improvement in the precision of CVD prevention strategies. At-risk women benefit similarly to lipid-lowering and other preventive therapies as men but are less likely to be treated.</p><p><strong>Summary: </strong>CVD prevention in women has made substantial progress over the past decade, marked by increasing awareness among clinicians, improved understanding of sex-specific risk-enhancing factors, and incorporation of sex-specific guidelines for management. However, there remain knowledge gaps that warrant ongoing efforts to optimize CVD prevention strategies in women, which will ultimately lead to improved cardiovascular health outcomes.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429363","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
Measuring lipoprotein(a) for cardiovascular disease prevention - in whom and when? 测量脂蛋白(a)以预防心血管疾病--何人、何时?
IF 2.3 4区 医学
Current Opinion in Cardiology Pub Date : 2023-11-03 DOI: 10.1097/hco.0000000000001104
Peter E Thomas, Signe Vedel-Krogh, Børge G Nordestgaard
{"title":"Measuring lipoprotein(a) for cardiovascular disease prevention - in whom and when?","authors":"Peter E Thomas, Signe Vedel-Krogh, Børge G Nordestgaard","doi":"10.1097/hco.0000000000001104","DOIUrl":"https://doi.org/10.1097/hco.0000000000001104","url":null,"abstract":"The aim of this study is to summarize major cardiovascular guideline recommendations on lipoprotein(a) and highlighting recent findings that emphasize how measuring lipoprotein(a) once in all adults is meaningful regardless of age, sex, comorbidities, or ethnicity.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138686852","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
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