| Page | Description | Tags | Date |
|---|---|---|---|
| sources/asundexian-oceanicaf-nejm-2025 | Piccini et al. 2025 NEJM OCEANIC-AF phase 3 double-blind, double-dummy RCT (n=14,810; 1,035 sites, 38 countries; AF, mean CHA₂DS₂-VASc 4.3, 18.6% CKD; asundexian 50 mg once daily vs apixaban; median follow-up 155 days): stopped on 19 November 2023 for excess stroke — stroke or systemic embolism 98 (1.3%) vs 26 (0.4%), cause-specific HR 3.79 (2.46–5.83); ischaemic stroke HR 4.06 (2.52–6.54); excess present from trial start and persisted; ISTH major bleeding 17 (0.2%) vs 53 (0.7%), HR 0.32 (0.18–0.55); major or CRNM 1.1% vs 2.6% (HR 0.44); ICH 3 vs 18 (HR 0.16); composite of stroke, systemic embolism or major bleeding favoured apixaban, HR 1.61 (1.21–2.15); death HR 0.84; asundexian half-life 16–18 h, <15% renal elimination; PACIFIC-AF 50 mg produced 92% trough and 94% peak factor XIa suppression, possibly below the near-complete >99% needed; apixaban arm beat its own CHA₂DS₂-VASc prediction and ARISTOTLE; single dose, early termination, no formal safety testing; ended the first wave of factor XIa inhibition in AF | atrial-fibrillation, factor-xi-inhibition, anticoagulation, stroke-prevention, randomized-controlled-trial | 2026-10-29 |
| sources/abelacimab-azaleatimi71-nejm-2025 | Ruff et al. 2025 NEJM AZALEA–TIMI 71 phase 2b partially blinded RCT (n=1,287; 95 centres, 7 countries; AF, median CHA₂DS₂-VASc 5, median HAS-BLED 2–3, 92% prior anticoagulant ≥60 days; abelacimab 150 mg or 90 mg subcutaneously monthly vs open-label rivaroxaban 20 mg; primary major or clinically relevant nonmajor bleeding): stopped early at median 1.8 years for greater-than-anticipated benefit — 3.22 and 2.64 vs 8.38 events/100 person-years (HR 0.38, 0.24–0.60; HR 0.31, 0.19–0.51); major bleeding 1.22 and 0.99 vs 3.73 (HR 0.33/0.26); GI bleeding 2 events in each abelacimab arm vs 18 (HR 0.11, 0.03–0.48); ICH 2 and 4 vs 4 patients; ischaemic stroke numerically higher, 1.21 and 1.24 vs 0.59/100 person-years (HR 2.06 and 2.10, both CIs crossing 1); net clinical outcome HR 0.55/0.58; free factor XI reduced 99% at 150 mg and 97% (IQR 51–99) at 90 mg; no antidrug antibodies; injection-site reactions 2.8%/1.6%; neither dose arm powered for stroke prevention; LILAC–TIMI 76 tests abelacimab against placebo in patients unsuitable for anticoagulation | atrial-fibrillation, factor-xi-inhibition, anticoagulation, bleeding, randomized-controlled-trial | 2026-10-29 |
| sources/af-ablation-asd-device-jce-2020 | Garg et al. 2020 J Cardiovasc Electrophysiol systematic review and meta-analysis of AF ablation in patients with a percutaneous ASD closure device (3 single-arm series, n=64; follow-up 6–22 months; mean age 54; LA 45 mm; 81% had AF before closure): transseptal puncture 100% successful, 81.25% via native septum and 18.75% through the device, all but one under fluoroscopy plus ICE; acute procedural success 98.4%; freedom from AF 77.7% (65.7–86.3; I²=0); recurrence 23.07% vs 16.66% (RR 1.18, 0.35–4.00; P=0.79); total procedure time 237.3 vs 180 min (P=0.004) although fluoroscopy time did not differ; no device dislodgement, residual interatrial shunt or device deformation; 4.7% inadvertent epicardial puncture (3/64) despite all series coming from high-volume centres; pooled observation supports safety ≥6 months after implantation; no comparator, no pooling of complications by route — medium certainty | atrial-fibrillation, catheter-ablation, atrial-septal-defect, transseptal-puncture, meta-analysis | 2026-10-29 |
| sources/adapt-af-des-nejm-2026 | Lee/Yu/Lee et al. 2026 NEJM ADAPT AF-DES open-label noninferiority RCT (n=960; 32 South Korean centres; AF + second/third-generation DES ≥1 year earlier; NOAC monotherapy vs NOAC + clopidogrel; 12 months): NACE 9.6% vs 17.2% (RD −7.6 pp; 95.2% CI −11.9 to −3.3; HR 0.54; noninferior and superior); major or CRNM bleeding 5.2% vs 13.2% (HR 0.38); major bleeding 2.3% vs 6.1%; stent thrombosis 0.4% both; stroke 1.0% vs 0.8%; ischaemic composite 3.3% vs 4.0% (NS); inappropriate NOAC underdosing 11.3% vs 29.0%; apixaban/rivaroxaban only; first DES-specific trial | atrial-fibrillation, drug-eluting-stent, NOAC, antithrombotic-therapy, randomized-controlled-trial | 2026-10-29 |
| sources/elan-doac-timing-nejm-2023 | Fischer/Koga/Strbian et al. 2023 NEJM ELAN open-label assessor-blinded RCT (n=2,013; 103 sites; 15 countries; AF + acute ischaemic stroke; stroke severity by infarct size; early vs later DOAC initiation): primary 30-day composite 2.9% vs 4.1% (adjusted RD −1.18 pp; 95% CI −2.84 to 0.47; OR 0.70); recurrent ischaemic stroke 1.4% vs 2.5% (OR 0.57); symptomatic ICH 0.2% both arms; 90-day composite 3.7% vs 5.6% (OR 0.65; exploratory); no formal hypothesis test — 98% probability early treatment adds ≤0.5 pp risk; primary evidence behind Class IIa early initiation after AF-related stroke | atrial-fibrillation, ischemic-stroke, anticoagulation, DOAC, randomized-controlled-trial | 2026-10-29 |
| sources/tavr-smart-nejm-2024 | Herrmann/Mehran/Blackman et al. 2024 NEJM SMART post-market RCT (716 treated; 83 sites, 13 countries; symptomatic severe AS with annulus ≤430 mm²; 86.7% women; bicuspid eligible; self-expanding supraannular Evolut PRO/PRO+/FX vs balloon-expandable SAPIEN 3/3 Ultra; 12 months): clinical coprimary (death/disabling stroke/HF rehospitalisation) 9.4% vs 10.6% (difference −1.2 pp; 90% CI −4.9 to 2.5; non-inferior; HR 0.90); bioprosthetic-valve dysfunction 9.4% vs 41.6% (difference −32.2 pp; 95% CI −38.7 to −25.6; superior), driven by haemodynamic SVD 3.2% vs 32.2% rather than thrombosis/endocarditis/reintervention; mean gradient 7.7 vs 15.7 mmHg; EOA 1.99 vs 1.50 cm²; moderate/severe PPM 11.2% vs 35.3%; new pacemaker 12.1% vs 7.8% (HR 1.61, 0.98–2.65); 5-year follow-up ongoing; Medtronic-funded with sponsor-led analysis | aortic-stenosis, TAVR, small-aortic-annulus, prosthesis-patient-mismatch, bioprosthetic-valve-dysfunction, randomized-controlled-trial | 2026-10-29 |
| sources/zilebesiran-ht-nejm-2023 | Desai/Webb/Taubel et al. 2023 NEJM phase 1 study (n=107; four UK sites; hypertension after ≥2-week washout; 18–65 years; diabetes, CVD and age >65 excluded): GalNAc-siRNA silencing hepatic angiotensinogen — single doses ≥200 mg lowered 24-hour ambulatory SBP >10 mmHg and DBP >5 mmHg by week 8, sustained to week 24; 800 mg −22.5/−10.8 mmHg at week 24 (n=8) with >90% angiotensinogen knockdown; effect abolished by a 5.75 g/day salt diet and augmented by irbesartan; 5 mild injection-site reactions, no hypotension/hyperkalaemia/renal events; no hypothesis testing and no outcomes; KARDIA-1/2 phase 2 ongoing; Alnylam-funded | hypertension, RNA-interference, angiotensinogen, blood-pressure-lowering, phase-1-trial | 2026-10-29 |
| sources/pfo-jama-2021 | Kent, Saver, Kasner, Carroll, Mas, Thaler et al. 2021 JAMA individual-patient-data meta-analysis (JAMA 2021;326(22):2277–2286) — the SCOPE consortium pooling all 6 randomised trials (3,740 patients, 121 events, median follow-up 57 months), and the primary source of PASCAL and of every effect estimate now quoted across this wiki. Annualised stroke 0.47% with closure vs 1.09% with medical therapy (adjusted HR 0.41, 0.28–0.60; 2-year ARR 1.72%) — an NNT of roughly 50, which the authors calibrate against antihypertensives, antiplatelets and statins. Two findings the secondary literature under-reports: closure cuts PFO-associated recurrence by 76% (HR 0.24) but all ischaemic recurrence by only 59%, and disability-worsening stroke never reached significance (HR 0.59, P=.14). Heterogeneity is the point: RoPE interacts significantly (P=.02) yet both strata benefit (HR 0.61 vs 0.21, NNT 91 vs 49), so it cannot guide decisions, whereas the PASCAL "unlikely" stratum (~15% of patients) is a true null (HR 1.14, ARR −0.7%) with more AF (risk difference +4.41% beyond 45 days vs 0.65% in probable). Safety: AF RR 4.54, beyond-45-day AF RR 2.60, VTE RR 2.59 (unexplained), major bleeding RR 0.80. Robust to per-protocol, as-treated, multiple imputation and leave-one-out; the tipping point requires 2-fold worse device outcomes to nullify. The extended PASCAL categories (straddling thrombus, concomitant DVT) could not be evaluated — those patients were not identified in the trial data, which is exactly the escape clause ESO 2024 relies on. Authors are the six trials' principal investigators with extensive device-industry disclosures | #patent-foramen-ovale, #pfo-closure, #pascal-classification, #rope-score, #heterogeneity-of-treatment-effect, #individual-patient-data-meta-analysis, #cryptogenic-stroke | 2026-10-27 |
| sources/pfo-eso-2024 | Caso, Turc, Abdul-Rahim, Pristipino et al. 2024 European Stroke Organisation guideline (Eur Stroke J 2024;9(4):800–834) — GRADE, six PICO questions, and the more sceptical of the two current PFO documents. Its central move is to insist that a PFO found after a cryptogenic stroke is not a PFO that caused it: recurrence on medical therapy is ~1/100 person-years, so closure operates on a small absolute risk and the treatment effect is almost entirely confined to PASCAL probable (HR 0.10) while being absent in unlikely (HR 1.14). High-quality evidence for closure plus antiplatelet therapy in selected patients aged 18–60 (SCOPE IPD-MA: annualised stroke 0.47% vs 1.09%, adjusted HR 0.41); large shunt plus atrial septal aneurysm gives 2-year ARR 5.5% and NNT 14. No evidence-based recommendation on diagnosis at all — c-TOE, the conventional reference, has only 89% sensitivity against autopsy/surgery/catheterisation; c-TCD 0.96/0.90 (AUC 0.96) versus c-TTE 0.71/0.99 (AUC 0.71). Anticoagulation: weak for closure over OAC, no recommendation for OAC versus APT. Post-procedure DAPT 1–6 months then SAPT ≥5 years by consensus; no recommendation on prolonged monitoring despite 4.3× more AF after closure. Over-60 and under-18: no evidence-based recommendation. TIA and pregnancy excluded | #patent-foramen-ovale, #cryptogenic-stroke, #embolic-stroke-of-undetermined-source, #pfo-closure, #anticoagulation, #atrial-fibrillation, #guideline, #GRADE | 2026-10-27 |
| sources/pfo-jscai-2022 | Kavinsky, Szerlip, Goldsweig, Tobis, Messé (AAN representative) et al. 2022 SCAI guideline (JSCAI 2022;1:100039) — GRADE with IOM/GIN standards, original systematic reviews, three patient representatives, 13 recommendations across 5 PICO questions. Goes where the trials did not: eight recommendations in patients with no prior PFO-associated stroke — against routine closure for migraine (conditional, moderate), decompression illness in divers (very low), isolated atrial septal aneurysm, TIA, DVT, thrombophilia; for closure in platypnea-orthodeoxia (SpO₂ +14.21%, 12.18–16.25) and in systemic embolism, the latter on the strength of three patients. The one strong recommendation is closure rather than antiplatelet therapy alone at 18–60 (moderate certainty, RR 0.26) and — unlike ESO — independent of anatomy. Closure versus anticoagulation: conditional for closure (RR 0.94 for stroke, RR 0.24 for major bleeding, RR 18.1 for AF, 86% within 45 days). No recommendation on DAPT beyond 1 month. Safety: surgery required in 0.2% of 13,736 implants | #patent-foramen-ovale, #pfo-closure, #migraine, #decompression-illness, #platypnea-orthodeoxia, #thrombophilia, #cryptogenic-stroke, #guideline, #GRADE | 2026-10-27 |
| sources/pfo-jama-2025 | Kent & Wang 2025 JAMA review (published online 28 July 2025) — the clearest account of PFO-associated stroke as a causal-inference problem, written by the developer of RoPE and co-leader of the SCOPE meta-analysis that produced PASCAL. PFO in ~25% of adults, mean tunnel diameter 4.9 mm; paradoxical embolism ~5% of all strokes and 10% under 55; ~50% of ESUS patients ≤60 have a PFO, so half are incidental. Attributable fraction by RoPE stratum: 23% PFO prevalence at RoPE <3 (fraction ≈0) versus 77% at RoPE 9–10 (fraction ≈90%) — but RoPE 9–10 also carries the lowest absolute recurrence (2% at 2 years), so causal probability and absolute benefit move in opposite directions. SCOPE IPD-MA (6 RCTs, 3,740): annualised stroke 0.47% vs 1.09%, adjusted HR 0.41; PASCAL probable HR 0.10, possible 0.38, unlikely 1.14 with more AF. Harm concentrated in the same place as absence of benefit: post-45-day AF risk difference 4.41% in unlikely versus 0.65% in probable. After closure stroke risk is still 2.5% vs 0.4% at 4 years (HR 6.3), driven by vascular risk factors. Anticoagulants beat antiplatelets for stroke (RR 0.59) but no closure-versus-DOAC trial exists | #patent-foramen-ovale, #cryptogenic-stroke, #embolic-stroke-of-undetermined-source, #rope-score, #pascal-classification, #pfo-closure, #atrial-fibrillation | 2026-10-27 |
| sources/pfo-jacc-2018 | Lee, Song et al. 2018 DEFENSE-PFO trial (J Am Coll Cardiol 2018;71:2335–2342) — the trial that made PFO morphology a treatment modifier. 1,715 patients screened by TOE, 450 with a PFO, 175 (38.9%) meeting a high-risk definition (atrial septal aneurysm ≥15 mm, septal hypermobility ≥10 mm, or PFO size ≥2 mm during Valsalva), 120 randomised to Amplatzer closure or medical therapy. Every primary endpoint event occurred in the medication arm: 0/60 versus 6/60 (2-year 12.9%, log-rank P=0.013), ischaemic stroke 0 versus 5 (10.5%, P=0.023), NNT 10 at 2 years. But two of the six events were bleeding caused by treatment rather than by the PFO, the trial stopped early at 120 of a planned 210 patients after CLOSE reported, it was open-label, warfarin was permitted in 25% of controls, and the PFO size criterion is stated as ≥2 mm in the Methods and >3 mm in the Figure 1 legend. Procedural AF 2, effusion 1, pseudoaneurysm 1 | #patent-foramen-ovale, #pfo-closure, #cryptogenic-stroke, #atrial-septal-aneurysm, #randomized-controlled-trial | 2026-10-27 |
| sources/cmp-pregnancy-jaccadv-2026 | Flores Rosario, Hussien, Grover, Witte et al. 2026 JACC: Advances state-of-the-art review (Duke/UNC/Cedars-Sinai, with genetic counsellors and maternal-fetal medicine as authors) — pregnancy in the genetic cardiomyopathies, organised around one structural problem: CARPREG II and mWHO take no genetic input, so a woman with an LMNA variant, normal ejection fraction and no arrhythmia scores as class I despite 90–95% penetrance by age 60. Works through five phenotypes with their mWHO classes and pre-conception obligations — DCM (highest risk: MACE 39%, mortality up to 7%, pre-pregnancy LVEF <50% the strongest predictor; III at LVEF 30–45%, IV at <30%), PPCM (~15% share DCM genes, >10% TTNtvs; testing recommended for all, referral 11%; recurrence rules turn on an undefined 'recovery'), ACM (uneventful for most but postpartum VA HR 13.74, 13% arrhythmia and 5% HF per pregnancy; secondary-prevention ICD before conception), HCM (mortality 0.2%, no obstructive/nonobstructive difference, myosin inhibitors contraindicated so myectomy moves pre-conception, phenylephrine and assisted second stage intrapartum), and GP/PN (10% significant complications in rare DCM variants; 34% of PKP2 relatives progress to ARVC; phenotype drives the decision). Also PGT-M eligibility (needs multiple positive relatives for linkage, never for VUS), CVS vs amniocentesis loss rates, GDMT conversion as a procedure, aspirin from 12 weeks, breastfeeding compatibility, and two illustrative cases (FLNC c.7443del with postpartum LVEF 47% and 7% LGE; TNNT2 p.Arg139His with recovery from LVEF 20% and ICD deferred). Mostly expert consensus, and says so | #pregnancy, #genetic-cardiomyopathy, #peripartum-cardiomyopathy, #hypertrophic-cardiomyopathy, #dilated-cardiomyopathy, #arrhythmogenic-cardiomyopathy, #cardio-obstetrics, #preimplantation-genetic-testing, #mWHO-classification | 2026-10-26 |
| sources/trabeculation-dcm-circ-2026 | Mora-Ayestarán, Ramos-Lopez, Ochoa, Amin, Bezzina et al. 2026 Circulation multicentre cohort — 1,160 genotyped DCM patients from 22 Spanish/Dutch centres, CMR and genotype centrally adjudicated, outcomes adjudicated blinded to trabeculation status, median follow-up 5.1 years. LV hypertrabeculation is present in 30.5% by fractal dimension (29.7% by Petersen, κ 0.638) and predicts nothing: embolism HR 1.50 (0.75–3.00), MVA 0.93 (0.59–1.48), advanced HF 0.82 (0.43–1.57) after adjustment for genotype, LGE, NYHA and LVEF. Unadjusted it looked protective (MVA HR 0.64) because hypertrabeculated ventricles were younger, higher LVEF and less LGE. The anticoagulation recommendation is the paper's target: embolic events 3.2% overall and 2.8% in sinus rhythm without anticoagulation at LVEF ≤40% (HR 1.89, 0.66–5.46), with AF (HR 3.26) and low LVEF (HR 1.04 per 1% decrease) carrying the risk and 57% of events occurring in patients with AF — so do not anticoagulate for trabeculation, even at LVEF ≤40%. Prevalence inverts prognosis: motor sarcomeric 57% (MYH7 71%, MYBPC3 55%), TTN 38%, genotype-negative 33%, desmosomal 20%, cytoskeleton/Z-disk 7%, nuclear envelope 5% (LMNA 1/20) — the genotypes that cause arrhythmic death do not produce the trait. Real predictors are nuclear envelope genotype (HR 4.4), LGE (3.1) and LVEF. AHA calls it a primary cardiomyopathy, ESC 2023 a trait; the data support the trait. Limits: retrospective, 37 embolic events, 98% White, nuclear-envelope group contains one hypertrabeculated patient | #left-ventricular-hypertrabeculation, #dilated-cardiomyopathy, #cardiac-magnetic-resonance, #anticoagulation, #thromboembolism, #genotype-phenotype, #TTN, #MYH7, #LMNA | 2026-10-26 |
| sources/genetic-eoaf-ehj-2026 | Laws, Shabani, Yoneda, Shoemaker et al. 2026 Eur Heart J prospective single-centre cohort from a dedicated AF Precision Medicine Clinic (Vanderbilt; 264 referred Oct 2020–Sep 2024; 242 completed a cardiomyopathy/arrhythmia panel). The first prospective measurement of what early-onset AF genetics finds and changes: 20% P/LP yield — twice unselected cohorts — with only 6 of 48 diagnosed before referral. TTN 23/48, LMNA and SCN5A three each, plus incidental HFE, CPT2, TTR p.Val142Ile and LZTR1 as treatable non-arrhythmic disease. Pre-test odds measured with adjusted logistic regression: prior cardiomyopathy OR 5.3, elevated T1 OR 4.0, infranodal conduction OR 3.3, LGE OR 2.4; OSA OR 0.4 and normal ECG OR 0.5 predict negative — while family history of AF and HARMS2-AF (P=.76) discriminate not at all. Ventricular penetrance 56% overall, 89% ACM genes versus 54% TTN-DCM. Management changed in 52% of genotype-positives: 7 new ICDs, 2 PPM→ICD upgrades, GDMT start/optimisation, anticoagulation in 7 with CHA₂DS₂-VA ≤1 newly diagnosed with HCM/ACM, Class I avoidance in SCN5A, Class III in KCNQ1, exercise ≤6 METs in desmoplastic ACM. Gene-elusive overlap 9%, half with no prior clue. Limitations: single centre, 90% White, small subgroups, no outcome data | #atrial-fibrillation, #early-onset-atrial-fibrillation, #genetic-testing, #cardiomyopathy, #arrhythmogenic-cardiomyopathy, #TTN, #cascade-family-screening | 2026-10-26 |
| sources/gene-therapy-arrhythmia-cjca-2026 | Grisorio & Roberts 2026 Can J Cardiol invited review — nucleic-acid therapeutics for inherited arrhythmia syndromes, organised by modality (replacement, silencing, editing) then by disease. The wiki's best current map of the field: three PKP2-ARVC trials now identified by number (NCT05885412 AAVrh74, NCT06228924 AAV9, NCT06109181 AAVrh10), plus AAV8-CASQ2 in RYR2-CPVT1 (NCT07148089, Phase Ib, adults then ages 7–17) and subcutaneous siRNA against PLN p.R14del (NCT07241104, PULSE). Its conceptual core is heterogeneous transduction: 70–80 contiguous cells must fire together to trigger an action potential in 1-D, ~7,000–8,000 in 2-D and ~700,000–800,000 in 3-D, and modelling puts the stabiliser-cell threshold at 30–50% (30–40% in 2-D/3-D) — far below the >70% needed for structural repair — while clustering, reduced coupling and fibrosis all raise it. Also carries the 2025 AAV safety signal (Rocket RP-A501 Danon death; three Sarepta AAVrh74 liver-failure deaths), the universal three-shRNA CALM Sup-Rep construct, CRDS as the hazard of RYR2 silencing, SCN10A-short as a second route to INa, and the revision of PLN p.R14del from gain-of-function to aberrant SR cluster formation | #gene-therapy, #channelopathies, #AAV, #CPVT, #long-qt-syndrome, #arrhythmogenic-cardiomyopathy, #PKP2, #PLN, #TMEM43, #suppression-replacement | 2026-10-26 |
| sources/atrial-standstill-hrs-2026 | Lin et al. 2026 Heart Rhythm narrative review (401 records screened; no meta-analysis; all recommendations level C) — the first integration of atrial standstill: complete atrial electrical and mechanical silence from diffuse atrial myocardial disease, proven by failed atrial capture at 10 mA/2 ms rather than by absent P waves. Distinguishes standstill from reversible atrial quiescence and from the intermittent and partial forms. Three convergent pathways mapped onto EHRAS histology — SCN5A ± GJA5 exit block (putatively class I), homozygous NPPA interstitial fibrosis (II), EMD/LMNA fibro-fatty replacement (III) — with the sharpest finding the EMD-versus-LMNA divergence: standstill in 46.7% of EMD versus 0 of 15 LMNA, ventricular arrhythmia 6.7% versus 60%, ICD 3.3% versus 60%. Thromboembolism 22–54%, and no AF risk score predicts it (CHA2DS2-VASc 0–1 forecasts 0.2–0.6%/yr against an observed ~5%/yr), so anticoagulation at diagnosis for every etiology. VVI is the default in complete standstill; EAM-guided DDD cuts RV pacing from 100% to 4–19% in partial standstill, and atrial leads fail within 3–8 years. LGE-MRI shows biatrial fibrosis with a clean ventricle; EAM maps a canonical proximal-to-distal scar progression. Calls for a tiered international registry | #atrial-standstill, #atrial-cardiomyopathy, #SCN5A, #NPPA, #EMD, #LMNA, #electroanatomic-mapping, #thromboembolism, #permanent-pacing, #anticoagulation | 2026-10-26 |
| sources/Syncope-Kenny-NEJM-2026 | Kenny 2026 NEJM Clinical Practice review: contemporary syncope framework — reflex/orthostatic/cardiac classification; syncope-falls overlap in older adults; carotid sinus syndrome up to 30% of unexplained falls; cardioneural ablation emerging; structured ED observation protocols; aligns with ESC 2018 over ACC/AHA/HRS 2017 | #syncope, #vasovagal-syncope, #orthostatic-hypotension, #cardiac-syncope, #falls-in-elderly | 2026-08-10 |
| sources/DAPT-MVD-NEJM-2026 | Tian et al. 2026 NEJM open-label RCT (n=8,250; 97 Chinese centers): extended clopidogrel + aspirin 12→24 months post-DES in multivessel CAD — primary CV death/MI/stroke HR 0.82 (P=0.03); MI HR 0.68; FIRST extended DAPT trial with NO bleeding increase (BARC ≥2 HR 0.89; P=0.54); 98.3% ACS; benefit driven by nontarget-lesion MI; sustained ≥12 months post-cessation | #dual-antiplatelet-therapy, #multivessel-coronary-artery-disease, #percutaneous-coronary-intervention, #clopidogrel, #randomized-controlled-trial | 2026-08-10 |
| sources/Finerenone-FIND-CKD-NEJM-2026 | Heerspink et al. 2026 NEJM Phase 3 double-blind RCT (n=1,584): finerenone vs placebo in non-diabetic CKD (eGFR 25–<90, UACR 200–3500, on RAS inhibitor) — total eGFR slope −3.3 vs −4.0 ml/min/1.73m²/yr (difference 0.7; P<0.001); composite kidney/CV events HR 0.77 (P=0.04); UACR reduction −41.3% vs −9.1% at 6 months; hyperkalemia 17.0% vs 13.3%; first trial establishing finerenone nephroprotection in non-diabetic CKD | #chronic-kidney-disease, #finerenone, #mineralocorticoid-receptor-antagonist, #non-diabetic-CKD, #randomized-controlled-trial | 2026-08-10 |
| sources/PFA-LPeAF-AVANT-GUARD-NEJM-2026 | Wazni et al. 2026 NEJM AVANT GUARD RCT (n=310 randomized + 100 safety-assigned): first RCT of PFA as first-line therapy for persistent AF — PFA+PVI+posterior wall ablation vs AAD; treatment success 56% vs 30% (HR 0.46; P<0.001); ICM continuous monitoring; 5.1% primary SAEs (6 strokes pre-pause, 0 post-pause after protocol modifications: TEE/CT <24h, uninterrupted OAC 4wk, ACT ≥350s, exclude CHA₂DS₂-VASc ≥4); AF burden 0% vs 0.2% median; pentaspline FARAWAVE catheter | #persistent-atrial-fibrillation, #pulsed-field-ablation, #catheter-ablation, #antiarrhythmic-drugs, #rhythm-control | 2026-08-01 |
| sources/PHT-RVsupport-WSPH-2019 | Hoeper et al. 2019 ERJ WSPH 6th consensus: ICU management of PH/RV failure (avoid intubation/fluid loading; IV prostacyclin; inotropes; vasopressors); ECLS — VA-ECMO or PA-LA as bridge to transplant (only established indication); awake ECMO preferred; RVAD contraindicated in PAH; bilateral lung Tx with perioperative + prolonged postoperative ECMO; 1-year survival >90%; REVEAL >7 → referral; REVEAL ≥10 → listing | #pulmonary-hypertension, #right-ventricular-failure, #extracorporeal-membrane-oxygenation, #lung-transplantation, #intensive-care | 2026-05-31 |
| sources/PAVB-HR-2009 | El-Sherif/Jalife 2009 Heart Rhythm review: paroxysmal AV block — TD-PAVB (atrial rate acceleration triggers repetitive concealed conduction in diseased His-Purkinje with postrepolarization refractoriness → prolonged asystole) vs PD-PAVB (pause-dependent; source-sink mismatch is sufficient; phase 4 depolarization distal to block zone may facilitate, not impair, conduction); His bundle most common block site (7/10 EPS cases); "phase 3/4 block" are misnomers | #paroxysmal-AV-block, #His-Purkinje-system, #tachycardia-dependent-block, #concealed-conduction, #atrioventricular-block | 2026-05-30 |
| sources/noac-ehra-2018 | Steffel/Verhamme et al. 2018 EHRA Practical Guide (EHJ 2018;39:1330–1393): 20-topic consensus on NOAC use in AF — EHRA VHD Type 1/2 classification (Type 1=VKA-mandatory; Type 2=NOAC-eligible); drug-specific renal clearance fractions (dabigatran 80%/edoxaban 50%/rivaroxaban 35%/apixaban 27%); perioperative management without bridging; AF+CAD dual therapy over triple (PIONEER AF-PCI, RE-DUAL PCI); cardioversion anticoagulation (3 weeks or TOE-guided); reversal agents (idarucizumab for dabigatran; andexanet alfa for FXa inhibitors); CKD dosing tables; Child-Pugh liver dosing | #atrial-fibrillation, #anticoagulation, #noac, #guidelines, #stroke-prevention | 2026-05-30 |
| sources/lvh-scar-aiecg-naturesr-2025 | Nezamabadi et al. 2025 Sci Rep: XplainScar — first explainable ML model detecting and localizing LV scar in HCM from 12-lead ECG; trained JH n=500, external validation UCSF n=248; global LV scar F1=89%, Se=91%, Sp=78% on held-out set; unsupervised ECG clustering + SCARF self-supervised learning + SHAP explainability; basal scar → deep Q/intrinsicoid QRS delay in aVR/V1; apical scar → T wave inversion V2–V6; outperforms 5 deep learning comparators | #hypertrophic-cardiomyopathy, #artificial-intelligence, #ECG, #LV-scar, #explainability | 2026-05-30 |
| sources/hemiblock-circ-2007 | Elizari/Acunzo/Ferreiro 2007 Circulation review from original Rosenbaum group: LAH and LPH anatomy (posterior division = most protected, dual LAD+PDA blood supply), ECG/VCG criteria (CCW frontal loop = pathognomonic of LAH; CW excludes LAH), 7 MI masking/simulation patterns (negative T in II/III/aVF = inferior ischemia despite LAH; VCG loop rotation differentiates LA from inferolateral infarction), masquerading RBBB (LAH eliminates RBBB S waves from I and V5-V6), RBBB+LPH = near-trifascicular (80–87% MI mortality; 42% complete AV block; Adams-Stokes 58.6%), LAH epidemiology (2.77% healthy population; 62% cases <40yr; spontaneous VSD closure underrecognized cause), Lev vs Lenègre disease | #left-anterior-hemiblock, #fascicular-block, #intraventricular-conduction-delay, #myocardial-infarction-masking, #electrocardiography | 2026-05-30 |
| sources/lbbb-europace-2017 | Surkova et al. 2017 Europace review: LBBB from cardiac mechanics to clinical challenges — TAVR-induced LBBB (CoreValve 45.2% vs Sapien 14.0%; Dutch registry mortality 37.8% vs 24.0% vs PARTNER no difference); pathophysiology (SF driven by RV free wall, not IVS; SF ≠ septal systolic rebound stretch; apical rocking; lateral hypertrophy; pro-arrhythmic state); echocardiographic CRT predictors (systolic stretch index >9.7% at QRS 120–149ms; LV pressure-strain loops; 1/3 of LBBB lack typical speckle-tracking pattern); stress testing meta-analysis (66 studies: stress echo highest specificity 88.7%/accuracy 84.4%; vasodilator preferred); Sgarbossa meta-analysis (score ≥3: sensitivity 20%, specificity 98%); connexin 40/43 genetics | #left-bundle-branch-block, #cardiac-mechanics, #echocardiography, #TAVR-complications, #LV-dyssynchrony | 2026-05-30 |
| sources/rbbb-ccr-2021 | Ikeda 2021 Curr Cardiol Rev review: RBBB anatomy (thin Purkinje structure, LAD supply), epidemiology (2–3% prevalence; 1% age 50 → 18% age 80 in men), ECG criteria (rSR' most common; initial 30–40 ms normal → MI diagnosis preserved), differential (Brugada pseudo-RBBB: no wide S in I/V6; Chiale maneuver unmasks concealed Brugada in RBBB), CRT generally no benefit in RBBB except RBBB+LAFB or prolonged PR; prognosis: isolated RBBB benign but RBBB+CVD = independent mortality predictor | #right-bundle-branch-block, #ECG-criteria, #ventricular-conduction-delay, #Brugada-syndrome, #bifascicular-block | 2026-05-30 |
| sources/vcg-fronphysiol-2022 | Vondrak/Penhaker 2022 Front. Physiol. review: VCG processing and transformation methods — Kors regression (~98%) and IDT (~97.2%) best ECG→VCG transforms; quasi-orthogonal NOT reliable; QRS area from VCG outperforms QRS duration and LBBB morphology for CRT response prediction; VCG superior to ECG for LQTS (86% vs 69%), MI detection (98% vs 73%), atrial enlargement; QRS-T spatial angle most commonly analyzed parameter; IDT contraindicated for AF f-wave analysis | #vectorcardiography, #ECG-derived-VCG, #Frank-lead-system, #QRS-T-angle, #cardiac-signal-processing | 2026-05-30 |
| sources/lbbb-evg-ane-2019 | Pérez-Riera et al. 2019 Ann Noninvasive Electrocardiol review: re-evaluating ECG/VCG criteria for CLBBB — Strauss strict criteria (QRS ≥140/130 ms men/women + mid-QRS notching/slurring in ≥2 leads) vs conventional AHA ≥120 ms; ~1/3 of conventional LBBB may be pseudo-LBBB (LVH+LAFB); concordant LBBB (~28–32%) vs discordant LBBB (~68–70%) with distinct clinical profiles and CRT prognosis; VCG mid-end conduction delay pathognomonic of true LBBB; gender differences in LBBB expression; ~30% CRT non-responder problem linked to false LBBB diagnosis | #left-bundle-branch-block, #cardiac-resynchronization-therapy, #ECG-criteria, #vectorcardiography, #ventricular-conduction-delay | 2026-05-30 |
| sources/co-cocc-2022 | Arya/Al-Moustadi/Dutta 2022 Curr Opin Crit Care review: CO monitoring in ICU — PAC thermodilution gold standard rebounding in cardiac ICUs (CCOM algorithm CO/SvO₂/SVR/RVEF every 20s; RV port for RV decompensation detection); TPT unreliable in ECMO/hypothermia/low CO; CCE/TTE ±25% error vs PAC (acceptable); noninvasive methods (bioimpedance/bioreactance/finger cuff/esCCO/USCOM 42.7% error/CO₂ rebreathing 40-49%) all unacceptable in critically ill; NICOM study: bioreactance poor in cardiogenic shock | #cardiac-output, #hemodynamic-monitoring, #pulmonary-artery-catheter, #critical-care-echocardiography, #critical-care | 2026-05-29 |
| sources/co-bjcp-2010 | Geerts/Aarts/Jansen 2010 BJCP review: all CO measurement methods for pharmacological studies — Fick (direct O₂ gold standard; CO₂ rebreathing limited by shunts), indicator dilution (PAC TD, continuous PAC, PiCCO, LiDCO), pulse contour (PiCCO/PRAM/LiDCO/Vigileo/Modelflow), echo-Doppler, bioimpedance; comparative Table 1 vs PAC TD; Critchley-Critchley ±28% criterion; calibrated Modelflow best pulse contour; no method surpasses 3-synchronized-injection thermodilution | #cardiac-output, #hemodynamic-monitoring, #thermodilution, #pulse-contour-analysis, #fick-principle | 2026-05-29 |
| sources/RVOT-LVOT-circ-ep-2019 | Anderson 2019 Circ Arrhythm Electrophysiol review: ECG signatures and 18 prediction algorithms for RVOT vs LVOT outflow tract VAs; combined TZ+V2S/V3R formula best overall (Youden 0.77); V3R/V7 index best AUC (0.95); preferential conduction in 25% of aortic sinus OTVAs is key pitfall | #outflow-tract-ventricular-arrhythmia, #ECG-localization, #catheter-ablation, #PVC, #ventricular-tachycardia | 2026-05-29 |
| sources/vo2max-jphysiol-2008 | Levine 2008 J Physiol topical review: VO2max bounded by Fick equation — (LVEDV−LVESV) × HR × a-v O2 diff; Hawkins 2007 (n=156) proves VO2max is a true parametric ceiling (subjects at >30% supramaximal work never exceeded it); elite athlete advantage = large LV EDV from enhanced chamber + pericardial compliance (not contractility; not a-v O2 extraction); Levine 1991 direct P-V curves; largest CO 42.3 L/min; largest SV 212 mL; highest VO2max 7.48 L/min; altitude VO2max reduction 0.6%/100m = O2 transport not motor recruitment (Wehrlin & Hallen 2006); peripheral fatigue mechanisms (Ca2+/Na-K pump/ROS/cross-bridge); Central Governor Model rebutted; ACE gene not confirmed as endurance gene | #VO2max, #exercise-physiology, #cardiac-output, #endurance-athletes, #oxygen-transport | 2026-05-28 |
| sources/asd-japc-2025 | Shah 2026 Ann Pediatr Cardiol brief communication: three ASD knowledge gaps — (1) Qp:Qs is a relative ratio masking absolute flow burden (7.2 vs 10.8 L/min at identical Qp:Qs 1.8 with CO 4 vs 6 L/min); (2) exercise-induced shunt dynamics contradictory across 3 small studies (Bay: increased; Nielsen: decreased; Stephensen: unchanged); (3) post-closure PAH predictors unvalidated — delayed closure >40yr, elevated pre-closure PVR, BMPR2 variants, pulmonary microvascular disease; no current exercise restriction guideline for unrepaired ASD | #atrial-septal-defect, #exercise-physiology, #pulmonary-arterial-hypertension, #hemodynamics, #congenital-heart-disease | 2026-05-28 |
| sources/shunt-nature-sr-2020 | Sigurdsson/Lindberg 2020 Sci Rep prospective method-comparison (n=44, mean age 12 months, ASD/VSD surgical cohort): COstatus transpulmonary ultrasound dilution vs perivascular flow probes + oximetric shunt equation for Qp/Qs estimation — sensitivity 95.7%/specificity 97.6%/AUC 0.97 for L→R shunt detection; significant Qp/Qs underestimation in moderate/small shunts (p<0.05); algorithm optimisation needed for young children; less invasive than catheterisation (existing arterial + central venous lines only) | #pediatric-hemodynamics, #intracardiac-shunt, #indicator-dilution, #congenital-heart-disease, #cardiac-output | 2026-05-28 |
| sources/dash-meddiet-cn-2023 | Filippou et al. 2023 Clinical Nutrition 4-arm RCT (n=240, 3 months, Greek adults, high-normal BP/grade 1 HT, never-treated): FIRST head-to-head DASH vs MedDiet on salt restriction background — MedDiet superior office SBP (MDG vs DDG −3.2 mmHg, P<0.001); EQUAL on 24h ambulatory SBP/DBP (gold standard); both outperform salt restriction alone; DASH NOT superior to salt restriction for 24h ambulatory DBP; contradicts network meta-analysis DASH superiority claim | #hypertension, #mediterranean-diet, #DASH-diet, #blood-pressure, #dietary-patterns | 2026-05-28 |
| sources/diet-mets-nutrients-2020 | Castro-Barquero et al. 2020 Nutrients comprehensive review: 7 dietary patterns benchmarked against all MetS criteria — MedDiet best overall (RR 0.81 MetS risk, 19% lower); DASH best for BP (−3.2/−2.5 mmHg, 30 RCTs, most effective vs 13 patterns); low-CH improves short-term TG/weight/HbA1c but U-shaped mortality curve (optimal 50–55% CH per PURE+Seidelmann); ketogenic benefits may be energy-restriction-mediated; DIETFITS: equal weight loss low-fat vs low-CH; high-protein: only TG reduction consistently; adherence is the decisive factor | #metabolic-syndrome, #dietary-patterns, #mediterranean-diet, #cardiovascular-prevention, #insulin-resistance | 2026-05-27 |
| sources/asd-closure-jc-2015 | Akagi 2015 JC review: transcatheter ASD closure in adults and elderly — atrial septal malalignment as novel cardiac erosion risk factor beyond aortic rim deficiency; updated ASO IFU (IVC rim <5 mm added as contraindication); LUPV/RUPV and balloon-assist techniques for large/complex ASD; PCWP monitoring protocol (abandon if PCWP rises >10 mmHg from baseline or >20 mmHg absolute during test balloon occlusion); ~1/3 of patients >60yr and ~1/2 of patients >70yr have AF; PVI before ASD closure for symptomatic paroxysmal/persistent AF (age <75, LA <50 mm, 3-month SR confirmation); ASD closure beneficial even in permanent AF | #atrial-septal-defect, #transcatheter-closure, #adult-congenital-heart-disease, #pulmonary-arterial-hypertension, #atrial-arrhythmia | 2026-05-27 |
| sources/dash-nutrients-2021 | Wickman/Steinberg et al. UC Davis 2021 Nutrients review: DASH diet in outpatient HF management — DASH + sodium restriction reduces hs-cTnI −20% and NT-proBNP −23% vs control; 3-week DASH in HFpEF improves ventricular diastolic function; short-chain acyl carnitine metabolomics correlate with LV function; precision nutrition framework; no large HF-specific RCT yet | #heart-failure, #DASH-diet, #nutrition-therapy, #precision-nutrition, #metabolomics | 2026-05-27 |
| sources/inclisiran-orion-nejm-2020 | Ray/Wright/Kallend et al. NEJM 2020: ORION-10 (US ASCVD; n=1,561) + ORION-11 (Europe/SA ASCVD/risk-equiv; n=1,617) Phase 3 RCTs; SC inclisiran 284 mg day 1/90/Q6m vs placebo; LDL-C −52.3%/−49.9% at day 510 (P<0.001); PCSK9 −83.3%/−79.3%; absolute −54.1/−51.9 mg/dL; consistent across all subgroups; safety comparable to placebo except mild ISAEs (2.6%/4.7% excess); no liver/platelet toxicity; ORION-4 CVOT (HR 0.84; P=0.01; did not meet pre-specified threshold P<0.005) | #inclisiran, #siRNA, #PCSK9, #LDL-cholesterol, #lipid-lowering-therapy | 2026-05-27 |
| sources/verve102-pcsk9-nejm-2026 | Vafai/Kathiresan et al. NEJM 2026: Heart-2 Phase 1 (n=35; HeFH/premature CAD); single IV infusion VERVE-102 (GalNAc-LNP ABE8.8 mRNA + gRNA → PCSK9 splice site A→G edit); at 1.0 mg/kg: PCSK9 −88%, LDL-C −62% (absolute −78 mg/dL; 128→51 mg/dL), stable ≥18 months; no DLTs/deaths; transient ALT ≤2.4×ULN; no thrombocytopenia; LNP t½ <20h; 15-year follow-up required | #base-editing, #PCSK9, #familial-hypercholesterolemia, #gene-therapy, #LDL-cholesterol | 2026-05-27 |
| sources/pericarditis-acc-2025 | Wang/Klein/Imazio et al. 2025 ACC Expert Consensus Statement (JACC 2025;86:2691-2719): novel diagnostic criteria (pleuritic chest pain mandatory + ≥1 of 5 additional findings; 0=unlikely/1=possible/2+=definite); paradigm shift — anti-IL-1 agents (anakinra/rilonacept/goflikicept) preferred over corticosteroids for recurrent inflammatory pericarditis; CMR LGE grading for risk stratification/monitoring; constrictive pericarditis transient vs chronic distinction; effusion sizing; tamponade diagnosis; pericarditis in oncology; Pericardial Diseases Center model | #pericarditis, #consensus, #guidelines, #cardiac-imaging, #anti-IL1 | 2026-05-27 |
| sources/asd-lancet-2014 | Geva/Martins/Wald 2014 Lancet Seminar: ASD foundational review — incidence 56–100/100,000 livebirths; 3rd most common CHD; spontaneous closure rates by size (56% at 4-5mm → 0% >10mm); life expectancy without closure (mortality 0.6%/yr decade 1-2; 7.5%/yr decade 6); surgical survival by age at repair (Murphy 27-32yr: <25yr near-normal; >41yr 40% vs 59%); device meta-analysis (28,142 pts): major complications 1.6%, cardiac erosion 0.1%; PVR >8 WU precluding closure per 2008/2010 guidelines (differs from ESC 2020 ≥5 WU); arrhythmia benefit short-term (OR 0.66) but lost at ≥5yr; maternal mortality 28% with ASD+PAH | #atrial-septal-defect, #congenital-heart-disease, #adult-congenital-heart-disease, #device-closure, #natural-history | 2026-05-26 |
| sources/asd-ehj-2022 | Brida/Gatzoulis et al. 2022 EHJ state-of-the-art review: ASD most common adult CHD (25–30%); 4 subtypes (secundum 80%/primum 15%/sinus venosus 5%/coronary sinus); proactive closure normalises prognosis; PVR thresholds for closure (safe <5 WU; contraindicated ≥5 WU despite PAH Rx); ASD closure NOT associated with AF reduction (meta-analysis 25 studies); pre-closure ablation before percutaneous closure (79% vs 37% AF-free); RV remodelling inversely related to age at closure; Eisenmenger closure contraindicated | #atrial-septal-defect, #adult-congenital-heart-disease, #congenital-heart-disease, #pulmonary-arterial-hypertension, #arrhythmia-management | 2026-05-26 |
| sources/levosimendan-eschf-2023 | Dobarro et al. 2023 ESC Heart Failure LEVO-D registry (n=403; 23 Spanish hospitals; retrospective; destination therapy — not HT/LVAD candidates): HF hosp 77.9%→38.7% (P<0.0001); unplanned visits 43.7%→22.7% (P<0.0001); 1-year mortality 26.8%; median survival 24.7 months; 43.7% responders; ICD/VT unchanged; 3.7% withdrawal due to adverse events; LEVO-D score (TEER+2, BB+1.5, Hgb>12+1.5, amiodarone−1.5, unplanned HF visit−1.5, HR>70−2; AUC 0.71 vs MAGGIC 0.60); no dosing strategy or dose per administration independently associated with response | #advanced-heart-failure, #levosimendan, #intermittent-inotropes, #heart-failure, #destination-therapy | 2026-05-26 |
| sources/levosimendan-ecr-2024 | Susilo et al. 2024 ECR comprehensive CS-focused review: triple mechanism confirmed (TnC, vascular KATP, mito-KATP/mPTP/cytochrome C); PDE3 only at supratherapeutic doses; endothelial NO via p38 MAPK; enoximone vs levosimendan survival 69% vs 37% (refractory CS/AMI); LIDO 180-day HR 0.57 (95% CI 0.34–0.95); VA-ECMO weaning mixed evidence (positive studies vs n=200 cohort negative + failed RCT); tVAD adjuvant improved weaning + 6-month mortality; PPCM preferred over dobutamine (teratogenicity); takotsubo LV recovery only levosimendan group; cardiac surgery LCOS reduction vs placebo/dobutamine/milrinone; septic shock meta-analyses positive; REVIVE VT contradiction vs SURVIVE; hypothermia safety (no triangulation at 26°C vs milrinone/isoprenaline); SBP >90 monotherapy threshold; levo+dobutamine combination MACE prevention | #cardiogenic-shock, #levosimendan, #inotropes, #advanced-heart-failure, #mechanical-circulatory-support | 2026-05-26 |
| sources/rhc-hf-jacchf-2024 | Rajagopalan/Borlaug et al. 2024 JACC HF state-of-the-art review (12:1141-1156): practical RHC guidance across HF spectrum — CS staging (SCAI 5 stages; RAP 8-12/PCWP ≤15/CI ≥2.2 targets; CPO <0.6W → escalate); HF-CS vs AMI-CS (HF-CS severe hemodynamics but preserved end-organs + normal lactate); HFpEF exercise RHC gold standard (1/3 normal resting PCWP; 2.4× risk with exercise PCWP elevation; normal PCWP <25 mmHg on exercise); LVAD risk predictors (RAP >15/RAP:PCWP >0.63/PAPI <1.85); LVAD goals post-implant (RAP <12/PCWP <18; ISHLT 2023 Class IIa ramp optimization); transplant assessment (PVR >5 WU/TPG >16 → vasodilator challenge; PVR <3 + SBP >85 → favorable); portal HTN assessment (hepatic vein wedge pressure gradient >5 mmHg = portal HTN; elevated hepatic vein pressure + normal gradient = HF congestion); high-output HF (CI >4.0; AV fistula compression test) | #right-heart-catheterization, #heart-failure, #hemodynamic-monitoring, #cardiogenic-shock, #HFpEF | 2026-05-25 |
| sources/papi-ejhf-2020 | Lim/Gustafsson 2020 EJHF review (22:32-38): physiological basis of PAPi — PAPP = SV/PAC equation; PAC-PVR hyperbolic relationship and RC time constant; PAWP disproportionately reduces PAC; same PAPi value reflects different hemodynamic states (PAC 5/SV 50/RAP 5 vs PAC 1.5/SV 40/RAP 14 both = PAPi 2.0); context-specific thresholds (≤0.9 RV infarction; <1.85 LVAD; <3.65 advanced HF; <3.7 PAH); PAPi NOT associated with 30-day mortality in SHOCK trial/registry; post-LVAD PAC improvement makes PAPi less sensitive; no single threshold applies across populations | #pulmonary-artery-pulsatility-index, #right-ventricular-failure, #hemodynamic-monitoring, #pulmonary-arterial-capacitance, #cardiogenic-shock | 2026-05-25 |
| sources/iabp-ajc-2006 | Trost/Hillis 2006 AJC review (97:1391-1398): IABP — history (Kantrowitz 1952/1968; Bregman 1980 percutaneous); device (8-9.5Fr, helium, 25-50mL, tip 2-3cm distal to left subclavian); 4 timing error patterns and hemodynamic consequences; coronary flow augmentation limited to impaired autoregulation, NOT past fixed severe stenoses; Benchmark Registry (n=16,909) major complications 2.6% (limb-threatening ischemia 0.9%, bleeding 0.8%); NRMI-2 IABP+thrombolysis benefited (49% vs 67%) but IABP+primary PCI did not (45% vs 47% NS); contraindications: AR/dissection/aneurysm/PVD/bleeding diathesis | #intra-aortic-balloon-pump, #cardiogenic-shock, #mechanical-circulatory-support, #hemodynamic-monitoring, #acute-myocardial-infarction | 2026-05-25 |
| sources/mcs-jic-2023 | Nakata/Yamamoto/Saku et al. 2023 J Intensive Care review (11:64): tMCS in cardiogenic shock — PV loop framework for IABP/VA-ECMO/Impella/ECPELLA; device complication rates (IABP: bleeding 12.9%/limb 1.5%; Impella: 27.7%/4.2%; VA-ECMO: 28.2%/14.3%); ECPELLA Schrage 2020 HR 0.79; J-PVAD Impella LVEF 35%→44.7%; three-step Impella/ECPELLA weaning protocol (PAPi ≥1.0 for VA-ECMO; PAWP <20+CPO ≥0.6W for Impella); SCAI-based selection protocol; IABP Shock II/SAVE/ENCOURAGE risk scores; shock team mortality reduction 40%→28% | #cardiogenic-shock, #mechanical-circulatory-support, #Impella, #VA-ECMO, #ECPELLA | 2026-05-25 |
| sources/lpa-molecules-2023 | Lampsas/Xenou/Oikonomou et al. 2023 Molecules narrative review (28:969): Lp(a) pathophysiology to treatment; distinct contribution — molecular thrombogenicity mechanisms: platelet GPIIb/IIIa via RGD epitope (cAMP-dependent); TF upregulation via Mac-1/NF-κB; TFPI inhibition (lysine-dependent); PAI-1 upregulation; fibrin clot tightening (Lp(a) ≥30 mg/dL → lower clot permeability); endothelial dysfunction (Rho/ROCK pathway → barrier disruption; EPC impairment; FMD r=−0.33; small apo(a) ≤22 KIV → lower FMD independent of Lp(a) level); arterial wall attachment via decorin 2-part interaction (apoB-GAG electrostatic + apo(a)-protein core hydrophobic); smaller isoform effects on OxPL/fibrin binding/thrombogenicity; dose-dependent OxPL bidirectionality (low Lp(a) anti-inflammatory; high pro-inflammatory); treatment: niacin only approved agent (25–38%); PCSK9i 26.7% (n=64,107, 41 studies); ASO up to 90% | #lipoprotein-a, #atherosclerotic-cardiovascular-disease, #oxidized-phospholipids, #thrombogenicity, #vascular-inflammation | 2026-05-23 |
| sources/lpa-jacc-2017 | Tsimikas S. 2017 JACC review (JACC 69:692-711): Lp(a) structure (apo[a] KIV-2 repeats 1→>40; disulfide bond at KIV-9/apoB; evolved from plasminogen), metabolism (>90% LPA-gene determined; LDLR modest role; longer plasma residence), CVD mechanisms (OxPL-apoB primary carrier; monocyte trafficking via radiolabeled study; antifibrinolytic potential limited in vivo), CAVS (LPA rs10455872 only monogenic CAVS risk factor; ASTRONOMER: Lp[a] >58.5 mg/dL + OxPL-apoB >5.5 nM → 0.26 vs 0.17 m/s/yr progression; rosuvastatin raised Lp[a] +20% OxPL-apoB +46%), residual risk (AIM-HIGH HR +89%; JUPITER HR +71%; LIPID HR +23%; pooled HR 1.61 across 13,167 statin-treated pts), 9 controversies, statin analysis (3,896 pts: mean +11% Lp[a]; +24% OxPL-apoB), >50% reduction threshold hypothesis, IONIS-APO(a)-LRx 66-92% reduction; CardiogramPlus4D: LPA locus most potent CAD genetic variant | #lipoprotein-a, #atherosclerotic-cardiovascular-disease, #calcific-aortic-valve-stenosis, #antisense-oligonucleotide, #oxidized-phospholipids | 2026-05-23 |
| sources/angptl3-inhibition-tcm-2024 | Luo/Das/Khetarpal/Rosenson/Qamar et al. 2024 Trends Cardiovasc Med review: ANGPTL3 biology (460aa hepatokine; LXR-regulated; chromosome 1p31; furin cleavage; inhibits LPL→raises TG + EL→raises HDL-C; ANGPTL8 complex; LDLR-independent LDL-C lowering via EL-dependent VLDL clearance); genetic epidemiology (DiscovEHR n=58,335 OR 0.59; MI Genetics Consortium n=180,180 OR 0.66; familial combined hypolipidemia Musunuru 2010 WES); evinacumab Phase 3 HoFH (Raal; n=65; −47% LDL-C −55% TG; null-null −43.4% vs non-null −49.1%); vupanorsen discontinued TRANSLATE-TIMI 70 (liver fat + ALT/AST); ARO-ANG3 siRNA ARCHES-2 Phase 2b ongoing; BE3-Angptl3 murine base editing 35% editing rate; VLP vaccine mouse models; FDA/EMA approved evinacumab HoFH ≥12yr | #angptl3, #dyslipidemia, #lipid-lowering-therapy, #familial-hypercholesterolemia, #atherosclerotic-cardiovascular-disease | 2026-05-23 |
| sources/syncope-aha-acc-hrs-2017 | Shen/Sheldon et al. 2017 ACC/AHA/HRS Syncope Guideline (JACC 2017;70:e39-110): syncope definition (cerebral hypoperfusion, trimodal 20/60/80yr), evaluation framework (history+ECG Class I; ICM 55% vs 19% diagnostic yield; routine neuro-imaging Class III No Benefit), risk stratification (short/long-term factors; risk scores not superior to clinical judgment), VVS management (counterpressure IIa; midodrine IIa; pacing IIb ≥40yr + documented pauses), cause-specific management across reflex/cardiac/channelopathic/structural etiologies, OH management (water ingestion Class I; midodrine/droxidopa IIa), carotid sinus syndrome pacing IIa | #syncope, #guidelines, #vasovagal-syncope, #risk-stratification, #orthostatic-hypotension | 2026-05-23 |
| sources/va-scd-aha-2017 | Al-Khatib/Stevenson et al. 2017 AHA/ACC/HRS Guideline (JACC 2018;72:e91-220): VA management and SCD prevention — comprehensive primary/secondary prevention ICD indications (LVEF ≤35% thresholds, 40-day post-MI/90-day post-revasc waiting periods), HCM risk factor table, ARVC ICD criteria, channelopathy management, Lamin A/C ≥2 risk factors criterion, value statements (primary prevention = high value <$50K/QALY), procainamide superiority for stable VT | #ventricular-arrhythmia, #sudden-cardiac-death, #ICD-indications, #catheter-ablation, #guideline | 2026-05-23 |
| sources/gene-editing-acc-2026 | Ambardekar et al. 2026 ACC Scientific Statement (JACC 2026): comprehensive GET overview — 4 editing mechanisms (CRISPR-Cas9/base/prime/epigenome editing); LNP vs AAV delivery platforms; ATTR-CM (nex-z −90% TTR; MAGNITUDE Phase 3 paused Oct 2025 for hepatotoxicity/death); lipid GET (PCSK9 base editing −53% LDL-C; ANGPTL3 −49% LDL-C −55% TG; LPA targets); DMD AAV clinical fatality; ~1% genetic testing rate; 15-year FDA follow-up requirement; no clinical recommendations issued | gene-therapy, CRISPR-Cas9, attr-cardiomyopathy, lipid-lowering-therapy, cardiovascular-genetics | 2026-05-23 |
| sources/bradycardia-acc-aha-hrs-2018 | Kusumoto et al. 2018/2019 ACC/AHA/HRS multi-society guideline (JACC 2019;74:e51-156): definitive bradycardia/conduction delay guideline superseding 2008 device-based therapy document; SND pacing requires symptom–bradycardia correlation (no minimum HR/pause threshold); Mobitz II/high-grade/third-degree AV block → PPM regardless of symptoms; LVEF 36–50% + ventricular pacing >40% → CRT/His bundle pacing preferred over RV; TAVR conduction disturbances; atrial-based pacing over VVI for SND; shared decision-making and pacemaker withdrawal rights | bradycardia, sinus-node-dysfunction, atrioventricular-block, permanent-pacing, cardiac-conduction-delay | 2026-05-23 |
| sources/marfan-ghent-aclingene-2015 | von Kodolitsch/De Backer et al. 2015 Appl Clin Genet review: comparative analysis Berlin 1988→Ghent-1 1996→Ghent-2 2010 nosologies; prevalence 1.5–17.2/100,000 (6 studies; far below 1:5,000 estimate); diagnostic delay median 2yr (EURORDIS 682 families; 72% harmed); seven-signs adult screening tool (ectopia lentis 4pts; FHx 2pts; 5 single-point features); Ghent-1 vs Ghent-2 near-identical yields (FBN1+ 90% vs 92%; FBN1- 15% vs 13%); no external reference standard; >1,500 FBN1 mutations; VUS burden; Z-score BSA issue (Roman 1989 underestimates in tall patients); Lacro 2014 NEJM: atenolol = losartan (definitive) | marfan-syndrome, ghent-nosology, diagnostic-criteria, connective-tissue-disorders, FBN1 | 2026-05-23 |
| sources/marfan-ghent-jmg-2010 | Loeys/Dietz et al. 2010 J Med Genet original article: revised Ghent nosology for MFS — 4 sporadic + 3 family-history diagnostic routes; cardinal features Ao Z≥2 + ectopia lentis; systemic score (max 20 pts; ≥7 = systemic); bona fide FBN1 mutation criteria (Box 3); children provisions (potential MFS; non-specific CTD); related conditions (ELS/MASS/MVPS) formally defined; surgery at 5.0 cm; ~90% concordance with 1996 criteria | marfan-syndrome, ghent-nosology, connective-tissue-disorders, aortic-aneurysm, diagnostic-criteria | 2026-05-23 |
| sources/marfan-cv-clingene-2015 | Cook/Ramirez 2015 Clin Genet review: Ghent 2010 criteria; MVP ~75%; aortic stiffness as independent dissection risk factor; elastic fiber fragmentation before dilation; DCM as primary cardiomyopathy (Cook 2014 JCI — exception to anti-TGFβ therapy); canonical/non-canonical TGFβ pathways; AT1R/AT2R balance; losartan Groenink 2013 RCT; doxycycline + pravastatin preclinical; AOS (SMAD3), SGS (SKI), sTAA (TGFB2); two-pathway TAA model | marfan-syndrome, tgf-beta-signaling, mouse-models, aortopathy, related-connective-tissue-disorders | 2026-05-23 |
| sources/marfan-naturerc-2010 | Cañadas/Vilacosta/Fuster 2010 Nat Rev Cardiol Part 1 (pathophysiology + diagnosis): >1,000 FBN1 mutations; exon 24–32 severe/neonatal cluster; Habashi 2006 losartan mouse data; cystic medial necrosis; echo measurement standards (leading-edge, z-score >2); sinus:annulus ratio ≥1.45 pediatric screen; dural ectasia quantitative (L3 >0.47 / S1 >0.57 — 95% Sn/98% Sp); LDS Type I vs II; ACTA2/MYH11 familial TAAS | marfan-syndrome, connective-tissue-disorders, echocardiography, fibrillin-1, tgf-beta-signaling | 2026-05-23 |
| sources/marfan-lancet-2005 | Judge/Dietz 2005 Lancet Seminar: Marfan syndrome — FBN1 haploinsufficiency, Ghent 1996 criteria, multisystem manifestations (aortic root, ectopia lentis, skeletal, dural ectasia), TGF-β dysregulation mechanism, beta-blockers standard of care, Bentall vs valve-sparing surgery, Loeys-Dietz syndrome differential | marfan-syndrome, connective-tissue-disorders, aortic-aneurysm, fibrillin-1, tgf-beta-signaling | 2026-05-23 |
| sources/cardiac-glycosides-hfrEF-fcvm-2026 | Wang/Pan/Peng et al. 2026 Front. Cardiovasc. Med. systematic review + meta-analysis (6 RCTs; n=8,488; HFrEF): cardiac glycosides vs placebo — all-cause mortality HR=0.98 (NS); HF hospitalization HR=0.79 (P<0.05); indirect digitoxin vs digoxin comparison NS for both outcomes; hospitalization result sensitive to DIG trial exclusion; DIGIT-HF (2025) only contemporary GDMT trial included | cardiac-glycosides, heart-failure, HFrEF, digoxin, meta-analysis | 2026-05-22 |
| sources/crp-hf-jacc-2021 | Bozkurt et al. 2021 JACC Expert Panel: CR in HF — Class 1A ACC/AHA; HF-ACTION backbone evidence; 10–30% participation worldwide; FITT framework; HF-ACTION protocol (60–70% HRR; 36 sessions); MCT mainstay; HIIT not superior (SMARTEX-HF); inspiratory muscle training in respiratory weakness; LVEF not reliable CR benefit marker; no CMS HFpEF coverage; 6-week wait removal + telemedicine expansion proposed | #heart-failure, #cardiac-rehabilitation, #exercise-training, #HFrEF, #HFpEF | 2026-05-22 |
| sources/mavacamten-explorer-hcm-lancet-2020 | Olivotto et al. 2020 Lancet EXPLORER-HCM phase 3 RCT (N=251; 30 weeks; obstructive HCM NYHA II–III): mavacamten vs placebo — primary composite (pVO2 + NYHA) 37% vs 17% (p=0.0005); post-exercise LVOT gradient −35.6 mmHg (p<0.0001); NYHA ≥1 class 65% vs 31%; complete response (LVOT <30+NYHA I) 27% vs 1%; NT-proBNP 80% greater reduction; hs-cTnI 41% greater reduction; LVEF <50% transient in 7 patients, all recovered; pivotal trial establishing mavacamten as first disease-specific HCM therapy | #hypertrophic-cardiomyopathy, #mavacamten, #LVOT-obstruction, #cardiac-myosin-inhibitor, #randomized-controlled-trial | 2026-05-22 |
| sources/wct-baseline-jecg-2021 | Evenson/Kashou/May et al. 2021 J Electrocardiol correspondence: conceptual basis — SWCT electrically constrained by His-Purkinje (near-identical QRS to baseline); VT has electrical freedom (markedly different from baseline); exceptions: fascicular VT + BBR-VT resemble baseline; literature timeline: Sandler 1965 (44% SVT vs 4% PVC shared initial vector), Dongas 1985 (unchanged V1/II/III morphology → SWCT), Griffith 1991 (≥40° axis shift 83% VT vs 36% SWCT), Pachón 2019 (4 baseline criteria: QRS normalisation AF 100% Sp; QRS narrower 99% Sp; discordant BBB 99% Sp; identical morphology 99% Sp SWCT); WCT Formula II 2020 (PTVAC; AUC 0.96); all 3 automated AUCs: WCT Formula 0.97, VT Prediction 0.90, WCT Formula II 0.96 | #wide-complex-tachycardia, #ventricular-tachycardia, #ECG-algorithm, #automated-ECG-interpretation, #baseline-ECG-comparison | 2026-05-22 |
| sources/wct-kashou-jaha-2020 | Kashou/May et al. 2020 JAHA mini review: comprehensive WCT algorithm taxonomy — multistep (Brugada/Vereckei/LLA), VT-as-default (Griffith), Bayesian (Lau 2000; pretest LR×serial multiplication), single-criterion (Pava), point-based (Jastrzebski PPV 100%≥4; Pachón PPV 100%≥2/PPV 98%−1); AV dissociation visible on 12-lead ECG in ~1/5 VTs; all algorithms EP-lab validated only — real-world performance unknown; automated methods: WCT Formula (frontal/horizontal amplitude change→VT probability 0–100%) and VT prediction model (QRS/T axis/duration change); both require paired baseline ECG; ML future direction; authors have CoI in automated methods | #wide-complex-tachycardia, #ventricular-tachycardia, #ECG-algorithm, #automated-ECG-interpretation, #electrocardiography | 2026-05-22 |
| sources/vt-chen-hrs-2019 | Chen/Natale et al. 2019 Heart Rhythm prospective original article (n=528 EP-confirmed WCTs; 397 VT, 131 SVT; Texas Cardiac Arrhythmia Institute + Henan Provincial Hospital China): introduces Limb Lead Algorithm (LLA) — (1) monophasic R aVR; (2) neg I+II+III; (3) OQL: concordant monophasic inferior leads + opposite polarity remaining limb leads; any one criterion = VT; Sn 87.2%, Sp 90.8% (highest), PPV 96.7% (highest), κ 0.98 (best), AUC 0.89; no measurements required; Brugada specificity 59.5% overall/48.1% RBBB (most granular independent validation); LLA fails for fascicular/para-Hisian/papillary muscle VT | #ventricular-tachycardia, #wide-QRS-complex, #electrocardiography, #ECG-algorithm, #differential-diagnosis | 2026-05-22 |
| sources/lpfvt-svt-circep-2017 | Michowitz/Tovia-Brodie/Belhassen et al. 2017 Circ EP original article (n=183 LPF-VT ECGs vs 61 RBBB+LAHB controls; Tel Aviv/Sheba ablation centres + Medline): first systematic ECG characterisation of LPF-VT; 4-criterion multivariate model — atypical V1 (OR 5.1), positive aVR (OR 19.2), V6 R/S ≤1 (OR 6.7), QRS ≤140 ms (OR 7.7); ≥3 criteria = high probability LPF-VT; Sn 82.1%/Sp 78.3%; confirms RS interval 62 ms (not discriminating from RBBB+LAHB P=0.4); Vi/Vt >1; Wellens >140 ms criterion inverted; all standard WCT algorithms fail for LPF-VT | #fascicular-ventricular-tachycardia, #wide-QRS-complex, #electrocardiography, #ECG-algorithm, #differential-diagnosis | 2026-05-21 |
| sources/vt-vereckei-ehj-2007 | Vereckei/Duray/Miller et al. 2007 EHJ prospective original article (n=453 EP-confirmed WCTs; 331 VT, 105 SVT, 17 PXT; Indiana University EP lab): introduces Vereckei 2007 12-lead algorithm — (1) AV dissociation; (2) initial R wave in aVR → VT (never positive in 17 PXTs); (3) morphology inconsistent with BBB/fascicular block → VT; (4) Vi/Vt ≤1 → VT (Vi/Vt = voltage initial 40 ms / terminal 40 ms); overall accuracy 90.3% vs Brugada 84.8% (P=0.006); Sn 95.7% vs 88.2%; Step 4 Vi/Vt TA 82.2% vs Brugada morphological 68% (P=0.004); superior in pre-existing BBB, AAD treatment, idiopathic VT subgroups; Vi/Vt not applicable in 3.5% (all VTs); first true head-to-head comparison vs Brugada; led to 2008 aVR-only simplification | #ventricular-tachycardia, #wide-QRS-complex, #electrocardiography, #ECG-algorithm, #differential-diagnosis | 2026-05-21 |
| sources/vt-brugada-circ-1991 | Brugada P et al. 1991 Circulation prospective original article (n=554 EP-confirmed WCTs; 384 VT, 170 SVT-A; OLV Hospital Aalst): landmark paper introducing the Brugada 4-step algorithm — (1) absence of RS in all precordials Sp 100%; (2) RS interval >100 ms in any precordial Sp 98%; (3) AV dissociation Sp 98%; (4) morphological criteria V1/V2 + V6 (RBBB: monophasic R/qR/RS R>S; V6 QS/QR/R≤S; LBBB: R>30 ms/RS>60 ms/notched S; V6 any Q) — overall Sn 98.7% Sp 96.5%; defines RS interval measurement; highlights fascicular VT and pre-excited SVT as algorithm limitations | #ventricular-tachycardia, #wide-QRS-complex, #electrocardiography, #ECG-algorithm, #differential-diagnosis | 2026-05-21 |
| SOURCES | |||
| sources/svt-esc-2019 | Brugada/Katritsis et al. 2019 ESC Guidelines for SVT (EHJ 2019;40:4768–4817): replaces 2003 ESC guidelines; 22 recommendation tables covering all SVT subtypes; key new evidence: PROCAMIO trial (procainamide superior to amiodarone in stable WCT); modified Valsalva (43% vs 17% conversion); asymptomatic pre-excitation EPS Class I for high-risk/athletes; TCM Class I for catheter ablation; intermittent pre-excitation downgraded as low-risk marker; amiodarone Class III/B in pre-excited AF (mechanism confirmed); anticoagulation IIa/C for flutter without AF; IST catheter ablation explicitly not recommended | #supraventricular-tachycardia, #catheter-ablation, #arrhythmia-management, #accessory-pathway, #guidelines | 2026-05-21 |
| sources/svt-aha-2015 | Page/Joglar/Caldwell et al. 2015/2016 ACC/AHA/HRS multi-society guideline (Circulation 2016;133:e506-e574): comprehensive SVT management (excluding AF) in adults — AVNRT, AVRT/WPW, focal/multifocal AT, atrial flutter, IST, junctional tachycardia; hierarchical acute management (vagal maneuvers → adenosine → IV CCB/BB → cardioversion); catheter ablation Class I first-line for symptomatic AVNRT/AVRT; Class III/Harm AV nodal blockers in pre-excited AF; atrial flutter anticoagulation mirrors AF; CTI ablation >97% success; full drug tables (acute/ongoing) and special populations (pregnancy, ACHD, pediatrics, elderly) | #supraventricular-tachycardia, #arrhythmia-management, #catheter-ablation, #antiarrhythmic-drugs, #guidelines | 2026-05-21 |
| sources/svt-vt-europace-2011 | Alzand/Crijns 2011 Europace review (Maastricht UMC): 45-year historical evolution of BCT diagnostic criteria — clinical history PPVs (MI 98%, CHF/angina 100%); AV dissociation in up to 50% of VTs (VA conduction); canon A waves vs frog sign; Lewis lead technique; classical criteria (Sandler-Marriott 1965 concordance/rabbit ears; Wellens 1978; Swanick 1972; Griffith 1991 multivariate; Alberca 1997 specificity); Brugada 4-step (Sn 0.987/Sp 0.965); Vereckei aVR 2007 vs 2008 simplified; limitations: class Ic/III drug-induced BCT, bundle branch reentry (rapid intrinsicoid deflection), fascicular VT (RS <80 ms — below Brugada threshold), pre-excited SVT; default VT diagnosis + procainamide when uncertain | #broad-complex-tachycardia, #ventricular-tachycardia, #ECG-algorithm, #supraventricular-tachycardia, #electrocardiography | 2026-05-21 |
| sources/svt-vt-basel-jaccep-2022 | Moccetti/Yadava/Reichlin et al. 2022 JACC CEP original research (n=206 derivation + 203 validation WCT episodes; EP-confirmed diagnoses; Basel University Hospital + OHSU): Basel Algorithm — 3-criterion WCT differentiation tool (clinical high-risk + lead II TFP >40 ms + lead aVR TFP >40 ms; VT if ≥2 of 3 met); SN 93.3%, SP 90.4% (validation); comparable to Brugada/Vereckei accuracy; time to diagnosis 38 sec vs 106 sec (Brugada; P=0.002) and 48 sec (Vereckei; P=0.02); superior diagnostic accuracy vs Vereckei (81% vs 72%; P=0.002) in clinical applicability test; underperforms in fascicular VT, antidromic AVRT, Mahaim | #wide-complex-tachycardia, #ventricular-tachycardia, #supraventricular-tachycardia, #electrocardiography, #ECG-algorithm | 2026-05-21 |
| sources/bisoprolol-copd-jcopd-2023 | Feng/Zhang/Liu et al. 2023 IJCOPD PRISMA meta-analysis of 35 RCTs (n=3,269; bisoprolol vs control in COPD; 32/35 Chinese studies; 2/35 placebo-controlled; 2/35 blinded): bisoprolol improved FEV1 +0.46 L (P<0.001), FVC +0.20 L (P=0.008), FEV1% +0.64pp (P<0.001), 6MWD (P<0.001); reduced IL-6 −1.16, IL-8 −0.94, CRP −1.74 (all P<0.001); adverse events NS vs control (RR 0.83; P=0.38); subgroup analyses showed effects independent of HF status; high heterogeneity (I²=66–95%); BLOCK COPD (metoprolol, placebo-controlled) not addressed; two ongoing bisoprolol RCTs (ISRCTN10497306; NCT03917914) | #bisoprolol, #COPD, #beta-blockers, #meta-analysis, #systematic-review | 2026-05-21 |
| sources/metoprolol-block-copd-nejm-2019 | Dransfield/Bhatt et al. 2019 NEJM BLOCK COPD double-blind RCT (n=532; 26 US centres; moderate-severe COPD, mean FEV1 41% predicted; no established BB indication; extended-release metoprolol vs placebo; ~1yr): primary endpoint (time to first COPD exacerbation) neutral (202 vs 222 days; HR 1.05; P=0.66) — trial stopped early for futility and safety; metoprolol increased hospitalisation for exacerbation (HR 1.91; 95% CI 1.29–2.83); very severe exacerbation rate ratio 3.71; 11 vs 5 deaths (7 vs 1 COPD-attributed); worsened dyspnea (SOBQ +4.80 pts, exceeds MCID) and COPD symptoms (CAT +1.47 pts); no FEV1 change; directly refutes observational data suggesting BB benefit in COPD without cardiac indication | #beta-blockers, #COPD, #exacerbations, #metoprolol, #randomized-controlled-trial | 2026-05-21 |
| sources/olezarsen-essence-timi73b-nejm-2025 | Bergmark/Marston/Sabatine et al. 2025 NEJM ESSENCE–TIMI 73b Phase 3 double-blind RCT (n=1,349; moderate HTG TG 150–499 mg/dL + elevated CV risk; 160 sites; monthly SC olezarsen 50 mg or 80 mg vs placebo; 12 months): primary 6-month placebo-adjusted TG reduction −58.4 pp (50 mg; P<0.001) and −60.6 pp (80 mg; P<0.001); TG <150 mg/dL achieved 85–89% vs 12.5% placebo; APOC3 −62–70%; remnant cholesterol up to −70%; non-HDL-C −22%; ApoB −15%; LDL-C unchanged; safety comparable to placebo except more injection-site reactions and mild transaminase elevations (no clinically significant hepatotoxicity); no platelet safety signal; first phase 3 RCT of APOC3 inhibition in broad moderate HTG population | #hypertriglyceridemia, #antisense-oligonucleotide, #apolipoprotein-C-III, #lipid-lowering-therapy, #cardiovascular-risk | 2026-05-21 |
| sources/pots-ccs-2020 | Raj/Guzman/Sheldon et al. 2020 CCS Position Statement on POTS and Related Disorders (Can J Cardiol 2020;36:357–372): novel nomenclature ecosystem for chronic orthostatic intolerance — POTS (core criteria with CCS clarifications: minimum HR 90 bpm adults/100 bpm teens; sustained ≥2 readings ≥1 min apart; ≥3 months), POTS plus (POTS + debilitating non-CV symptoms ± comorbidities: hEDS 25%, CFS/ME 21%, fibromyalgia 20%, MCAS 9%), PSWT (symptoms without tachycardia — NOT POTS), PTOC (secondary identifiable cause — NOT POTS), asymptomatic orthostatic tachycardia; GRADE-graded treatment: salt 10 g/day + 3 L fluid + semirecumbent exercise (strong first-line); midodrine (strong, moderate QOE) + low-dose propranolol (strong, moderate QOE) as first-line pharmacotherapy; pyridostigmine/fludrocortisone/ivabradine/clonidine/methyldopa weak suggestions; strong recommendations AGAINST chronic IV saline, RF sinus node ablation, Chiari decompression, jugular venoplasty | #postural-orthostatic-tachycardia-syndrome, #orthostatic-intolerance, #autonomic-dysfunction, #dysautonomia, #guidelines | 2026-05-21 |
| sources/POTS-IST-VVS-HRS-2015 | Sheldon et al. 2015 HRS/AAS/ACC/AHA/APHRS/EHRA/PACES/SOLAECE multi-society consensus on POTS, IST, and VVS: POTS defined by HR ≥30 bpm increase on standing (≥40 bpm aged 12–19), 4 subtypes (neuropathic/hypovolemic/hyperadrenergic/deconditioning), prevalence 0.2%; IST defined by resting HR >100 bpm + mean 24h HR >90 bpm, ivabradine 70% symptom elimination in small RCT; VVS cumulative incidence 42% women/32% men by age 60, physical counterpressure maneuvers 39% RRR, ISSUE-3 pacing 57% RRR in asystole + negative tilt test; pacing and sinus node ablation not recommended for POTS/IST | #POTS, #vasovagal-syncope, #inappropriate-sinus-tachycardia, #autonomic-dysfunction, #orthostatic-intolerance | 2026-05-20 |
| sources/ht-esc-2024 | McEvoy/McCarthy/Bruno et al. 2024 ESC Guidelines for Elevated Blood Pressure and Hypertension (European Heart Journal 2024;45:3912–4018): new 3-category BP classification (Non-elevated <120/70; Elevated 120–139/70–89; Hypertension ≥140/90); unified SBP target 120–129 mmHg (Class I, A); SCORE2/SCORE2-OP risk-stratified treatment of elevated BP; primary aldosteronism ARR screening ALL confirmed HT patients (Class IIa, B); renal denervation upgraded Class III → IIb; HMOD triggers treatment at elevated BP without SCORE2; pregnancy threshold lowered to ≥140/90 mmHg; single guideline replacing 2018 ESC/ESH | hypertension, blood-pressure, cardiovascular-risk, pharmacotherapy, guidelines | 2026-05-20 |
| sources/obicetrapib-broadway-nejm-2025 | Nicholls/Nelson/BROADWAY Investigators 2025 NEJM phase 3 double-blind RCT (n=2,530; 188 sites; China/Europe/Japan/US; HeFH 17% or ASCVD 89% on max LLT; 2:1 obicetrapib 10 mg OD vs placebo; 365 days): primary LDL-C change Day 84: −32.6 pp between-group difference (P<0.001); achieved LDL 62.8 vs 92.3 mg/dL; <55 mg/dL attainment 51% vs 8%; Lp(a) −33.5%; ApoB −18.9%; HDL-C +136.3%; adverse events comparable to placebo; new-onset DM/glycaemia numerically lower (35.1% vs 40.0%); exploratory CV events HR 0.79 (NS; underpowered); BROOKLYN outcomes trial ongoing | dyslipidemia, CETP-inhibitor, LDL-cholesterol, familial-hypercholesterolemia, lipid-lowering-therapy | 2026-05-20 |
| sources/lorundrostat-advancehtn-nejm-2025 | Laffin/Nissen/Advance-HTN Investigators 2025 NEJM phase 2b double-blind RCT (n=285; 103 US sites; uncontrolled HT on 2–5 drugs; standardized regimen + 24h ABPM; 12 weeks): lorundrostat 50 mg vs 50→100 mg dose-adjustment vs placebo; primary 24h ambulatory SBP placebo-adjusted −7.9 mmHg (50 mg; P=0.001) and −6.5 mmHg (dose-adjusted; P=0.006); week 4 combined −5.3 mmHg (P<0.001); 53% Black; hyperkalemia K>6.0: 5–7% vs 0%; eGFR −13–15% (reversible); MATE1 inhibition → spurious creatinine rise (cystatin C preferred); no adrenal insufficiency | resistant-hypertension, aldosterone-synthase-inhibitor, lorundrostat, ambulatory-blood-pressure, randomized-controlled-trial | 2026-05-20 |
| sources/edoxaban-af-cad-nejm-2024 | Cho/Kang/Ahn et al. 2024 NEJM EPIC-CAD open-label RCT (n=1,040; 18 South Korean sites; AF + stable CAD; 12 months): edoxaban monotherapy vs edoxaban + antiplatelet (aspirin/clopidogrel) — NACE 6.8% vs 16.2% (HR 0.44; 95% CI 0.30–0.65; P<0.001; NNT 10.6); major ischemic events 1.6% vs 1.8% (HR 1.23; NS; underpowered); major + CRNM bleeding 4.7% vs 14.2% (HR 0.34); benefit driven by bleeding reduction; first RCT with standard-dose edoxaban including medically managed stable CAD; East Asian population only | atrial-fibrillation, coronary-artery-disease, edoxaban, antithrombotic-therapy, anticoagulation | 2026-05-20 |
| sources/NOAC-VTE-COBRRA-NEJM-2026 | Castellucci/Le Gal/Rodger et al. 2026 NEJM COBRRA PROBE RCT (n=2,760; 32 centres; Canada/Australia/Ireland; 3-month treatment; acute PE or proximal DVT): apixaban vs rivaroxaban — clinically relevant bleeding 3.3% vs 7.1% (RR 0.46; 95% CI 0.33–0.65; P<0.001); major bleeding 0.4% vs 2.4% (RR 0.16); CRNMB 2.9% vs 4.9% (RR 0.59); recurrent VTE 1.1% vs 1.0% (NS); first head-to-head RCT establishing apixaban as safer NOAC for acute VTE; bleeding difference concentrated in rivaroxaban loading-dose period (days 1–21) | venous-thromboembolism, noac, apixaban, rivaroxaban, bleeding-risk | 2026-05-20 |
| sources/Apixaban-VTE-HIPRO-NEJM-2025 | Piazza/Bikdeli/Goldhaber et al. 2025 NEJM HI-PRO double-blind RCT (n=600; single-centre Brigham and Women's Hospital; provoked VTE + ≥1 enduring risk factor; ≥3 months prior anticoagulation completed; 12-month extension): apixaban 2.5 mg BID vs placebo — recurrent VTE 1.3% vs 10.0% (HR 0.13; 95% CI 0.04–0.36; P<0.001; 87% reduction); major bleeding 0.3% vs 0% (NS); CRNMB 4.8% vs 1.7% (HR 2.68; P=0.06 trend); 10% placebo recurrence rate in "provoked" VTE challenges provoked/unprovoked binary; enduring risk factors (obesity, autoimmune, lung disease, ASCVD) identify high-recurrence subpopulation | venous-thromboembolism, apixaban, extended-anticoagulation, provoked-VTE, randomized-controlled-trial | 2026-05-20 |
| sources/baxdrostat-baxhtn-nejm-2025 | Flack/Williams/BaxHTN Investigators 2025 NEJM phase 3 double-blind RCT (n=794; 214 sites; uncontrolled HT ≥2 drugs or resistant HT ≥3 drugs including diuretic; SBP 135–170 mmHg; 12-week Part 1 + 8-week randomised-withdrawal Part 3): baxdrostat 1 mg and 2 mg once daily vs placebo added to background therapy — primary endpoint met: placebo-corrected SBP −8.7 mmHg (1 mg; 95% CI −11.5 to −5.8; P<0.001) and −9.8 mmHg (2 mg; 95% CI −12.6 to −7.0; P<0.001); BP <130 mmHg at 12 weeks ~40% vs 18.7%; resistant HT subgroup consistent (−9.1 and −9.8 mmHg); randomised-withdrawal confirmed slow BP offset (−5.1 mmHg difference; P=0.002); hyperkalemia K>5.5: 6.1% (1 mg) and 11.1% (2 mg) vs 0.4%; hyponatremia ~20%; eGFR −7 ml/min (reversible); no adrenal insufficiency; funded by AstraZeneca | resistant-hypertension, aldosterone-synthase-inhibitor, baxdrostat, randomized-controlled-trial, hypertension | 2026-05-20 |
| sources/vffr-fastiii-nejm-2026 | Daemen/FAST III Investigators 2026 NEJM investigator-initiated noninferiority RCT (n=2,235; 37 centers; 7 European countries; intermediate coronary lesions 30–80% stenosis; chronic or ACS; 1yr follow-up): vFFR (3D-QCA, no wire, no adenosine) vs pressure-wire FFR for revascularization guidance — primary MACE (death/MI/revasc) NONINFERIOR: 7.5% vs 7.5% (risk diff −0.02 pp; 95% CI −2.25 to 2.21; P=0.004 NI); vFFR detected more functionally significant lesions (40.9% vs 31.3%); higher revascularization rate (45% vs 36%); procedure time −5.1 min; intraprocedural complications 3.7% vs 6.0%; first RCT establishing angiography-based vFFR as equivalent to wire-based FFR for clinical outcomes | angiography-based-physiology, fractional-flow-reserve, coronary-physiology, intermediate-coronary-lesions, randomized-controlled-trial | 2026-05-20 |
| sources/bp-dm-bproad-nejm-2025 | Bi et al. 2025 NEJM BPROAD RCT (n=12,821; T2DM ≥50 years; SBP <120 vs <140 mmHg; 145 Chinese sites; median 4.2yr): primary composite (nonfatal stroke/MI, HF hosp, CV death) HR 0.79 (95% CI 0.69–0.90; P<0.001); stroke HR 0.79; albuminuria HR 0.87; SAE equivalent; hypotension 0.1% vs <0.1%; hyperkalemia 2.8% vs 2.0%; first adequately-powered RCT to confirm SBP <120 mmHg superior to <140 mmHg in T2DM | type-2-diabetes, hypertension, blood-pressure-control, cardiovascular-outcomes-trial, randomized-controlled-trial | 2026-05-20 |
| sources/ffrpci-mi-fullrevasc-nejm-2024 | Böhm/James et al. 2024 NEJM FULL REVASC RCT (n=1,542; STEMI + very-high-risk NSTEMI + multivessel CAD; FFR-guided complete revascularization vs culprit-only PCI; 32 centres, 7 countries; median 4.8yr): primary composite (death/MI/unplanned revasc) neutral (19.0% vs 20.4%; HR 0.93; P=0.53); death/MI HR 1.12 NS; unplanned revasc HR 0.76 NS; any revascularization HR 0.59 (lower with complete); stent thrombosis HR 2.80 (2.5% vs 0.9%; significant harm); 40% of FFR arm deferred all nonculprit lesions (FFR >0.80); diverges from angiography-guided COMPLETE trial (26% CV death/MI reduction); FFR cannot detect vulnerable plaque | stemi, multivessel-pci, fractional-flow-reserve, complete-revascularization, randomized-controlled-trial | 2026-05-20 |
| sources/cep-tavi-bhfprotecttavi-nejm-2025 | Kharbanda/BHF PROTECT-TAVI Investigators 2025 NEJM RCT (n=7,635; 33 UK centres; aortic stenosis; 1:1 Sentinel CEP vs no CEP during TAVI; stopped for futility Oct 2024): routine CEP did NOT reduce stroke (2.1% CEP vs 2.2% control; diff −0.02 pp; 95% CI −0.68 to 0.63; P=0.94); disabling stroke 1.2% vs 1.4% (NS); death within 72h 0.8% vs 0.7% (NS); serious adverse events 0.6% vs 0.3% (doubled with CEP); lower 99% CI excluded ≥40% RRR; device (both filters) deployed in 81.2%; CACE analysis concordant; confirms/supersedes PROTECTED TAVR (n=3,000) null result; definitively settles routine CEP in TAVI | TAVI, cerebral-embolic-protection, stroke-prevention, randomized-controlled-trial, aortic-stenosis | 2026-05-20 |
| sources/mvteer-matterhorn-nejm-2024 | Baldus/Doenst/Pfister et al. 2024 NEJM MATTERHORN investigator-initiated noninferiority RCT (n=210; Germany; HF + secondary MR; LVEF ≥20%; TEER MitraClip vs MV surgery; 1yr follow-up): first head-to-head TEER vs surgery in SMR — primary efficacy composite (death/HF hosp/reintervention/LVAD/stroke) TEER 16.7% vs surgery 22.5% (diff −6 pp; 95% CI −17 to 6; NI P<0.001); RRR 0.74 (0.41–1.34); primary 30-day safety: 14.9% vs 54.8% (diff −40 pp; P<0.001); major bleeding 3.1% vs 24.4%; new-onset AF 3.1% vs 27.8%; stroke 0% vs 4.4%; MR ≥3+ recurrence at 1yr: 8.9% vs 1.5% (NI met but directionally worse); NYHA/6MWD similar between groups; MR ≤2+ at 1yr 96.1% vs 98.6%; lower-risk population than COAPT (mean LVEF 43%; STS-PROM 2.0%); industry-independent academic oversight | secondary-mitral-regurgitation, transcatheter-edge-to-edge-repair, mitral-valve-surgery, heart-failure, randomized-controlled-trial | 2026-05-19 |
| sources/mvteer-reshapehf2-nejm-2024 | Anker/Friede/von Bardeleben et al. 2024 NEJM RESHAPE-HF2 investigator-initiated RCT (n=505; 30 sites; 9 countries; symptomatic HFrEF LVEF 20–50% + moderate-to-severe SMR 3+/4+ despite GDMT; median EROA 0.23 cm²; MitraClip TEER + GDMT vs GDMT alone; 24-month follow-up): all 3 co-primary endpoints met — HF hosp/CV death 37.0 vs 58.9/100 pt-yr (RR 0.64; P=0.002); HF hosp alone 26.9 vs 46.6/100 pt-yr (RR 0.59; P=0.002); KCCQ-OS +10.9 pts (P<0.001); NNT 5.1 for HF hosp; all-cause mortality NS (HR 0.90; consistent with less advanced disease than COAPT); NYHA I/II 74.5% vs 58.5% at 12m; MR ≤2+ 90.4% vs 36.1%; device safety 1.6%; extends TEER evidence below EROA 0.40 cm² threshold; first trial in moderate-to-severe SMR | secondary-mitral-regurgitation, transcatheter-edge-to-edge-repair, MitraClip, heart-failure, randomized-controlled-trial | 2026-05-19 |
| sources/mvteer-coapt-nejm-2023 | Stone/Mack et al. 2023 NEJM COAPT 5-year RCT follow-up (n=614; 78 US/Canadian sites; symptomatic HFrEF LVEF 20–50% + moderate-to-severe/severe SMR despite maximal GDMT; MitraClip TEER + GDMT vs GDMT alone): annualized HF hosp 33.1% vs 57.2%/yr (HR 0.53); all-cause mortality 57.3% vs 67.2% (HR 0.72; 95% CI 0.58–0.89); death/HF hosp 73.6% vs 91.5% (HR 0.53); device-specific safety events 1.4% (all ≤30 days); landmark analysis: benefit concentrated first 2–3 years; 44.9% of eligible control crossover after 2yr attenuates late divergence; days alive out of hospital 1124 vs 895; MR ≤1+ at discharge 82.3%; severe MS 7.6% device (no surgery); first-generation MitraClip; SGLT2i used in only 3 patients | secondary-mitral-regurgitation, transcatheter-edge-to-edge-repair, MitraClip, heart-failure, randomized-controlled-trial | 2026-05-19 |
| sources/tavr-dedicate-nejm-2024 | Blankenberg/Seiffert et al. 2024 NEJM DEDICATE-DZHK6 RCT (n=1,414; 38 German sites; severe symptomatic AS; low/intermediate surgical risk; median STS-PROM 1.8%; mean age 74; operator-choice CE-marked devices; industry-independent; 1yr follow-up): primary composite (death or stroke) TAVI 5.4% vs SAVR 10.0%; HR 0.53 (95% CI 0.35–0.79; P<0.001 noninferiority); all-cause death 2.6% vs 6.2% (HR 0.43); disabling stroke 1.3% vs 3.1% (HR 0.42); new-onset AF 12.4% vs 30.8% (HR 0.36); pacemaker 11.8% vs 6.7% (HR 1.81); major bleeding 4.3% vs 17.2% (HR 0.24); vascular complications 7.9% vs 0.7%; valve hemodynamics equivalent at 1yr; SAVR event rates higher than PARTNER 3 (COVID-19 + higher female proportion); largest industry-independent pragmatic TAVI–SAVR RCT | aortic-stenosis, TAVI, SAVR, randomized-controlled-trial, valvular-heart-disease | 2026-05-19 |
| sources/tvteer-triluminate-nejm-2023 | Sorajja/Adams et al. 2023 NEJM TRILUMINATE Pivotal RCT (n=350; 1:1; 65 centers US/Canada/Europe; severe symptomatic TR; intermediate/high surgical risk; 93.9% functional TR; 70.7% massive/torrential; mean age 78; 1yr follow-up): win ratio 1.48 (95% CI 1.06–2.13; P=0.02) favouring TriClip TEER; QoL-driven — KCCQ ≥15pts 49.7% vs 26.4%; mean KCCQ +12.3 vs +0.6 (P<0.001); TR ≤moderate 87.0% at 30 days, 88.1% at 1yr; NYHA I/II 83.9% vs 59.5%; 6MWD NS (−8.1 vs −25.2m); death/TV surgery 9.4% vs 10.6% NS; HF hosp 0.21 vs 0.17/pt-yr NS (control lower); safety: 98.3% MAE-free 30 days; PPM 2.9% both groups (no increase); BARC ≥3a 5.2%; no device embolization/thrombosis; single-leaflet attachment 7.0%; QoL-TR correlation: ≥2 grade reduction +18pts KCCQ vs no-change +2pts; echo core lab unblinded to group assignment | tricuspid-regurgitation, transcatheter-edge-to-edge-repair, TriClip, structural-heart-disease, randomized-controlled-trial | 2026-05-19 |
| sources/ttvr-triscendii-nejm-2025 | Hahn/Kodali et al. 2025 NEJM TRISCEND II RCT (n=400; 45 centers US+Germany; severe symptomatic TR; 2:1 EVOQUE TTVR + med therapy vs med therapy alone; 1yr follow-up): win ratio 2.02 (95% CI 1.56–2.62; P<0.001) favoring TTVR; QoL-driven — KCCQ-OS ≥10pts 66.4% vs 36.5%; NYHA ≥1 class 78.9% vs 24.0%; 6MWD ≥30m 47.6% vs 31.8%; TR ≤mild 95.2% vs 2.3%; RV EDD −5.8 mm (reverse remodeling); all-cause death 12.6% vs 15.2% (NS; not powered); HF hosp 20.9% vs 26.1% (NS); severe bleeding 15.4% vs 5.3% (P=0.003); new PPM 17.4% vs 2.3% (P<0.001); PPM 27.8% in naive patients; periprocedural anticoagulation protocol drives excess 30-day bleeding; no RVAD/transplant in either group; pivotal trial under FDA Breakthrough Device Program | tricuspid-regurgitation, transcatheter-valve-replacement, EVOQUE, structural-heart-disease, randomized-controlled-trial | 2026-05-19 |
| sources/tavi-earlytavr-nejm-2025 | Généreux/Leon et al. 2025 NEJM EARLY TAVR RCT (n=901; 75 US/Canadian sites; asymptomatic severe AS; LVEF ≥50%; STS-PROM ≤10%; mean age 75.8; 83.6% low surgical risk; SAPIEN 3/3 Ultra; median 3.8yr): early TAVR vs clinical surveillance — primary composite (death+stroke+unplanned CV hosp) HR 0.50 (95% CI 0.40–0.63; P<0.001); death HR 0.93 NS; stroke HR 0.62 NS; unplanned CV hosp HR 0.43; favorable outcome at 2yr 86.6% vs 68.0% (P<0.001); LV/LA health 48.1% vs 35.9% (P=0.001); 87% surveillance crossover at median 11.1 months; 39.2% with advanced symptoms before conversion; HF hosp HR 0.32 (exploratory); supports ESC 2025 Class IIa early intervention in asymptomatic severe AS | aortic-stenosis, asymptomatic-AS, TAVR, randomized-controlled-trial, valvular-heart-disease | 2026-05-19 |
| sources/iFR-PPCI-iMODERN-NEJM-2026 | Nijveldt/Maeng/van Royen et al. 2026 NEJM iMODERN RCT (n=1,146; 41 sites; STEMI + multivessel CAD; 3-year follow-up): immediate iFR-guided nonculprit PCI (iFR ≤0.89) vs deferred cardiac stress MRI-guided PCI within 6 weeks — primary composite (death/recurrent MI/HF hosp) NOT superior: 9.3% vs 9.8% (HR 0.95; 95% CI 0.65–1.40; P=0.81); iFR treated more lesions (42.6% vs 18.7%); HF hosp HR 0.24 (0.07–0.84) lower in iFR; stroke/TIA HR 0.36 (0.15–0.86) lower in iFR; stent thrombosis 1.7% vs 0.6% (higher iFR); first trial comparing physiologic (iFR) vs noninvasive imaging (MRI) guidance for nonculprit revascularization | stemi, multivessel-pci, ifr-guided-pci, complete-revascularization, randomized-controlled-trial | 2026-05-19 |
| sources/reduced-apixaban-apicat-nejm-2025 | Mahé/Carrier et al. 2025 NEJM API-CAT double-blind RCT (N=1,766; active cancer; ≥6 months prior anticoagulation for proximal DVT or PE; 121 centers; 11 countries; 12 months): apixaban 2.5 mg BID vs 5.0 mg BID — recurrent VTE noninferior (2.1% vs 2.8%; SHR 0.76; 95% CI 0.41–1.41; P=0.001); clinically relevant bleeding superior (12.1% vs 15.6%; SHR 0.75; P=0.03); major bleeding 2.9% vs 4.3% (NS); mortality 17.7% vs 19.6% (HR 0.96; NS); first RCT establishing reduced-dose apixaban as preferred extended-duration strategy in cancer-associated VTE | cancer-associated-VTE, apixaban, venous-thromboembolism, extended-anticoagulation, randomized-controlled-trial | 2026-05-19 |
| sources/PCI-TAVI-NOTION3-NEJM-2024 | Lønborg/Jabbari/Engstrøm et al. 2024 NEJM NOTION-3 RCT (n=455; 12 Nordic-Baltic sites; severe AS + FFR ≤0.80 or ≥90% stenosis; median age 82; STS-PROM 3%; SYNTAX 9; median 2yr follow-up): PCI + TAVI vs conservative + TAVI — primary MACE (death/MI/urgent revasc) HR 0.71 (95% CI 0.51–0.99; P=0.04); MI HR 0.54; urgent revasc HR 0.20 (both significant); all-cause death HR 0.85 (NS); bleeding HR 1.51 (higher with PCI); AKI HR 0.45 (lower with PCI); 89% complete revascularisation; supersedes neutral ACTIVATION trial; informs ESC 2025 Class IIa B recommendation for PCI ≥90% stenosis before TAVI | TAVI, aortic-stenosis, coronary-artery-disease, fractional-flow-reserve, randomized-controlled-trial | 2026-05-19 |
| sources/PCI-Elderly-SENIORRITA-NEJM-2024 | Kunadian/Fox et al. 2024 NEJM BHF SENIOR-RITA RCT (n=1,518; ≥75 years; mean age 82; 45% women; 32% frail; 62.5% cognitively impaired; 48 UK sites; median 4.1 years): invasive strategy (angiography ± revascularisation + best medical therapy) vs conservative (best medical therapy alone) — primary composite CV death or nonfatal MI neutral (HR 0.94; P=0.53); nonfatal MI HR 0.75 (P<0.05); CV death HR 1.11 NS; time-varying benefit: early advantage at 1 year (12.8% vs 16.8%) erodes by 5 years; subsequent revascularisation 3.9% vs 13.7%; radial access 89.3%; procedural complications <1%; largest and longest RCT in elderly NSTEMI | nstemi, elderly-patients, invasive-strategy, frailty, randomized-controlled-trial | 2026-05-18 |
| sources/oral-semaglutide-soul-nejm-2025 | McGuire/Marx/Mulvagh et al. 2025 NEJM SOUL superiority RCT (n=9,650; T2DM HbA1c 6.5–10%; age ≥50; ASCVD, CKD, or both; 444 sites, 33 countries; median 49.5 months; Novo Nordisk): oral semaglutide 14mg once daily vs placebo — primary 3-point MACE HR 0.86 (95% CI 0.77–0.96; P=0.006); nonfatal MI HR 0.74 (dominant); CV death HR 0.93 NS; nonfatal stroke HR 0.88 NS; kidney composite (confirmatory secondary) HR 0.91 (P=0.19) — not significant; major adverse limb events HR 0.71 (directional); HbA1c −0.56 pp; weight −2.95 kg; hsCRP 1.56 vs 2.01 mg/L; serious AEs 47.9% vs 50.3% (P=0.02 lower); GI discontinuations 6.4% vs 2.0%; first oral GLP-1 RA with CV superiority | type-2-diabetes, GLP-1-receptor-agonist, cardiovascular-outcomes-trial, oral-semaglutide, MACE | 2026-05-18 |
| sources/spironolactone-ami-clear-nejm-2025 | Jolly/d'Entremont/Pitt et al. 2025 NEJM CLEAR RCT spironolactone arm (n=7,062; 104 centres; 14 countries; 2×2 factorial; 95.1% STEMI post-PCI; spironolactone 25 mg vs placebo; median 3yr follow-up): both primary endpoints neutral — CV death/new HF HR 0.91 (P=0.51); MACE composite HR 0.96 (P=0.60); on-treatment HR 0.79/0.83 (approaching significance; driven by 28% dropout); gynecomastia 2.3% vs 0.5%; hyperkalemia 1.1% vs 0.6%; eGFR −1.8 ml/min/1.73m²; no LVEF data; largest RCT of routine MRA in unselected AMI — definitively negative ITT | spironolactone, acute-myocardial-infarction, mineralocorticoid-receptor-antagonist, randomized-controlled-trial, STEMI | 2026-05-18 |
| sources/as-recovery-nejm-2026 | Kang/Park et al. 2026 NEJM RECOVERY trial 10-year extended follow-up (N=145; asymptomatic very severe AS; AVA ≤0.75 cm² + Vmax ≥4.5 m/s; early SAVR vs conservative care; median 144 months): primary composite (CV death + operative mortality) 3% vs 24% (HR 0.10; P=0.002); all-cause mortality 15% vs 32% (HR 0.42); NNT=6 CV death, NNT=7 all-cause; 0% vs 19% HF hospitalisation; Kaplan-Meier curves diverged continuously at 10 years | aortic-stenosis, surgical-avr, asymptomatic-AS, randomized-controlled-trial, valvular-heart-disease | 2026-05-18 |
| sources/hf-copd-hfreview-2025 | Magrì/Fiori/Agostoni et al. 2025 narrative review (Heart Failure Reviews; Italian Society of Cardiology HF Working Group): bidirectional HF-COPD pathophysiology; 70% of COPD+HF is HFpEF; COPD 13% of HF patients (highest in HFpEF 16%); CPET VE intercept (≥2.6 L/min) identifies COPD in HF across EF spectrum; bisoprolol preferred in HFrEF+COPD; β-blockers contraindicated in HFpEF+COPD; LAMA+ICS preferred over LABA in new COPD diagnosis in HF | heart-failure, COPD, cardiopulmonary-interaction, HFpEF, beta-blockers | 2026-05-18 |
| sources/aav9-danon-nejm-2025 | Greenberg/Taylor/Rossano et al. 2025 NEJM Phase 1 open-label trial (n=7 males; Danon disease; rAAV9-LAMP2B single IV infusion 6.7×10¹³ or 1.1×10¹⁴ gc/kg + prednisone/calcineurin inhibitor/rituximab; 24–54 months follow-up): all 7 alive; 6 evaluable — LVM index median −23%; troponin I −84%; natriuretic peptides −57%; LAMP2 protein confirmed biopsy 6/6 at 12 months; adult patients now 21–24 yr (beyond typical transplant/death age 19–21 yr); grade 4 TMA in 1 high-dose patient (LVEF 32% baseline) requiring RRT → transplant; grade 3 steroid-induced myopathy (3 patients); anti-LAMP2B antibodies in several patients (no clinical sequelae); longest published AAV cardiac follow-up | gene-therapy, danon-disease, AAV9, hypertrophic-cardiomyopathy, LAMP2 | 2026-05-18 |
| sources/aav9-pompe-nejm-2025 | Ma/Zhuang/Feng et al. 2025 NEJM pilot trial (n=4 infants; infantile-onset Pompe disease; single IV rAAV9-coGAA 1.2×10¹⁴ vg/kg + prednisolone; 52-week observation): 3/4 survived with improved LVM index, LVEF, and HINE scores; 2 patients reached normal neurological milestones by 12 months; walked without assistance by 22–25 months — no anti-GAA antibodies detected in any patient (vs universal anti-rhGAA IgG with ERT); AAV9 crosses BBB (potential CNS benefit); respiratory infections (all 4 patients) worsened cardiac function and reduced GAA activity; 1 death (parental withdrawal); first human systemic AAV9-GAA data | gene-therapy, pompe-disease, AAV9, lysosomal-storage-disorder, acid-alpha-glucosidase | 2026-05-17 |
| sources/empagliflozin-empactmi-nejm-2024 | Butler/Jones/Udell et al. 2024 NEJM EMPACT-MI double-blind RCT (n=6,522; 451 sites; 22 countries; median 17.9 months): empagliflozin 10 mg within 14 days of MI (LVEF <45% or in-hospital congestion + ≥1 HF enrichment factor; 74.8% STEMI; 89.3% revascularised) — primary composite HF hosp or all-cause death NEUTRAL (8.2% vs 9.1%; HR 0.90; 95% CI 0.76–1.06; P=0.21); HF hosp alone HR 0.77 (0.60–0.98); all-cause death HR 0.96 (NS); CV death HR 1.03 (NS); total HF hosp rate ratio 0.67 (exploratory; 0.51–0.89); all secondary endpoints NS; safety comparable to placebo | empagliflozin, acute-myocardial-infarction, sglt2-inhibitors, heart-failure-prevention, randomized-controlled-trial | 2026-05-17 |
| sources/dapagliflozin-dapackd-nejm-2020 | Heerspink/Wheeler et al. 2020 NEJM DAPA-CKD double-blind RCT (n=4,304; 386 sites; 21 countries; eGFR 25–75; UACR 200–5000; 67.5% T2DM; 32.5% non-DM; dapagliflozin 10 mg vs placebo; median 2.4 years; stopped early for efficacy): primary composite (≥50% eGFR decline/ESKD/renal or CV death) HR 0.61 (9.2% vs 14.5%; P<0.001; NNT=19); renal-specific HR 0.56; CV composite HR 0.71; all-cause mortality HR 0.69; non-T2DM subgroup HR 0.50; eGFR chronic slope +1.92 mL/min/yr benefit; no DKA; first SGLT2i trial establishing benefit in non-diabetic CKD | sglt2-inhibitors, chronic-kidney-disease, dapagliflozin, cardiorenal-outcomes, randomized-controlled-trial | 2026-05-22 |
| sources/empagliflozin-empakidney-nejm-2025 | Herrington/Staplin et al. 2025 NEJM EMPA-KIDNEY post-trial follow-up (n=6,609 randomised; 4,891 in post-trial; ~4 years total; 185 sites; 7 countries): empagliflozin 10 mg vs placebo in CKD (eGFR 20–44 any UACR; or eGFR 45–89 + UACR ≥200) — combined primary composite (KD progression or CV death) HR 0.79 (95% CI 0.72–0.87; 26.2% vs 30.3%); ESKD HR 0.74; CV death HR 0.75; post-trial-only HR 0.87 (CI 0.76–0.99); legacy effect up to 12 months after stopping (6-month HR 0.60, year 2 HR 0.90 NS); benefits consistent across diabetes/non-diabetes, all eGFR/albuminuria strata; no non-CV death effect | sglt2-inhibitors, chronic-kidney-disease, empagliflozin, cardiorenal-outcomes, post-trial-follow-up | 2026-05-17 |
| sources/bb-mi-abyss-nejm-2024 | Silvain/Montalescot et al. 2024 NEJM ABYSS RCT (n=3,698; LVEF ≥40%; median 2.9yr post-MI; 49 French sites; PROBE design; median 3yr follow-up): BB interruption vs continuation — primary composite (death/MI/stroke/CV hosp) 23.8% vs 21.1%; HR 1.16 (95% CI 1.01–1.33); upper CI 5.5pp exceeds 3pp NI margin; noninferiority NOT met; hard outcomes identical (death 4.1 vs 4.0%; MI 2.5 vs 2.4%; stroke 1.0 vs 1.0%); CV hospitalisation drove composite (18.9 vs 16.6%); QoL no improvement (EQ-5D diff 0.002); concordant with REDUCE-AMI on hard outcomes | beta-blockers, myocardial-infarction, secondary-prevention, noninferiority-trial, coronary-artery-disease | 2026-05-17 |
| sources/tirzepatide-hfpef-summit-nejm-2025 | Packer/Zile/Borlaug et al. 2025 NEJM SUMMIT Phase 3 double-blind RCT (n=731; LVEF ≥50%; BMI ≥30; NYHA II–IV; 129 centres; 9 countries; median 104 weeks; Eli Lilly): tirzepatide up to 15 mg SC weekly vs placebo — both primary endpoints met: composite CV death/worsening HF HR 0.62 (95% CI 0.41–0.95; P=0.026); KCCQ-CSS +6.9 pts (P<0.001); weight −13.9% vs −2.2%; 6MWT +18.3m; CRP −38.8% (all P<0.001); all-cause death HR 1.25 NS (19 vs 15); first hard composite outcome benefit in obesity-HFpEF | heart-failure-preserved-ejection-fraction, tirzepatide, GLP-1-receptor-agonist, GIP-receptor-agonist, obesity | 2026-05-17 |
| sources/nexz-crispr-attrcm-nejm-2024 | Fontana/Gillmore et al. 2024 NEJM Phase 1 open-label trial (n=36; ATTR-CM; 50% NYHA III; 31% ATTRv; single site UK; median 18 months follow-up): nexiguran ziclumeran (nex-z/NTLA-2001), CRISPR-Cas9 LNP gene editing therapy, single IV infusion; mean serum TTR −89% at 28 days, −90% at 12 months (95% CI −93 to −87), sustained through 24 months; disease stable in 66% on all prognostic markers; NYHA improved 47%; KCCQ +8 pts; safety manageable (5 infusion reactions, 2 transient AST elevations, 1 unrelated death); first clinical CRISPR-Cas9 in ATTR-CM; Phase 3 MAGNITUDE trial ongoing | gene-therapy, attr-cardiomyopathy, CRISPR-Cas9, TTR-knockdown, lipid-nanoparticle | 2026-05-17 |
| sources/fe-hf-heartfid-nejm-2023 | Mentz et al. 2023 NEJM HEART-FID RCT (n=3,065; ambulatory HFrEF LVEF ≤40%; iron deficiency; median 1.9 yr): IV ferric carboxymaltose vs placebo; hierarchical primary composite (death/HF hosp/6MWT) win ratio 1.10 (99% CI 0.99–1.23; P=0.02) — did NOT meet pre-specified p<0.01; CV death/HF hosp HR 0.93 NS; all-cause death HR 0.90 NS; safe; largest IV iron RCT; contrasts with AFFIRM-AHF (acute HF) near-significant result | heart-failure, iron-deficiency, ferric-carboxymaltose, HFrEF, randomized-controlled-trial | 2026-05-17 |
| sources/tavr-partner3-5yr-nejm-2023 | Mack/Leon et al. 2023 NEJM PARTNER 3 5-year RCT (n=1,000; 71 sites; low-risk AS; STS-PROM 1.9%; SAPIEN 3 vs SAVR): composite death/stroke/rehospitalization TAVR 22.8% vs SAVR 27.2% (P=0.07; HR 0.79) — NS; win ratio 1.17 (NS); early TAVR superiority attenuated by year 5; mortality 10.0% vs 8.2% (NS; landmark years 1–5 HR 1.17 favoring surgery); AF 13.7% vs 42.4%; valve thrombosis 2.5% vs 0.2%; bioprosthetic-valve failure 3.3% vs 3.8%; KCCQ-OS 86.2 vs 85.9 | aortic-stenosis, TAVR, low-surgical-risk, bioprosthetic-valve-durability, randomized-controlled-trial | 2026-05-17 |
| sources/complete-pci-multistars-ami-nejm-2023 | Stähli et al. 2023 NEJM MULTISTARS AMI RCT (n=840; 37 European sites; hemodynamically stable STEMI + multivessel CAD): immediate multivessel PCI vs staged (19–45 days); primary composite (death/MI/stroke/unplanned revasc/HF hosp) 8.5% vs 16.3%; RR 0.52 (95% CI 0.38–0.72); P<0.001 noninferiority AND superiority; benefit in first 45 days from lower MI (2.0% vs 5.3%) and unplanned revasc (4.1% vs 9.3%); death/stroke/HF NS; major bleeding NS | stemi, multivessel-pci, complete-revascularization, coronary-artery-disease, pci-timing | 2026-05-17 |
| sources/pfa-advent-nejm-2023 | Reddy et al. 2023 NEJM ADVENT RCT (n=607; 30 US centers; Bayesian NI): PFA vs thermal ablation (RF/cryo) in drug-refractory PAF — efficacy NI (73.3% vs 71.3%; posterior NI >0.999); safety NI (2.1% vs 1.5%; posterior NI >0.999); PV area superior (−0.9% vs −12.0%; posterior superiority >0.999); 1 death (catheter manipulation); 3 asymptomatic MRI cerebral lesions PFA vs 0 thermal; first RCT of PFA vs thermal ablation | paroxysmal-atrial-fibrillation, pulsed-field-ablation, catheter-ablation, randomized-controlled-trial, noninferiority-trial | 2026-05-17 |
| sources/pfa-cryo-singleshotchampion-nejm-2025 | Reichlin/Kueffer/Sticherling 2025 NEJM SINGLE SHOT CHAMPION RCT (n=210; 2 Swiss centers; Farapulse pentaspline PFA vs Arctic Front cryo; all patients ICM continuous monitoring): PFA NI (P<0.001) AND superior (P=0.046) to cryoablation (37.1% vs 50.7% recurrence days 91–365; −13.6 pp; 95% CI −26.9 to −0.3); lower recurrence during blanking period too (−20.0 pp); PFA 18 min shorter; safety comparable (1 stroke PFA vs 2 tamponades cryo); first RCT with superiority signal for PFA over cryo | atrial-fibrillation, pulsed-field-ablation, cryoballoon-ablation, randomized-controlled-trial, continuous-rhythm-monitoring | 2026-05-18 |
| sources/crt-longterm-raft-nejm-2024 | Sapp/Tang 2024 NEJM RAFT Long-Term (n=1,050; 8 sites from original 1,798-patient RAFT; median 7.7yr all/13.9yr survivors; ITT; exponential AFT model): CRT-D vs ICD; primary all-cause death acceleration factor 0.80 (95% CI 0.69–0.92; P=0.002); secondary composite (death/HTx/LVAD) AF 0.85 (0.74–0.98); curves converge after 12yr; ~80% mortality at 15yr in CRT-D; benefit sustained despite AF and non-LBBB inclusion; longest CRT survival data available | cardiac-resynchronization-therapy, heart-failure-reduced-EF, long-term-outcomes, implantable-cardioverter-defibrillator, randomized-controlled-trial | 2026-05-17 |
| sources/tr-nejm-2023 | Hahn 2023 NEJM comprehensive TR review: anatomy (40% annular dilation threshold; RCA <3mm inferiorly; AV node 3–5mm from anteroseptal commissure), epidemiology (severe TR 1yr mortality 36–42%; HR 2.74 vs aortic HR 1.62 vs mitral HR 1.25), atrial/ventricular/CIED classification, 5-grade echo scheme, surgical (10–12% isolated TV mortality), TEER (80–85% ≤moderate; 30–50% ≤mild), TRILUMINATE Pivotal (WR 1.48 QoL-driven) | #tricuspid-regurgitation, #valvular-heart-disease, #transcatheter-interventions, #right-heart-failure, #echocardiography | 2026-05-17 |
| sources/semaglutide-stephfpef-nejm-2023 | Kosiborod/Borlaug 2023 NEJM STEP-HFpEF RCT (n=529; HFpEF LVEF ≥45% + BMI ≥30; no diabetes; 96 sites; 13 countries; 52 weeks): semaglutide 2.4mg SC weekly vs placebo — both dual primary endpoints met P<0.001: KCCQ-CSS +7.8 pts (vs 0.5–2.3 pts in prior HFpEF pharmacotherapy) and body weight −10.7 pp; all confirmatory secondary endpoints met: 6MWT +20.3m; hierarchical composite win ratio 1.72; CRP −43.5% vs −7.3%; HF hospitalizations 1 vs 12 (exploratory); serious adverse events 13.3% vs 26.7% (P<0.001; cardiac events 2.7% vs 11.3%); first obesity-targeting pharmacotherapy in HFpEF | heart-failure-preserved-ejection-fraction, semaglutide, GLP-1-receptor-agonist, obesity, randomized-controlled-trial | 2026-05-17 |
| sources/patisiran-attrcm-apollob-nejm-2023 | Maurer/Gillmore/APOLLO-B Investigators 2023 NEJM Phase 3 double-blind RCT (n=360; ~80% ATTRwt; 25% on tafamidis; 12 months): patisiran 0.3 mg/kg IV Q3W (LNP-siRNA) vs placebo in ATTR-CM — primary 6MWT +14.69 m (P=0.02) ✓ below MCID; KCCQ-OS +3.7 pts (P=0.04) ✓; composite death/CV events win ratio 1.27 NS ✗; composite death/hosp HR 0.88 NS ✗; deaths 4 vs 10 (HR 0.36 NS; underpowered); 86.8% TTR knockdown; exploratory: LV mass −9.45 g, NT-proBNP ratio 0.80, troponin I ratio 0.87; infusion reactions/arthralgia/muscle spasms more common; patisiran not approved for ATTR-CM; proof-of-concept for cardiac RNAi; succeeded by vutrisiran (HELIOS-B 2025 mortality benefit) | attr-cardiomyopathy, patisiran, RNA-interference, TTR-knockdown, heart-failure | 2026-05-17 |
| sources/CA-HF-CASTLEHTx-NEJM-2023 | Sohns/Marrouche/CASTLE-HTx Investigators 2023 NEJM single-center open-label RCT (n=194; end-stage HFrEF LVEF ≤35% + symptomatic AF + transplant/LVAD evaluation; ablation + GDMT vs GDMT alone; stopped early at 18-month median follow-up): primary composite (death/LVAD/urgent HTx) 8% vs 30% HR 0.24 (P<0.001); all-cause mortality 6% vs 20% HR 0.29; LVEF +7.8 vs +1.4 pp at 12mo; AF burden −31.4 vs −8.6 pp; first RCT demonstrating ablation benefit in end-stage HFrEF; single-center limitation | atrial-fibrillation, catheter-ablation, heart-failure, end-stage-heart-failure, randomized-controlled-trial | 2026-05-17 |
| sources/edoxaban-ahre-noahafnet6-nejm-2023 | Kirchhof/NOAH-AFNET 6 Investigators 2023 NEJM double-blind RCT (N=2,536; age ≥65; CIED-detected AHREs ≥6 min; no ECG-confirmed AF; median CHA₂DS₂-VASc 4; median AHRE duration 2.8h; 206 sites; 18 European countries; stopped early at 21 months): edoxaban vs placebo; primary composite (CV death + stroke + SE) HR 0.81 (NS); safety composite (death + major bleeding) HR 1.31 (P=0.03); major bleeding HR 2.10; stroke ~1%/yr in both groups (far below ECG-confirmed AF comparators); 18.2% developed ECG-confirmed AF during follow-up; low arrhythmia burden = unexpectedly low embolic risk; companion/contrasting trial to ARTESIA | subclinical-atrial-fibrillation, anticoagulation, edoxaban, atrial-high-rate-episodes, stroke-prevention | 2026-05-17 |
| sources/apixaban-scaf-artesia-nejm-2024 | Healey/Connolly ARTESIA Investigators 2024 NEJM Phase 3 double-blind RCT (N=4,012; mean CHA₂DS₂-VASc 3.9; mean age 76.8; CIED-detected SCAF 6 min–24 h; 247 sites; 16 countries; mean 3.5yr): apixaban vs aspirin; stroke/SE HR 0.63 (P=0.007; 37% RRR); disabling/fatal stroke HR 0.51 (49% RRR); major bleeding HR 1.80 (P=0.001); fatal bleeding and ICH NS; 90% bleeds managed without invasive procedures; net clinical benefit favours OAC at CHA₂DS₂-VASc ~3.9; contradicts neutral NOAH-AFNET 6 (edoxaban vs placebo, underpowered) | subclinical-atrial-fibrillation, anticoagulation, stroke-prevention, apixaban, randomized-controlled-trial | 2026-05-17 |
| sources/crp-nejm-2024 | Thomas RJ 2024 NEJM review: cardiac rehabilitation — 36-session multidisciplinary secondary prevention program; only 24% of eligible US patients participate; 1–2% mortality reduction per session attended (dose-response, observational); NNT=12 readmission, NNT=34 death at 1yr post-PCI; women/Black/Hispanic patients <19%; home-based CR: 43% vs 13% initiation, 36% lower mortality (VA); Cochrane RCTs neutral for all-cause mortality; future: wearables, prehabilitation, expanded eligibility (AF, HFpEF, cancer+CVD) | cardiac-rehabilitation, secondary-prevention, coronary-artery-disease, exercise-training, participation-disparities | 2026-05-17 |
| sources/crp-jcm-2025 | Aleksova et al. 2025 J Clin Med review (Part 1 of 2): four-phase CR programme after acute MI — Phase I (in-hospital, 3–7 days post-PCI; 25% mortality reduction in 1988 meta-analysis); Phase II (post-discharge 6–12 wks; illness perception/BIPQ as adherence driver); Phase III/IV sparse evidence; RESILIENT RCT: mHealth-CR failed in older adults; historical evolution from bedrest to early mobilisation | cardiac-rehabilitation, myocardial-infarction, exercise-training, secondary-prevention, illness-perception | 2026-05-22 |
| sources/corin-acmp-nejm-2023 | Baris Feldman et al. 2023 NEJM Brief Report: two Filipino siblings with homozygous CORIN LOF (c.684dupG; p.Met229Aspfs*16) — first human case of complete corin deficiency; phenotype: isolated LA cardiomyopathy (fibrosis + hypertrophic remodelling) + resistant hypertension + refractory AF; plasma corin undetectable, NT-proANP negligible, BNP compensatory; β-ENaC upregulated; PICP elevated; TIMP-1 normal; soluble corin replacement as therapeutic concept | #atrial-cardiomyopathy, #natriuretic-peptides, #genetics, #hypertension, #atrial-fibrosis | 2026-05-17 |
| sources/bb-mi-reduceami-nejm-2024 | Yndigegn/Jernberg/REDUCE-AMI Investigators 2024 NEJM RCT (n=5,020; 45 centres; LVEF ≥50%; metoprolol/bisoprolol vs no BB; median 3.5 yr): primary composite death/new MI HR 0.96 (95% CI 0.79–1.16; P=0.64) — neutral; all secondary endpoints (CV death, all-cause death, MI, AF hosp, HF hosp) and safety endpoints similar; annual event rate 2.4% vs 2.5%; first contemporary well-powered RCT showing no benefit of BBs in preserved-EF post-MI | beta-blockers, myocardial-infarction, preserved-ejection-fraction, secondary-prevention, randomized-controlled-trial | 2026-05-17 |
| sources/wearable-cv-nejm-2024 | Spatz/Ginsburg/Turakhia 2024 NEJM review: wearable DHTs for CV monitoring — RPM for HF/HTN/AF; single-lead ECG sensitivity 78–88%/specificity 80–86% for AF; Apple (PPV 84%) and Fitbit (PPV 98%) Heart Studies; ambulatory ECG diagnostic yield 32–34%; no validated cuffless BP device (www.validatebp.org); hub model for RPM; pulse oximetry racial bias; long-term outcome benefit unproven | wearable-digital-health, remote-patient-monitoring, atrial-fibrillation, heart-failure, cardiovascular-monitoring | 2026-05-17 |
| sources/finerenone-hfpef-fineartshf-nejm-2024 | Solomon, McMurray et al. 2024 NEJM Phase 3 double-blind RCT (n=6,001; 654 sites; 37 countries; median 32 months): finerenone (nonsteroidal MRA) vs placebo in HF with LVEF ≥40% — primary composite (total worsening HF events + CV death) rate ratio 0.84 (P=0.007); HF events RR 0.82 (P=0.006); CV death HR 0.93 (NS); all-cause death HR 0.93 (NS); KCCQ +1.6 pts (below MCID); kidney composite HR 1.33 (NS, numerically worse); hyperkalemia 3.0% vs 1.4%; benefit consistent in SGLT2i users; first MRA with positive primary endpoint in HFpEF/HFmrEF | #heart-failure, #HFpEF, #finerenone, #mineralocorticoid-receptor-antagonist, #randomized-controlled-trial | 2026-05-16 |
| sources/vutrisiran-attrcm-heliosb-nejm-2025 | Fontana et al. 2025 NEJM Phase 3 double-blind RCT (n=655; 87 sites; 26 countries; up to 36 months): vutrisiran (GalNAc-siRNA, 25 mg SC Q12W; 81% TTR knockdown) vs placebo in ATTR-CM — primary composite endpoint met (death + recurrent CV events HR 0.72; P=0.01); all-cause mortality HR 0.65 through 42 months (P=0.01); 6MWT +26.5 m; KCCQ-OS +5.8 pts; benefits on and off background tafamidis; first RNAi therapy to reduce mortality in ATTR-CM | #attr-cardiomyopathy, #RNA-interference, #vutrisiran, #heart-failure, #randomized-controlled-trial | 2026-05-16 |
| sources/aficamten-sequoiahcm-nejm-2024 | Maron et al. 2024 NEJM Phase 3 double-blind RCT (N=282; 101 sites; 14 countries; 24 weeks): aficamten (5–20 mg) vs placebo on background therapy in symptomatic obstructive HCM — primary endpoint met (peak VO2 +1.7 ml/kg/min; P<0.001); all 10 secondary endpoints significant (NYHA 58.5% vs 24.3%; KCCQ-CSS +7 pts; Valsalva LVOTO −50 mmHg; post-Valsalva <30 mmHg 49.3% vs 3.6%; SRT eligibility −78 days); NT-proBNP 80% reduction; LVEF <50% in 3.5% (transient, no HF exacerbations); benefit consistent regardless of background beta-blocker use | #hypertrophic-cardiomyopathy, #aficamten, #cardiac-myosin-inhibitor, #obstructive-HCM, #randomized-controlled-trial | 2026-05-17 |
| sources/aficamten-maplehcm-nejm-2025 | Garcia-Pavia et al. 2025 NEJM Phase 3 head-to-head RCT (N=175; 71 sites; 24 weeks): aficamten monotherapy vs metoprolol monotherapy in obstructive HCM — primary endpoint met (peak VO2 difference +2.3 ml/kg/min; P<0.001); aficamten superior on NYHA (51% vs 26% improved), KCCQ-CSS (+6.9 points), Valsalva gradient (−40.7 vs −3.8 mmHg), NT-proBNP (81% relative difference), LAVi; metoprolol failed to improve any objective hemodynamic endpoint despite HR −23.4 bpm; LVEF <50% only 1% with aficamten; first RCT of cardiac myosin inhibitor superiority over beta-blockers as monotherapy | hypertrophic-cardiomyopathy, aficamten, obstructive-HCM, cardiac-myosin-inhibitor, beta-blockers | 2026-05-16 |
| sources/mavacamten-odysseyhcm-nejm-2025 | Desai et al. 2025 NEJM Phase 3 RCT (N=580; 201 centers; 22 countries; 48 weeks): mavacamten in symptomatic nonobstructive HCM — both primary endpoints missed (peak VO2 P=0.07; KCCQ-CSS P=0.06); NT-proBNP reduced 59% (biomarker-clinical dissociation); LVEF <50% in 21.5% vs 1.7% placebo; serious CHF 6.6% vs 1.7%; confirms LVOTO relief is primary mechanism of benefit in obstructive HCM; no approved therapy exists for nonobstructive HCM | hypertrophic-cardiomyopathy, mavacamten, nonobstructive-HCM, cardiac-myosin-inhibitor, clinical-trial | 2026-05-16 |
| sources/ecg-technology-aha-2007 | Kligfield et al. 2007 AHA/ACCF/HRS scientific statement (Part I of 6-part ECG standardization series): digital ECG technology and recording standards; high-frequency cutoff ≥150 Hz adults (≥250 Hz children); 40 Hz monitor cutoff invalidates amplitudes; global measurement preferred over single-lead (systematically longer — all QRS/QT criteria require recalibration); V5 on horizontal plane of V4; V1/V2 superior misplacement → false anterior infarction; Cabrera sequence (aVL→I→−aVR→II→aVF→III) "highly recommended"; Mason-Likar NOT interchangeable with standard ECG; right-sided leads recommended in inferior STEMI; computerized ECG is adjunct only — physician overreading required (cardiologist 96% vs computer 91%) | electrocardiography, ECG-technology, ECG-standardization, digital-ECG, lead-placement | 2026-05-16 |
| sources/ecg-bbb-aha-2009 | Surawicz/Childers/Deal/Gettes 2009 AHA/ACCF/HRS scientific statement (Part III of 6-part ECG standardization series): intraventricular conduction disturbances; normal QRS duration (>110 ms abnormal in adults); frontal plane axis table by age; complete RBBB (QRS ≥120 ms; rsr'/rsR'/rSR' in V1/V2; S duration > R in I/V6; R-peak >50 ms in V1); complete LBBB (8 criteria; criterion 7: negative concordance = ABNORMAL — formal AHA basis for Sgarbossa concordant criteria); LAFB (axis −45° to −90°; qR in aVL; R-peak ≥45 ms in aVL; QRS <120 ms); LPFB; WPW criteria; nonspecific IVCD; deprecated terms ("bifascicular block," "trifascicular block," "Brugada pattern" in automated algorithms) | electrocardiography, bundle-branch-block, intraventricular-conduction, ECG-standardization, ventricular-preexcitation | 2026-05-16 |
| sources/ecg-chambers-aha-2009 | Hancock/Deal/Mirvis/Okin/Kligfield/Gettes 2009 AHA/ACCF/HRS scientific statement (Part V of 6-part ECG standardization series): cardiac chamber hypertrophy; LVH voltage criteria (Sokolow-Lyon SV1+RV5 ≥35 mm; Cornell SV3+RaVL ≥28 mm men / ≥20 mm women; Romhilt-Estes point score); sensitivity <50% all criteria; specificity 85–90%; confounders (age/sex/race/obesity diverge Sokolow-Lyon vs Cornell); "strain" → "secondary ST-T abnormality" (AHA recommended); LVH in LBBB with caution; RVH (best in CHD; COPD pattern); atrial abnormality terminology ("intraatrial" not "interatrial"); PTF-V1 >40 mm·ms; RAA criteria P II >2.5 mm | electrocardiography, left-ventricular-hypertrophy, cardiac-chamber-hypertrophy, ECG-standardization, atrial-abnormality | 2026-05-16 |
| sources/ecg-ischemia-aha-2009 | Wagner/Macfarlane/Wellens 2009 AHA/ACCF/HRS scientific statement (Part VI of 6-part ECG standardization series): acute ischemia/infarction ECG criteria; sex/age J-point elevation thresholds; Cabrera contiguous lead format; coronary artery localization from ST-segment spatial vector; V3R/V4R for RV infarction; Wellens T-wave pattern (proximal LAD stenosis warning); Sgarbossa criteria for LBBB (concordant STE/STD high specificity; discordant ≥5 mm very low specificity per HERO-2); left main/multivessel 8-lead STD pattern; Selvester QRS score | electrocardiography, myocardial-ischemia, ST-segment, acute-coronary-syndrome, ECG-standardization | 2026-05-16 |
| sources/ecg-sttu-aha-2009 | Rautaharju/Surawicz/Gettes 2009 AHA/ACCF/HRS scientific statement (Part IV of 6-part ECG standardization series): ST/T/U wave and QT interval standards; primary vs secondary repolarization distinction; ST elevation thresholds by age/sex/race (V2: 0.30 mV men <40; 0.15 mV women); T-wave quantitative descriptors (inverted/deep negative/giant negative); U wave norms; linear regression preferred over Bazett for QT correction; QT thresholds (women ≥460 ms; men >450 ms prolonged; ≤390 ms short); QT dispersion NOT recommended for routine reports | electrocardiography, QT-interval, ST-segment, repolarization, ECG-standardization | 2026-05-16 |
| sources/cdf-pe-hipeitho-nejm-2026 | Rosenfield/Klok/Piazza/HI-PEITHO Investigators 2026 NEJM RCT (N=544; intermediate-risk PE; 59 US/European sites; adaptive design; ITT): ultrasound-facilitated CDL (EkoSonic + alteplase) + anticoagulation vs anticoagulation alone; primary composite (PE-related death + cardiorespiratory decompensation/collapse + PE recurrence at 7 days) 4.0% vs 10.3% (RR 0.39; 95% CI 0.20–0.77; P=0.005); major bleeding 4.1% vs 3.0% (P=0.64); no intracranial hemorrhage in either group; first RCT to demonstrate CDL superiority over anticoagulation alone in intermediate-risk PE | pulmonary-embolism, catheter-directed-fibrinolysis, intermediate-risk, RCT, thrombolysis | 2026-05-16 |
| sources/ivus-chip-nejm-2026 | Diletti/Daemen/IVUS-CHIP Investigators 2026 NEJM RCT (N=2020; complex high-risk PCI; 37 European centres; median 19 months): IVUS-guided vs angiography-guided PCI; TVF 13.9% vs 11.1%; HR 1.25 (95% CI 0.97–1.60; P=0.08) — NOT superior; stent thrombosis lower with IVUS (0.2% vs 1.0%; HR 0.20); stent optimisation met in only 48% of IVUS lesions; neutral result despite Class IA guideline recommendation | ivus, complex-pci, intracoronary-imaging, pci-outcomes, coronary-artery-disease | 2026-05-16 |
| sources/ivus-optimal-nejm-2026 | Testa/Spitzer/Banning/OPTIMAL Investigators 2026 NEJM RCT (N=806; unprotected left main PCI; 28 European centres; median 2.9 years): IVUS-guided vs angiography-guided PCI; patient-oriented composite (stroke/MI/revascularisation/death) 33.7% vs 30.9%; HR 1.11 (95% CI 0.87–1.42; P=0.40) — NOT superior; stroke 3.0% vs 1.0% (HR 3.11; unexpected/unexplained); challenges Class IA IVUS recommendation for left main PCI | ivus, left-main-pci, intracoronary-imaging, pci-outcomes, coronary-artery-disease | 2026-05-16 |
| sources/intensive-ldl-ezpave-nejm-2026 | Lee YJ/Byeong-Keuk Kim/Ez-PAVE Investigators 2026 NEJM RCT (n=3,048; ASCVD; 17 South Korean sites; open-label; median 3.0 years; investigator-initiated): LDL-C target <55 mg/dL vs <70 mg/dL; first RCT directly comparing the two current guideline targets; primary composite (CV death/nonfatal MI/stroke/revascularisation/UA hosp) HR 0.67 (P=0.002); revascularisation HR 0.63; nonfatal MI HR 0.46; CV death NS; achieved LDL 56 vs 66 mg/dL; only 60.8% reached <55 mg/dL target; creatinine elevation lower in intensive group (1.2% vs 2.7%; P=0.004) | dyslipidemia, ldl-c, secondary-prevention, ASCVD, randomized-controlled-trial | 2026-05-16 |
| sources/crt-companion-nejm-2004 | Bristow/COMPANION Investigators 2004 NEJM RCT (n=1,520; NYHA III/IV; LVEF ≤35%; QRS ≥120ms + PR >150ms; ischaemic/non-ischaemic CM; 1:2:2 OPT/CRT-P/CRT-D; 128 US centres; Guidant-funded; stopped early): primary composite (death or any-cause hosp) HR 0.81 CRT-P (P=0.014) and HR 0.80 CRT-D (P=0.010); CRT-P mortality HR 0.76 (P=0.059 NS); CRT-D mortality HR 0.64 (P=0.003); HF death/hosp CRT-P 34% ↓, CRT-D 40% ↓; non-ischaemic CRT-D mortality HR 0.50 (P=0.015); 26% OPT withdrawal requiring reconsent; foundational CRT-D mortality RCT in NYHA III/IV | cardiac-resynchronization-therapy, heart-failure-reduced-EF, implantable-cardioverter-defibrillator, randomized-controlled-trial, intraventricular-conduction-delay | 2026-05-16 |
| sources/biological-tx-af-hrs-2019 | McRae/Davis 2019 Heart Rhythm systematic review + meta-analysis (25 preclinical animal studies; PubMed+Embase July 2018; CIHR-funded; SYRCLE/CAMARADES quality): biological therapies (gene transfer, miRNA, cell therapy) reduced AF inducibility OR 0.15 (P<0.01), fibrosis −6.7% (P<0.01), sinus rhythm +6.4 days (P<0.01); anti-miR-21 most replicated (4 labs); zero clinical trial translation; delivery/pre-AF design/single-target barriers identified | atrial-fibrillation, gene-therapy, microRNA, atrial-fibrosis, biological-therapy | 2026-05-15 |
| sources/icd-nicm-definite-nejm-2004 | Kadish/DEFINITE Investigators 2004 NEJM RCT (n=458; NICM; LVEF <36%; NSVT or ≥10 PVCs/hour; ACEi + BB background; 37 US centres; mean 29 months; St. Jude Medical-funded): single-chamber ICD vs standard therapy; primary all-cause mortality HR 0.65 (P=0.08 — NS); sudden arrhythmic death HR 0.20 (P=0.006); subgroups: men HR 0.49 (P=0.018), NYHA III HR 0.37 (P=0.02); underpowered (~1/3 arrhythmic deaths vs >50% assumed); first large NICM-specific primary prevention ICD trial; pattern replicated in DANISH | implantable-cardioverter-defibrillator, non-ischaemic-cardiomyopathy, primary-prevention, sudden-cardiac-death, randomized-controlled-trial | 2026-05-15 |
| sources/crt-maditcrt-nejm-2009 | Moss/MADIT-CRT Investigators 2009 NEJM RCT (n=1,820; LVEF ≤30%; QRS ≥130ms; NYHA I/II ischaemic or NYHA II non-ischaemic; CRT-D vs ICD; 3:2; 110 centres; mean 2.4 years; stopped early; Boston Scientific): primary composite (death/nonfatal HF event) HR 0.66 (P=0.001); HF events 41% ↓; no mortality difference; QRS ≥150ms HR 0.48 vs 130–149ms HR 1.06 (P=0.001 interaction); women HR 0.37 vs men HR 0.76; LV reverse remodeling at 1 year; foundational NYHA I/II CRT trial | cardiac-resynchronization-therapy, heart-failure-reduced-EF, randomized-controlled-trial, QRS-duration, left-ventricular-remodeling | 2026-05-15 |
| sources/icd-programming-hrs-2015 | Wilkoff/HRS 2015 international consensus (32 recommendations; 96% consensus; HRS/EHRA/APHRS/SOLAECE): ICD programming guidance across 4 domains — bradycardia mode (minimise RV pacing; MVP; biventricular ≥98%); tachycardia detection (prolonged 30/40 intervals; VF ≥200 bpm; SVT-VT discriminators); tachycardia therapy (ATP first-line 188–250 bpm; 71% shock reduction PainFREE Rx II; shocks = 5× mortality in SCD-HeFT); DT omission safe for standard left-sided transvenous implants (SIMPLE n=2,500 RCT; NORDIC-ICD noninferior); DT still required for S-ICD | implantable-cardioverter-defibrillator, ICD-programming, tachycardia-detection, antitachycardia-pacing, defibrillation-threshold-testing | 2026-05-15 |
| sources/crt-carehf-nejm-2005 | Cleland/CARE-HF Investigators 2005 NEJM multicenter RCT (n=813; NYHA III/IV; LVEF ≤35%; QRS ≥120ms + echo dyssynchrony criteria; CRT-P vs medical therapy; 82 European centres; mean 29.4 months): primary composite (death/unplanned CV hosp) HR 0.63 (P<0.001); all-cause mortality HR 0.64 (P<0.002; NNT≈9); HF hosp 18% vs 33%; LV reverse remodeling confirmed by core-lab echo; 7% residual SCD despite CRT-P; definitive CRT mortality trial | cardiac-resynchronization-therapy, heart-failure-reduced-EF, dyssynchrony, randomized-controlled-trial, all-cause-mortality | 2026-05-15 |
| sources/omecamtiv-galactichf-nejm-2021 | Teerlink/GALACTIC-HF Investigators 2021 NEJM phase 3 RCT (n=8,232; LVEF ≤35%; NYHA II–IV; inpatients + outpatients; >19% ARNi; 2.6% SGLT2i; 945 sites, 35 countries; median 21.8 months; Amgen/Cytokinetics/Servier): omecamtiv mecarbil vs placebo; primary composite (HF event or CV death) HR 0.92 (P=0.03); CV death HR 1.01 NS; all-cause death HR 1.00 NS; HF hosp HR 0.95 NS; KCCQ NS; LVEF ≤28% HR 0.84 vs LVEF >28% HR 1.04 (prespecified interaction); not approved/guideline-listed | cardiac-myosin-activator, heart-failure-reduced-EF, omecamtiv-mecarbil, randomized-controlled-trial, systolic-function | 2026-05-15 |
| sources/digitoxin-hfref-digithf-nejm-2025 | Bavendiek/Bauersachs 2025 NEJM DIGIT-HF RCT: digitoxin vs placebo in HFrEF (LVEF ≤40%; n=1,212; ARNi 39.5%, SGLT2i 19.3%; 65 sites Austria/Germany/Serbia; median 36 months); primary composite (death or first HF hosp) HR 0.82 (P=0.03; NNT=22); all-cause death noninferiority confirmed; individual components NS; underpowered (1,212 vs planned 2,190); digitoxin ≠ digoxin; first cardiac glycoside RCT on contemporary GDMT | cardiac-glycosides, heart-failure-reduced-EF, digitoxin, randomized-controlled-trial, cardiovascular-outcomes | 2026-05-14 |
| sources/mra-hfref-rales-nejm-1999 | Pitt/RALES Investigators 1999 NEJM double-blind RCT (n=1,663; LVEF ≤35%; NYHA III/IV; ACEi + loop diuretic; no BB required; pre-BB era; 195 centres; mean 24 months; stopped early; Searle-funded): spironolactone 25 mg OD; all-cause mortality RR 0.70 (P<0.001; 30% RRR); progressive HF death RR 0.64; SCD RR 0.71; HF hospitalisation RR 0.65; hyperkalemia 2% vs 1% NS; foundational MRA Class I NYHA III/IV trial | mineralocorticoid-receptor-antagonist, heart-failure-reduced-EF, spironolactone, randomized-controlled-trial, aldosterone-antagonist | 2026-05-14 |
| sources/icd-hfref-scdheft-nejm-2005 | Bardy/SCD-HeFT Investigators 2005 NEJM three-arm RCT (n=2,521; LVEF ≤35%; NYHA II/III; ischaemic 52%/NICM 48%; pre-SGLT2i/ARNi; median 45.5 months): ICD HR 0.77 (P=0.007; 23% RRR; absolute −7.2% at 5 years); amiodarone HR 1.06 (NS); no aetiology interaction (P=0.68); NYHA II ICD HR 0.54 vs NYHA III HR 1.16 NS; amiodarone NYHA III HR 1.44 harm (P=0.004 interaction); establishes LVEF ≤35% primary prevention ICD threshold | ICD, heart-failure-reduced-EF, sudden-cardiac-death, primary-prevention, randomized-controlled-trial | 2026-05-14 |
| sources/spironolactone-hfpef-topcat-nejm-2014 | Pitt/Pfeffer 2014 NEJM TOPCAT RCT: spironolactone vs placebo in HFpEF (LVEF ≥45%; n=3,445; 6 countries; mean 3.3y); primary composite HR 0.89 (NS); HF hosp HR 0.83 (P=0.04); BNP-stratum HR 0.65 (P=0.003); Russia/Georgia data integrity concern (canrenone in only 38% of "active" patients); Americas-only HR 0.82; basis for COR 2b/IIb MRA in HFpEF | mineralocorticoid-receptor-antagonist, heart-failure-preserved-EF, spironolactone, randomized-controlled-trial, cardiovascular-outcomes | 2026-05-14 |
| sources/icd-icm-maditii-nejm-2002 | Moss 2002 NEJM MADIT-II RCT: primary prevention ICD in ICM (prior MI + LVEF ≤30%; n=1,232; no EPS required; mean 20 months); all-cause mortality HR 0.69 (95% CI 0.51–0.93; P=0.016); 14.2% vs 19.8%; consistent across all subgroups; benefit at ~9 months; HF hospitalisation trend higher ICD arm (19.9% vs 14.9%); stopped early; foundational basis for Class I/AUC A(8–9) in ischaemic CMP | ICD, ischaemic-cardiomyopathy, primary-prevention, sudden-cardiac-death, randomized-controlled-trial | 2026-05-14 |
| sources/icd-nicm-danish-nejm-2016 | Køber 2016 NEJM DANISH RCT: primary prevention ICD in NICM (LVEF ≤35%; n=1,116; 58% CRT; median 67.6 months); all-cause mortality HR 0.87 (NS); SCD HR 0.50 (P=0.005); CV death HR 0.77 (NS); 31% non-CV deaths; age <68 HR 0.64 (significant); pre-SGLT2i/ARNi era; supports ESC Class IIa (not I) for NICM primary prevention | ICD, non-ischaemic-cardiomyopathy, sudden-cardiac-death, primary-prevention, randomized-controlled-trial | 2026-05-14 |
| sources/empagliflozin-hfpef-nejm-2021 | Anker/Packer 2021 NEJM EMPEROR-Preserved RCT: empagliflozin vs placebo in HFpEF/HFmrEF (LVEF >40%, n=5988, ~50% T2DM, median 26.2 months); primary composite CV death or HF hospitalisation HR 0.79 (NNT=31; P<0.001); HF hospitalisation HR 0.71; CV death HR 0.91 (NS); all-cause death HR 1.00; eGFR decline slower; first large positive pharmacotherapy trial in HFpEF | SGLT2-inhibitors, heart-failure-preserved-EF, empagliflozin, randomized-controlled-trial, cardiovascular-outcomes | 2026-05-14 |
| sources/empagliflozin-hfref-nejm-2020 | Packer 2020 NEJM EMPEROR-Reduced RCT: empagliflozin vs placebo in HFrEF (LVEF ≤40%, n=3730, 73% LVEF ≤30%, median 16 months); primary composite CV death or HF hospitalisation HR 0.75 (NNT=19); eGFR decline 4× slower (−0.55 vs −2.28 mL/min/yr; P<0.001); composite renal outcome HR 0.50; renal benefit persists post-discontinuation (disease-modifying); CV death and all-cause death NS | SGLT2-inhibitors, heart-failure-reduced-EF, empagliflozin, randomized-controlled-trial, cardiovascular-outcomes | 2026-05-14 |
| sources/dapagliflozin-hfref-nejm-2019 | McMurray 2019 NEJM DAPA-HF RCT: dapagliflozin vs placebo in HFrEF (LVEF ≤40%, n=4744, 55% no T2DM, median 18.2 months); primary composite worsening HF or CV death HR 0.74 (P<0.001; NNT=21); all-cause death HR 0.83; serious renal AEs lower (1.6% vs 2.7%); benefit identical in T2DM and non-T2DM; landmark trial establishing SGLT2i as fourth-pillar Class I GDMT for HFrEF | SGLT2-inhibitors, heart-failure-reduced-EF, dapagliflozin, randomized-controlled-trial, cardiovascular-outcomes | 2026-05-14 |
| sources/acetazolamide-acutehf-nejm-2022 | Mullens 2022 NEJM ADVOR RCT: IV acetazolamide 500mg OD + loop diuretics vs placebo in ADHF + volume overload (n=519, Belgium); successful decongestion within 3 days 42.2% vs 30.5% (RR 1.46; P<0.001); higher natriuresis (468 vs 369 mmol); shorter hospital stay; death/HF rehospitalization at 3 months HR 1.07 (NS); no metabolic acidosis; SGLT2i excluded | acute-heart-failure, decongestion, diuretics, acetazolamide, volume-overload | 2026-05-14 |
| sources/arrhythmia-diastolic-circep-2020 | Pezawas 2020 Circ EP prospective pilot (n=210; ICM/DCM; 7-year follow-up): grade III diastolic dysfunction independently predicts arrhythmic death/RCA (HR 3.52; P<0.001), LVEF-independent (persists in LVEF ≤35% and >35%); 58% 8-year AD/RCA risk in grade III vs 5% in normal; no patient with normal diastolic function died of arrhythmic death | diastolic-dysfunction, sudden-cardiac-death, risk-stratification, ventricular-arrhythmia, ICD | 2026-05-14 |
| sources/dapagliflozin-deliver-nejm-2022 | Solomon 2022 NEJM DELIVER RCT: dapagliflozin vs placebo in HFmrEF/HFpEF (LVEF >40%, n=6263, 2.3 years); primary composite worsening HF or CV death HR 0.82 (P<0.001); worsening HF HR 0.79; CV death HR 0.88 (NS); KCCQ +2.4 pts; consistent benefit across full LVEF spectrum including ≥60% and diabetes-independent; established ESC 2023 Class I, Level A | SGLT2-inhibitors, heart-failure-preserved-EF, dapagliflozin, randomized-controlled-trial, cardiovascular-outcomes | 2026-05-12 |
| sources/clingen-summary-2026-05-09 | ClinGen 2026-05-09 Curation Activity Summary: 419 cardiovascular gene-disease curations across 258 genes; 7-tier validity framework; highlights disputed/refuting BrS/HCM/ARVC genes; SCN5A broad designation; PAH definitive genes | clingen, gene-disease-validity, hereditary-cardiovascular-disease, dosage-sensitivity, clinical-actionability | 2026-05-09 |
| sources/levosimendan-jcm-2022 | Masarone/Kittleson/Pollesello et al. 2022 JCM narrative review (11:6408; COI: Pollesello = Orion Pharma employee): levosimendan in advHFrEF — triple mechanism (calcium sensitisation + vascular KATP + mitochondrial KATP); OR-1896 active metabolite t½ ≈80h, peak 48–72h post-infusion, pharmacodynamic effect 10–14 days; severe CKD (CrCl <30): OR-1896 AUC 2× → dose reduction required; AF risk signal vs dobutamine and placebo (unlike VT/VF which remains low); contraindications (SBP <70, severe MS/AS, CrCl <30, MELD >30); pulsed infusion RCTs: LevoRep (n=120, primary FAILED), LION-HEART (n=69, HF hosp HR 0.25 p=0.001, NT-proBNP p<0.001), LAICA (n=97, primary NS but 12m survival p=0.044); meta-analysis (n=984): CV death lower p=0.02, all-cause mortality NS; pre-LVAD RCT (n=84): RV failure NS; HELP trial (HFpEF, n=37): exercise PCWP −3.9 mmHg + 6MWT +29.3m; ESC 2021 Class IIb palliative/bridge-to-transplant/LVAD; practical dosing protocol | advanced-heart-failure, levosimendan, inotropes, heart-failure, mechanical-circulatory-support | 2026-05-26 |
| sources/levosimendan-drugs-2001 | Figgitt/Gillies/Goa 2001 Drugs new drug profile review (61:613-627): levosimendan pharmacodynamics (calcium sensitisation via troponin C binding — calcium-dependent, avoids diastolic impairment; KATP channel vasodilation; neutral myocardial energetics vs dobutamine; RV efficiency +24%; PVR reduced 22–27% post-CPB; non-arrhythmogenic — 0% VF vs 50% milrinone in dog model; no QTc prolongation); pharmacokinetics (t½β ≈1h; OR-1896 active metabolite extends haemodynamic effects; 97–98% protein binding; linear PK); LIDO trial (decompensated CHF, n=203: primary endpoint 28% vs 15% dobutamine p=0.022; 30-day worsening HF/death 6.8% vs 17% p=0.039); RUSSLAN trial (post-AMI, n=504: 14-day mortality 11.4% vs 19.6% placebo p=0.029); drug interactions clean (captopril/felodipine/β-blockers/digoxin/warfarin/isosorbide/carvedilol/alcohol/itraconazole all NS); approved Sweden 2000; US in late-phase development at time of publication | calcium-sensitizer, inotropes, decompensated-heart-failure, pharmacology, heart-failure | 2026-05-26 |
| sources/hatw-jacc-advances-2025 | Meyers 2025 JACC:Advances: first quantitative HATW definition — T-wave magnitude (AUC/QRS amplitude) + symmetry; HATW score ≥0.7 in 2 contiguous leads → 98.4% spec, 20.7% sens in non-STEMI; T-wave amplitude alone insufficient | hyperacute-T-waves, occlusion-MI, ECG-diagnosis, acute-coronary-syndrome, STEMI-criteria | 2026-05-03 |
| sources/conduction-disorders-jaha-2025 | Balla 2025 JAHA Contemporary Review: CCDs in young adults — acquired (Lyme 80–90% AVB, sarcoidosis 30% unexplained AVB, Chagas RBBB+LAFB, autoimmune RA/SLE) and familial (SCN5A 76% familial CCD, LMNA 33% DCM+CCD, Fabry 6% devices, Kearns-Sayre PM, Holt-Oram/NKX2-5 CHD-related); conduction system pacing preferred; PM <50 → 3–4× risk; ESC rec ICD over PM in LMNA | conduction-disorders, atrioventricular-block, genetics, cardiomyopathy, young-adults | 2026-05-02 |
| sources/ch-aha-2026 | AHA 2026 Scientific Statement: CH cardiovascular implications — gene-specific mechanisms (TET2/IL-1β/NLRP3; DNMT3A/efferocytosis/HB-EGF; JAK2/thrombosis); 25% HF risk (n=56,597); TET2 2.4× HFpEF; therapy-related CH (TP53/PPM1D); CANTOS canakinumab benefit in TET2-CH; colchicine/vitamin C/metformin strategies; no proven CH-specific CVD therapy | clonal-hematopoiesis, cardiovascular-risk, inflammation, atherosclerosis, cardio-oncology | 2026-05-02 |
| sources/membrane-potential-physrev-2021 | Varró 2021 Physiol Rev: comprehensive review of all cardiac ion channels (INa/IKr/IKs/Ito/ICaL/IK1/If/NCX), AP phases, regional differences, EAD/DAD/reentry mechanisms, electrical remodeling in AF/HF/HCM/MI, all channelopathy genes | cardiac-electrophysiology, ion-channels, arrhythmia-mechanisms, channelopathies, electrical-remodeling | 2026-04-30 |
| sources/cardio-oncology-vascular-metabolic-aha-2019 | AHA 2019 Scientific Statement: vascular and metabolic perspectives in cardio-oncology — vascular toxicity mechanisms table (5-FU/platinum/taxane/bleomycin/RT), VEGF HTN mechanisms, Ottawa VTE score, LMWH vs DOAC, CHIP as shared cancer-CVD risk, ADT metabolic risk | cardio-oncology, vascular-toxicity, cancer-associated-VTE, metabolic-complications, clonal-hematopoiesis | 2026-04-30 |
| sources/alt-medicine-hf-aha-2023 | AHA 2023 Scientific Statement: CAM in HF — omega-3 PUFA Class 2b rec; CoQ10 uncertain; hawthorn harm in LVEF ≤35%; licorice/Vit E/grapefruit juice harm; yoga/tai chi beneficial; drug-interaction catalog | heart-failure, complementary-alternative-medicine, drug-interactions, nutraceuticals, guidelines | 2026-04-30 |
| sources/subclinical-af-aha-2019 | AHA 2019 Scientific Statement: SCAF prevalence (10–55% CIED; 24% ESUS); 2.4× stroke risk; dose-dependent duration threshold; progression to clinical AF; pre-ARTESiA/NOAH OAC uncertainty | subclinical-atrial-fibrillation, atrial-fibrillation, stroke-prevention, cardiac-monitoring, anticoagulation | 2026-04-29 |
| sources/genetic-test-aha-2020 | AHA 2020 Scientific Statement: genetic testing framework across cardiomyopathies, arrhythmic disorders (SCN5A-only for BrS; KCNQ1/KCNH2/SCN5A definitive for LQTS), HTAD (11 definitive genes), and FH (Table 4 criteria); ACMG 59/30 CVD genes; cascade testing principles; GINA limitations | genetic-testing, cardiomyopathy, channelopathies, guideline, cascade-family-screening | 2026-04-29 |
| sources/imaging-viability-aha-2020 | AHA 2020 Scientific Statement: state-of-art viability imaging — hibernation/stunning pathophysiology; LGE-CMR transmural extent tiers; STICH/PARR-2 viability substudy; modality comparison table | myocardial-viability, cardiac-imaging, ischemic-cardiomyopathy, late-gadolinium-enhancement, coronary-revascularization | 2026-04-29 |
| sources/sdb-arrhythmia-aha-2022 | AHA 2022 Scientific Statement: SDB (OSA/CSA/CSB) and cardiac arrhythmias (AF/VTA/SCD/bradyarrhythmia); VARIOSA-AF directionality; CPAP RCTs all negative; NABS/ODI screening; circadian KLF15 mechanism; stepped clinical care model | sleep-disordered-breathing, atrial-fibrillation, ventricular-arrhythmia, obstructive-sleep-apnea, arrhythmia-management | 2026-04-29 |
| sources/BPA-AHA-2024 | AHA 2024 Scientific Statement: BPA for CTEPD with/without PH; Class I ESC 2022; RACE/MR BPA trials; disease-level classification; lesion subtypes; complication trends; expert centre requirements | balloon-pulmonary-angioplasty, CTEPH, pulmonary-hypertension, interventional-cardiology, pulmonary-embolism | 2026-04-28 |
| sources/incident-gene-aha-2023 | AHA 2023 Scientific Statement: Bayesian framework for interpreting incidentally identified variants in CVD genes; ACMG-78 (42 CVD genes); pretest probability + variant pathogenicity → posttest probability; LP/P-only cascade testing; 1–8%/year reclassification; diverse populations | incidental-variants, genetic-testing, heritable-cardiovascular-disease, variant-interpretation, precision-medicine | 2026-04-28 |
| sources/imaging-cardio-oncology-aha-2024 | AHA 2023 Scientific Statement: multimodality cardiovascular imaging in cardio-oncology; Tables 1 & 2 by therapy type and clinical presentation | cardio-oncology, cardiovascular-imaging, echocardiography, CMR, cancer-therapy-related-cardiac-dysfunction | 2026-04-28 |
| sources/ACS-AHA-2025 | 2025 ACC/AHA/ACEP/NAEMSP/SCAI full-revision ACS guideline; ticagrelor monotherapy Class I; Impella IIa (DanGer-SHOCK); complete revascularization; IABP/VA-ECMO no benefit | acute-coronary-syndrome, STEMI, antiplatelet-therapy, revascularization, guidelines | 2026-04-21 |
| sources/CCS-AHA-2023 | 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for Chronic Coronary Disease; beta-blocker COR 3 No Benefit without LV dysfunction; ISCHEMIA paradigm; SGLT2i/GLP-1 RA COR 1; COMPASS low-dose rivaroxaban | chronic-coronary-disease, secondary-prevention, revascularization, antiplatelet-therapy, guidelines | 2026-04-22 |
| sources/ACHD-AHA-2025 | 2025 ACC/AHA/HRS/ISACHD/SCAI full-revision guideline for adults with congenital heart disease; Eisenmenger PAH COR 1; new Fontan liver/TOF PVR criteria | congenital-heart-disease, guideline, tetralogy-of-fallot, Fontan-circulation, Eisenmenger-syndrome | 2026-04-21 |
| sources/STT-mechanism-ACA-2026 | Narrative review: electrophysiological basis of primary (ischemia/electrolytes) and secondary (LBBB/LVH/pacemaker) ST-T changes; injury current mechanism; hyperkalemia ECG progression | electrocardiography, ST-T-changes, myocardial-ischemia, cardiac-electrophysiology, electrolyte-disturbances | 2026-05-01 |
| sources/failure-stemi-criteria-lad-omi-ehjacc-2025 | Meyers 2025 EHJAcuteCVCare: STEMI criteria miss 38% of total LAD occlusions (TIMI-0 flow) on all serial ECGs; expert and AI (PMCardio Queen of Hearts) both 100% sensitive on first ECG; DBT 97 vs 40 min without vs with STEMI criteria; equivalent infarct size | occlusion-MI, STEMI-criteria, LAD-occlusion, ECG-diagnosis, artificial-intelligence-ECG | 2026-05-02 |
| sources/acm-padua-criteria-ijc-2020 | Corrado/Perazzolo Marra/Zorzi et al. 2020 Int J Cardiol international expert consensus: the Padua criteria. Upgrades the 2010 RV-only Task Force criteria to the full ACM spectrum by adding CMR tissue characterisation (RV transmural LGE major; LV LGE stria in ≥1 Bull's Eye segment major, septal junctional LGE excluded) and LV-specific morpho-functional, ECG and arrhythmia criteria (low limb-lead voltages, lateral TWI, RBBB-morphology arrhythmia). Diagnosis requires ≥1 morpho-functional or structural criterion; ARVC definite/borderline/possible thresholds retained; biventricular requires both ventricles; ALVC requires LV phenotype plus a pathogenic variant because LV findings overlap with DCM/myocarditis/sarcoidosis. Post-hoc reclassification: 51/87 definite ARVC became biventricular, 7/9 possible became ALVC. | arrhythmogenic-cardiomyopathy, ARVC, ALVC, diagnostic-criteria, cardiac-magnetic-resonance, late-gadolinium-enhancement | 2026-10-28 |
| sources/acm-evolving-criteria-jaha-2021 | Corrado/Zorzi/Cipriani et al. 2021 JAHA Contemporary Review: evolution of ACM diagnosis from the 1994 Task Force to the 2010 revision to the 2020 Padua criteria, category by category. Explains why each revision happened — 1994 qualitative and RV-only, 2010 quantitative but still RV-only and without CMR tissue characterisation, 2020 adds LGE and LV criteria — and gives the post-hoc reclassification of 112 Padua patients (51/87 definite ARVC → biventricular; 5/15 borderline → definite; 6 → biventricular; 7/9 possible → ALVC). Includes the mapping caution that two-thirds of RBBB-morphology VT in ACM arise from the RV septum and only 17% from the LV, and the ALVC-versus-DCM discriminator that LVEF correlates with LGE extent in ALVC but not in DCM. | arrhythmogenic-cardiomyopathy, ARVC, ALVC, diagnostic-criteria, cardiac-magnetic-resonance, late-gadolinium-enhancement | 2026-10-28 |
| sources/acm-european-tf-criteria-rcm-2024 | Graziano/Zorzi/Ungaro/Corrado 2024 Rev Cardiovasc Med member-authored review of the 2023 European Task Force criteria. Three-step diagnosis (ventricular involvement → phenotype → aetiology) with separate RV and LV blocks. Changes from Padua: regional LV hypokinesia criterion removed; EMB histology major while RV LGE demoted to minor; "ring-like" LV LGE ≥3 segments major and 1–2 segments minor; low limb-lead voltages upgraded to major; RV arrhythmia major requires non-inferior axis; likely pathogenic variant split out as minor; ALVC no longer requires a pathogenic variant and may be diagnosed regardless of aetiology. Proposes renaming the disease "scarring/arrhythmogenic cardiomyopathy" and rejects ESC 2023's 2010-ARVC-plus-NDLVC framework. | arrhythmogenic-cardiomyopathy, ARVC, ALVC, diagnostic-criteria, cardiac-magnetic-resonance, late-gadolinium-enhancement | 2026-10-28 |
| sources/acm-hrs-2019 | 2019 HRS Expert Consensus on evaluation, risk stratification, and management of ACM | consensus, arrhythmogenic-cardiomyopathy | 2026-04-11 |
| sources/channelopathies-jaha-2025 | Clinical diagnosis and therapeutics for cardiac channelopathies | channelopathies, inherited-arrhythmias | 2026-04-11 |
| sources/repolarisation-jaccep-2023 | JACC:EP 2023 state-of-the-art review: cardiac repolarization genetics (ClinGen LQTS/SQTS), T-wave morphology by genotype, EAD/TdP mechanism, 176 QT-SNPs, PRS for LQTS, AI-ECG for concealed LQTS | long-qt-syndrome, cardiac-repolarization, channelopathies, polygenic-risk-score, short-qt-syndrome | 2026-04-30 |
| sources/eoaf-jama-2021 | Genetic yield of WGS in early-onset AF; 10.1% carry P/LP variants, mostly cardiomyopathy genes | atrial-fibrillation, genetics | 2026-04-11 |
| sources/gene-therapy-arrhythmia-2025 | Gene therapy modalities for cardiac arrhythmias (ARVC, CPVT, LQTS, biological pacemaker) | gene-therapy, channelopathies | 2026-04-11 |
| sources/HCM-AHA-2024 | 2024 AHA/ACC guideline for HCM management | hypertrophic-cardiomyopathy, guideline | 2026-04-11 |
| sources/HCM-VA-FCVMed-2022 | Bench-to-bedside review of ventricular arrhythmia and SCD in HCM | hypertrophic-cardiomyopathy, sudden-cardiac-death | 2026-04-11 |
| sources/VA-DCM-Sammani-2020 | Meta-analysis of VA predictors in DCM (n=11,451); LGE HR 5.55 strongest predictor | dilated-cardiomyopathy, ventricular-arrhythmias | 2026-04-12 |
| sources/VA-SCD-ESC-2022 | 2022 ESC guidelines for ventricular arrhythmias and SCD prevention | ventricular-arrhythmia, sudden-cardiac-death, guideline | 2026-04-11 |
| sources/esc-cmp-2023 | 2023 ESC guidelines for cardiomyopathy management | cardiomyopathy, guideline | 2026-04-11 |
| sources/AF-AHA-2023 | 2023 AHA/ACC/ACCP/HRS guideline for AF diagnosis and management | atrial-fibrillation, guideline | 2026-04-12 |
| sources/AF-ESC-2024 | 2024 ESC guidelines for AF management; AF-CARE framework; CHA2DS2-VA | atrial-fibrillation, guideline | 2026-04-12 |
| sources/EAST-AFNET4-NEJM-2020 | EAST-AFNET 4 RCT: early rhythm control reduces CV death/stroke in AF (HR 0.79) | atrial-fibrillation, rhythm-control, RCT | 2026-04-12 |
| sources/laao-closureaf-nejm-2026 | Landmesser/Skurk/Kirchhof 2026 NEJM CLOSURE-AF RCT (n=888; 42 German sites; mean CHA₂DS₂-VASc 5.2; HAS-BLED 3.0; LAAO vs physician-directed best medical care — 85% DOAC; median 3 yr follow-up): LAAO failed noninferiority for composite stroke/SE/major bleeding/CV death (16.8 vs 13.3/100 pt-yr; RMST −0.36 yr; P=0.44 for NI); stroke equal (2.6 vs 2.7/100 pt-yr); major bleeding higher with LAAO (7.4 vs 6.2); CV death higher (9.5 vs 7.7); periprocedural + DAPT-driven early bleeding negates stroke benefit in highest-risk elderly AF population | atrial-fibrillation, left-atrial-appendage-closure, stroke-prevention, anticoagulation, noninferiority-trial | 2026-05-16 |
| sources/laao-championaf-nejm-2026 | Doshi/Kar/Ellenbogen 2026 NEJM CHAMPION-AF RCT (n=3000; 141 sites; 16 countries; Boston Scientific–sponsored; Watchman FLX vs NOAC in NOAC-eligible AF; mean CHA₂DS₂-VASc 3.5; HAS-BLED 1.3; 85% NOAC post-implant): NI demonstrated for efficacy (CV death/stroke/SE 5.7% vs 4.8%; difference 0.9%; P<0.001 for NI); superiority demonstrated for non-procedure-related bleeding (10.9% vs 19.0%; HR 0.55; P<0.001); net clinical benefit favours device (15.1% vs 21.8%; HR 0.66); ischaemic stroke numerically higher with device (3.2% vs 2.2%); first large RCT showing LAAO reduces clinically relevant bleeding vs NOAC in NOAC-eligible patients | atrial-fibrillation, left-atrial-appendage-closure, stroke-prevention, anticoagulation, noninferiority-trial | 2026-05-16 |
| sources/laao-option-nejm-2025 | Wazni/Saliba/Nair/OPTION Investigators 2025 NEJM RCT (n=1,600; 106 sites; 10 countries; Boston Scientific–sponsored; Watchman FLX vs OAC — 95% NOAC — in post-ablation AF; CHA₂DS₂-VASc 3.5; HAS-BLED 1.2; post-implant OAC+ASA 90d → ASA alone): superiority demonstrated for non-procedure-related bleeding (8.5% vs 18.1%; HR 0.44; P<0.001); NI demonstrated for death/stroke/SE (5.3% vs 5.8%; P<0.001 for NI); ischemic stroke equally low (1.2% vs 1.3%); device success 98.8%; first large RCT of LAAO specifically in post-ablation AF patients | atrial-fibrillation, left-atrial-appendage-closure, catheter-ablation, stroke-prevention, bleeding-prevention | 2026-05-16 |
| sources/ca-af-ehj-2024 | State-of-art review: AF catheter ablation indications, PFA technology, QOL, cognition, AF progression | atrial-fibrillation, catheter-ablation, pulsed-field-ablation | 2026-04-12 |
| sources/MYBPC3-MYH7-JACCEP-2024 | AF substrate and catheter ablation outcomes in MYBPC3/MYH7-mediated HCM; primary atrial myopathy independent of LA pressure | hypertrophic-cardiomyopathy, atrial-fibrillation, catheter-ablation, genetics, atrial-myopathy | 2026-04-12 |
| sources/arrhythmia-genetics-mgenetik-2025 | Current-state review of inherited arrhythmia genetics; ClinGen gene curation, CRDS, variant reclassification, cardiogenetic centres | channelopathy, genetics, LQTS, sudden-cardiac-death, arrhythmia | 2026-04-12 |
| sources/eoaf-riskfactor-ehj-2026 | Prospective AF <40 without SHD (n=122): 89% lifestyle risk factors, 11.6% P/LP variants (TTN/LMNA/PKP2), 4.1% stroke with CHA₂DS₂-VA=0 | atrial-fibrillation, early-onset-atrial-fibrillation, genetics, lifestyle-risk-factors, catheter-ablation | 2026-04-12 |
| sources/HF-AHA-2022 | 2022 AHA/ACC/HFSA HF Guideline: 4-pillar HFrEF GDMT (SGLT2i COR 1); SGLT2i COR 2a HFpEF/HFmrEF; HFimpEF; cardiac amyloidosis pathway; genetic testing COR 2a | heart-failure, guideline, HFpEF, SGLT2-inhibitors, cardiac-amyloidosis | 2026-04-12 |
| sources/HF-ESC-2026 | 2026 ESC HF Guidelines (Køber/Adamo): HFmrEF abolished — HFrEF now LVEF <50%, HFpEF ≥50% (LVEF never previously <50%); ACC/AHA stages A–D adopted; 'decompensated HF' replaces acute HF; FMT/AMT/GDIT replace GDMT. SGLT2i + MRA Class I/A in ALL symptomatic HF (MRA new in HFpEF); ICD ischaemic I/B1, non-ischaemic IIa/B1; CRT LBBB ≥150 ms I/A but 130–149 ms IIa/C (was I) and CRT-over-RV-pacing downgraded I→IIa; LVAD upgraded to I/C; mitral TEER I/B1; in-hospital SGLT2i I/B1; microaxial pump IIa/B1 in STEMI-shock, IABP III; TSAT <20% adopted as the iron deficiency definition; semaglutide/tirzepatide IIa/B1 in obesity-HFpEF; ATTR-CA vutrisiran/tafamidis/acoramidis I/A; CHA2DS2-VA; catheter ablation for AF narrowed to IIa/C | heart-failure, guideline, HFrEF, HFpEF, decompensated-heart-failure, foundational-medical-therapy, cardiac-amyloidosis | 2026-10-25 |
| sources/HF-ESC-2021 | 2021 ESC HF Guidelines: 4-pillar HFrEF therapy (SGLT2i added); HFmrEF category; AF management (CASTLE-AF, rate/rhythm); DCM minimum gene panel; gene-specific outcomes (LMNA, TTN) | heart-failure, guidelines, atrial-fibrillation, cardiomyopathy, genetic-testing | 2026-04-12 |
| sources/HF-update-ESC-2023 | 2023 ESC Focused HF Update: SGLT2i Class I for HFmrEF/HFpEF; STRONG-HF post-discharge strategy; finerenone + SGLT2i for CKD+T2DM; IV iron upgraded to Class I | heart-failure, HFpEF, SGLT2-inhibitors, guideline, acute-heart-failure | 2026-04-12 |
| sources/Cardio-Oncology-ESC-2022 | First ESC cardio-oncology guideline (272 recommendations): HFA-ICOS risk stratification; CTRCD grading; monitoring protocols for anthracyclines/HER2/ICI/RT; AF in cancer (TBIP algorithm); long-term survivorship | cardio-oncology, cardiovascular-toxicity, heart-failure, atrial-fibrillation, guideline | 2026-04-12 |
| sources/Biobank-AF-JAMA-2024 | UK Biobank WES (n=403,990): 6 pLOF genes (TTN/PKP2/CTNNA3/KDM5B/RPL3L) associated with AF; combined PRS+pLOF OR 7.08; TTNtv drives 3× cardiomyopathy risk before and after AF | atrial-fibrillation, genetics, polygenic-risk-score, cardiomyopathy, early-onset-atrial-fibrillation | 2026-04-13 |
| sources/PHT-ESC-2022 | 2022 ESC/ERS PH Guidelines: new mPAP >20 mmHg threshold; 5-group classification; 4-strata follow-up risk model; ERA+PDE5i Class I for PAH; BPA Class I for CTEPH; exercise training Class I | pulmonary-hypertension, pulmonary-arterial-hypertension, CTEPH, right-heart-failure, guideline | 2026-04-13 |
| sources/genetic-cmp-jcf-2018 | 2018 HFSA+ACMG joint guideline for genetic evaluation of cardiomyopathy; 9 guidelines; cascade screening intervals; gene-specific yields and ICD thresholds (LMNA Guideline 9) | genetics, cardiomyopathy, guideline, genetic-testing, cascade-family-screening | 2026-04-15 |
| sources/genetic-eoaf-ehj-2024 | State-of-art review: genetic testing in EOAF; 4–11% P/LP yield; TTN/LMNA/PKP2/MYBPC3 dominant genes; AF precedes cardiomyopathy in ~50% TTNtv carriers; Class IIb ACC/AHA rec ≤45 years; ~60% VUS rate | atrial-fibrillation, early-onset-atrial-fibrillation, genetic-testing, cardiomyopathy, cascade-family-screening | 2026-04-15 |
| sources/genetic-af-dxmx-jce-2022 | Invited review: genetic basis of AF (linkage/GWAS/single-gene); 5-criterion testing framework; 4q25 SNPs modulate ablation outcomes; GENETIC-AF trial (bucindolol vs metoprolol in ADRB1 Arg389Arg HFrEF) | atrial-fibrillation, genetic-testing, catheter-ablation, polygenic-risk-score, dilated-cardiomyopathy | 2026-04-15 |
| sources/genetic-af-cjc-2024 | CJC White Paper: 3-tier genetic testing framework for AF; ClinGen appraisal (only SCN5A/KCNA5/TTN definitive); ablatogenomics — largest SNP-ablation study (n=3259) negative; 3 case vignettes (PKP2/MYBPC3/LMNA) | atrial-fibrillation, genetic-testing, early-onset-atrial-fibrillation, cardiomyopathy, polygenic-risk-score | 2026-04-15 |
| sources/genetic-yield-jama-card-2022 | Combined cardiomyopathy + arrhythmia panel (n=4,782): 19.9% overall yield; 66% of positives have management implications; combined testing gains 10.9% diagnoses vs. disease-specific panels; 42% cascade yield | genetic-testing, cardiomyopathy, arrhythmia, diagnostic-yield, cascade-testing | 2026-04-16 |
| sources/cardiorenal-aha-2019 | AHA 2019 Scientific Statement: CRS 5-type classification (Acute Dialysis Quality Initiative); hemodynamic (CVP-driven, not just low CO) and non-hemodynamic (FGF-23/neurohormonal/inflammatory) pathophysiology; biomarkers (NGAL, TIMP-2×IGFBP7, ST2, galectin-3); UF trials (CARRESS-HF vs UNLOAD); RAAS/beta-blocker/MRA/ARNI evidence tables by GFR; SGLT-2i in diabetic CRS (EMPA-REG, CANVAS); ICD/CRT in CKD; HF in KT recipients; palliative care | cardiorenal-syndrome, heart-failure, kidney-dysfunction, diuretics, chronic-kidney-disease | 2026-04-30 |
| sources/lpa-aha-2021 | AHA 2021 Scientific Statement: Lp(a) as genetically determined causal ASCVD risk factor; KIV2 CNV mechanism; HR 1.11 per 50 nmol/L (UK Biobank n=460K); PCE risk adjustment formula; assay standardisation (nmol/L vs mg/dL); OxPL pathophysiology; CAVD; pelacarsen/ARO-LPA/SLN360 trials | lipoprotein-a, ASCVD, genetics, cardiovascular-risk, lipid-lowering | 2026-04-30 |
| sources/osa-af-jama-2018 | Review: OSA in AF (21–74% prevalence); dual acute/chronic arrhythmogenic mechanism; CPAP reduces AF recurrence (observational); AHI limitations; no RCT evidence | atrial-fibrillation, obstructive-sleep-apnea, CPAP, atrial-remodeling, catheter-ablation | 2026-04-18 |
| sources/vhd-esc-2025 | 2025 ESC/EACTS VHD guidelines: TAVI expanded (asymptomatic AS, BAV, AR); atrial vs ventricular SMR distinct; TEER Class I A for ventricular SMR; transcatheter TR upgraded Class IIa A; unified SVD definitions | valvular-heart-disease, guideline, TAVI, aortic-stenosis, mitral-regurgitation | 2026-04-18 |
| sources/arrhythmia-pregnancy-hrs-2023 | Joglar et al. 2023 HRS Expert Consensus (8 societies; 163 recommendations; 98.4% consensus): AF most common sustained arrhythmia in pregnancy; cardioversion safe/same energy; lead apron only 3% fetal dose reduction; flecainide 1st-line fetal SVT (especially with hydrops); verapamil avoided fetal SVT; DOACs contraindicated; perimortem C-section within 5 min; IAS pregnancies 8× stillbirth risk; LQTS2 highest postpartum risk; BrS/CPVT no increased pregnancy risk | pregnancy, arrhythmia, antiarrhythmic-drugs, fetal-arrhythmia, inherited-arrhythmia-syndrome | 2026-05-22 |
| sources/lqts-pregnancy-medicina-2022 | Review: LQTS in pregnancy; postpartum 2.7× cardiac event risk; LQT2 highest risk; beta-blockers Class I; propranolol/nadolol > metoprolol; amiodarone contraindicated | long-qt-syndrome, pregnancy, channelopathies, beta-blockers, arrhythmia-management | 2026-04-18 |
| sources/brs-jaccep-2022 | State-of-the-art review: BrS pathophysiology, quantified risk stratification (annual SAE rates by clinical subgroup), Brugada burden concept, QUIDAM trial, ICD vs. complications data, epicardial ablation outcomes | brugada-syndrome, risk-stratification, channelopathies, sudden-cardiac-death, inherited-arrhythmias | 2026-04-19 |
| sources/drug-arrhythmia-aha-2020 | AHA 2020 Scientific Statement: comprehensive catalog of drug-induced arrhythmias (7 types); TdP risk factors; repolarization reserve theory; CAST trial; 0.08%/year SCD for drug-induced BrS; IV Mg for TdP | drug-induced-arrhythmias, torsades-de-pointes, QT-prolongation, Brugada-syndrome, arrhythmia-management | 2026-04-19 |
| sources/amiodarone-cvdrug-2020 | Comprehensive clinical review: amiodarone mechanism (all 4 AP phases), indications (VF/VT/AF), pharmacokinetics (t½ 50–60d), multisystem toxicity monitoring, drug interactions (warfarin, sofosbuvir) | amiodarone, antiarrhythmic-drugs, drug-toxicity, ventricular-arrhythmias, atrial-fibrillation | 2026-04-19 |
| sources/HT-AHA-2025 | 2025 AHA/ACC multi-society hypertension guideline: PREVENT replaces PCEs; SPC for Stage 2; RDN COR 2b; primary aldosteronism screening in resistant HT; dementia prevention COR 1 | hypertension, guidelines, blood-pressure-management, cardiovascular-risk, PREVENT-score | 2026-04-20 |
| sources/TTN-CVResearch-2022 | Invited review: titin molecular biology — isoform switch (N2B/N2BA/RBM20), PTMs (acetylation/oxidation/phosphorylation), PQC, TTNtv-DCM triple pathomechanism; failed clinical trials (RELAX/VITALITY/SOCRATES) | titin, dilated-cardiomyopathy, heart-failure, sarcomere, post-translational-modifications | 2026-04-19 |
| sources/atrial-cmp-esc-2025 | ESC/HFA 2025 consensus: AtCM diagnostic framework (P-wave score 0–4 + LAVi >40 ml/m²/LASr <23%); atrial failure as end-stage; BMP10/mid-regional proANP biomarkers; NLRP3 inflammasome and epicardial adipose tissue targets | atrial-cardiomyopathy, atrial-fibrillation, heart-failure, atrial-fibrosis, electrocardiography | 2026-05-01 |
| sources/csp-ehra-2023 | 2023 EHRA consensus on CSP implantation: HBP and LBBAP technique, capture confirmation criteria, complications, device configuration; endorsed by APHRS/CHRS/LAHRS | conduction-system-pacing, his-bundle-pacing, left-bundle-area-pacing, cardiac-pacing, cardiac-resynchronization-therapy | 2026-04-19 |
| sources/csp-jaccep-2023 | JACC:EP 2023 state-of-the-art review: CSP hemodynamics (vs RVP/BVP), ventricular synchrony (UHF-ECG), LBB capture criteria, HOT/LOT-CRT, 7 published RCTs, ongoing PROTECT-HF/Left vs Left | conduction-system-pacing, his-bundle-pacing, left-bundle-area-pacing, cardiac-resynchronization-therapy, heart-failure | 2026-04-19 |
| sources/fabry-ehj-2024 | EHJ 2024 state-of-the-art review: cardiologist's role in AFD; cardiac HCM genocopy; HFpEF (40%); ERT/migalastat/gene therapy; amiodarone contraindicated; CMR 4-stage model; AI diagnostics | fabry-disease, hypertrophic-cardiomyopathy, lysosomal-storage-disorders, cardiomyopathy, enzyme-replacement-therapy | 2026-04-19 |
| sources/fabry-pcvd-2025 | PCVD 2025 systematic review: Fabry cardiomyopathy mechanisms (TLR4/NF-κB, TGF-β, impaired autophagy); ERT paradox (LGE augmented by ERT, meta-analysis n=11); animal model failure; female AFD (mean death 55.4y); miR-17/fatigue | fabry-disease, cardiomyopathy, enzyme-replacement-therapy, lysosomal-storage-disorders, fibrosis | 2026-04-19 |
| sources/rhc-hf-ehj-2025 | EHJ 2025 state-of-the-art review: RHC across HF spectrum; PAWP zone of uncertainty (12–18 mmHg); normal PAWP upper limit 13 mmHg; haemodynamic thresholds for acute/chronic HF, cardiogenic shock (SCAI), LVAD, HTX | right-heart-catheterization, pulmonary-hypertension, heart-failure, cardiogenic-shock, advanced-heart-failure | 2026-04-19 |
| sources/echo-hfpef-ase-2025 | ASE 2025 guideline update: LV diastolic function assessment; LARS as primary LAP parameter; new 2-step diastolic dysfunction definition; revised LAP algorithm (LAVi demoted); stepwise HFpEF diagnosis algorithm; diastolic exercise echo; special populations | echocardiography, diastolic-function, HFpEF, heart-failure, left-atrial-strain | 2026-04-19 |
| sources/VHD-AHA-2020 | 2020 ACC/AHA VHD guideline: A–D staging system; age-based TAVI vs SAVR selection; COAPT criteria for secondary MR TEER; prosthetic valve antithrombotic (INR 2.5/3.0; DOACs Class III:Harm); SVD surveillance schedule | valvular-heart-disease, guideline, aortic-stenosis, prosthetic-valves, TAVI | 2026-04-19 |
| sources/hemodynamics-circ-2012 | Circulation 2012 review: invasive hemodynamic catheterization principles; Gorlin/Hakki equations; AS/MS gradient measurement pitfalls; constrictive vs restrictive differential; HCM provocative maneuvers | hemodynamics, cardiac-catheterization, valvular-heart-disease, aortic-stenosis, pulmonary-hypertension | 2026-04-20 |
| sources/lipid-aha-2026 | 2026 ACC/AHA Dyslipidemia Guideline: PREVENT equations replace PCE; LDL-C/non-HDL-C goals reinstated; universal Lp(a) measurement COR 1; CAC-guided treatment tiers; bempedoic acid/inclisiran/olezarsen incorporated | dyslipidemia, guidelines, primary-prevention, ldl-c, ASCVD | 2026-04-20 |
| sources/lipid-esc-2025 | 2025 ESC/EAS Focused Update: SCORE2/SCORE2-OP replace SCORE; bempedoic acid COR I B for statin-intolerant; evinacumab COR IIa B for HoFH ≥5 y; ACS combination initiation; Lp(a) >105 nmol/L risk-enhancing COR IIa B; volanesorsen for FCS (EMA); statins for HIV/cancer | dyslipidemia, guidelines, ldl-c, ASCVD, ESC | 2026-04-20 |
| sources/acute-pe-aha-2026 | 2026 AHA/ACC multi-society PE guideline; introduces 5-category AHA/ACC Acute PE Clinical Categories (A–E); PERT COR 1; DOACs over VKAs; LMWH over UFH; advanced therapy by category; CTEPD surveillance | pulmonary-embolism, venous-thromboembolism, anticoagulation, guidelines, risk-stratification | 2026-04-21 |
| sources/periop-aha-2024 | 2024 AHA/ACC multi-society guideline for Perioperative Cardiovascular Management for NCS; stepwise algorithm; RCRI/NSQIP/DASI; MINS surveillance; BP targets (MAP ≥60–65); pharmacotherapy (SGLT2i COR 1 stop, BB COR 3 no start day-of); POAF; special populations (AS, PH, HCM, AF) | perioperative-medicine, noncardiac-surgery, cardiovascular-risk, guideline, anticoagulation | 2026-04-22 |
| sources/imaging-amyloidosis-aha-2021 | 2021 AHA 8-society consensus on multimodality imaging in cardiac amyloidosis (Part 1): evidence base + standardized protocols; scintigraphy Grade 0–3 system; SPECT mandatory addendum; PSIR LGE; ECV >0.40 | cardiac-amyloidosis, multimodality-imaging, ATTR-amyloidosis, echocardiography, radionuclide-imaging | 2026-04-22 |
| sources/imaging-amyloidosis-2nd-aha-2021 | 2021 AHA 8-society consensus on multimodality imaging in cardiac amyloidosis (Part 2): formal diagnostic criteria (ECV >0.40, apical GLS ratio >1, PET thresholds); AUC ratings for 32 clinical scenarios; scintigraphy Rarely Appropriate in AL | cardiac-amyloidosis, multimodality-imaging, ATTR-amyloidosis, appropriate-use-criteria, diagnostic-criteria | 2026-04-22 |
| sources/PVD-AHA-2024 | 2024 ACC/AHA multi-society guideline for lower extremity PAD; rivaroxaban+aspirin COR 1A; SET COR 1A for claudication; BEST-CLI vs BASIL-2; CLTI multispecialty care; ALI 4–6h ischaemia window; health disparities | peripheral-artery-disease, guidelines, revascularization, CLTI, claudication | 2026-04-24 |
| sources/rvfailure-nejm-2023 | Houston/Brittain/Tedford 2023 NEJM Review: RV failure pathophysiology (adaptive homeometric → maladaptive heterometric via β₁-adrenergic depletion, ischaemia, fibrosis, FAO→glycolysis shift); classification by mechanism (preload: TR/shunts/AV fistulas; afterload: acute PE/chronic PH; contractility: RV MI/post-surgical/LHF/ARVC/sarcoidosis); TAPSE/PASP ratio as noninvasive RV–PA coupling surrogate; PDE5i harmful in LHD-associated PH (SIOVAC); volume loading NOT universally beneficial; dobutamine/milrinone; isolated RVAD contraindicated in severe PAH | right-ventricular-failure, pulmonary-hypertension, hemodynamics, right-heart-catheterization, right-ventricular-remodeling | 2026-05-17 |
| sources/rv-failure-aha-2026 | 2026 AHA Scientific Statement: RV failure in PH — RV–PA coupling (Ees/Ea thresholds), adaptive vs maladaptive remodeling, multiomics biomarkers (H19/SPARCL1/CILP1/FSTL3), imaging (CMR/PET/4D flow), sotatercept RV effects | right-ventricular-failure, pulmonary-hypertension, RV-PA-coupling, ventricular-remodeling, multiomics-biomarkers | 2026-04-22 |
| sources/hemodynamic-hf-pht-aha-2026 | 2026 AHA Scientific Statement: standardized provocative RHC protocols — SNP/milrinone vasodilator challenge (Table 1), PAH AVT (adenosine dropped, Table 2), volume challenge (PAWP ≥19 threshold), invasive exercise HFpEF criteria (Table 4), LVAD ramp/reverse ramp, remote PA monitoring | right-heart-catheterization, heart-failure, pulmonary-hypertension, invasive-hemodynamics, HFpEF | 2026-04-22 |
| sources/diet-aha-2026 | 2026 AHA Scientific Statement: 9-feature heart-healthy dietary pattern; alcohol initiation not recommended (MR negates protection); fish oil supplement increases AF risk; ultraprocessed foods linked to CVD/T2DM/obesity; saturated→unsaturated fat lowers LDL-C; sodium↓+potassium↑ for BP | cardiovascular-prevention, dietary-control, nutrition-guidelines, ultraprocessed-foods, primary-prevention | 2026-04-24 |
| sources/cuffless-bp-aha-2026 | 2026 AHA Scientific Statement: cuffless BP devices (PPG/tonometry/PAT/PTT) — mechanism overview, theoretical applications, validation gaps; 2025 AHA/ACC recommends against clinical use (COR 3: No Benefit); ISO 81060-7 pending | hypertension, blood-pressure-monitoring, digital-health, wearable-technology, photoplethysmography | 2026-04-24 |
| sources/ais-aha-2026 | 2026 AHA/ASA full AIS guideline: tenecteplase COR 1A replaces alteplase; EVT expanded (ASPECTS 3–5 COR 1A; BAO 24h COR 1A); post-EVT SBP <140 mmHg COR 3:Harm; elastic stockings COR 3:Harm; DAPT 21d for minor AIS/TIA COR 1A | acute-ischemic-stroke, endovascular-thrombectomy, thrombolysis, stroke-management, guideline | 2026-04-24 |
| sources/DCM-Lancet-2023 | 2023 Lancet Seminar: DCM causes, mechanisms, and treatment; second hit paradigm; 12 definitive genes with genotype-phenotype table; REALM-DCM failure (LMNA p38-MAPK); TRED-HF 44% relapse; gene therapy (LAMP2/CRISPR/PLN-ASO) | dilated-cardiomyopathy, genetics, myocarditis, gene-therapy, heart-failure | 2026-04-25 |
| sources/periop-cied-aha-2024 | 2024 AHA Scientific Statement on periprocedural management of CIEDs; device-specific magnet responses (Micra no response; AVEIR response); leadless/S-ICD/EV-ICD distinctions; three-phase multidisciplinary workflow; ICD re-enablement safety imperative | cied-management, perioperative-care, leadless-pacemaker, electromagnetic-interference, icd | 2026-04-25 |
| sources/consumer-genetictest-aha-2025 | 2025 AHA Scientific Statement on DTC genetic testing for CVD; regulatory gaps, ACCE framework, monogenic/PRS/pharmacogenomic testing, clinical algorithm for actionable DTC results, cascade testing challenges | genetic-testing, direct-to-consumer-genetics, polygenic-risk-scores, pharmacogenomics, precision-medicine | 2026-04-25 |
| sources/cardiac-rehab-aha-2024 | AHA/AACVPR 2024 Scientific Statement: 9 CR core components; strength training and program quality newly standalone; hybrid/virtual delivery; LVEF ≤35% HF qualifying indication; LDL-C <70/<55, BP <130/80, HbA1c <7% targets; 70% enrollment goal | cardiac-rehabilitation, secondary-prevention, exercise-training, heart-failure, cardiovascular-disease | 2026-04-25 |
| sources/competitive-sports-aha-2025 | 2025 AHA/ACC Scientific Statement on competitive sports in athletes with CVD; SDM paradigm shift; HCM/DCM/ACM no universal restriction; PKP2 ACM restricted; LQTS/CPVT sports reasonable under supervision; BrS no restriction; myocarditis 4–6 wk return; masters athlete guidance | sports-cardiology, sudden-cardiac-death, shared-decision-making, cardiomyopathy, guidelines | 2026-04-25 |
| sources/ai-cardiooncology-aha-2025 | 2025 AHA Scientific Statement: AI for precision medicine in cardio-oncology; multi-omics biomarkers (genomics/transcriptomics/proteomics/metabolomics); AI risk models (90% discrimination); AI-ECG (ICI myocarditis, anthracycline LV dysfunction); NLP/LLM; national registry call; ethical challenges | cardio-oncology, artificial-intelligence, precision-medicine, cardiotoxicity, multi-omics | 2026-04-25 |
| sources/AKI-HF-AHA-2024 | 2024 AHA Scientific Statement: kidney dysfunction in advanced HF; Heart-Kidney Profiles A/B/C; reversibility framework (TKPP >60 mmHg); LVAD/HTx perioperative kidney management; peritoneal dialysis preferred in LVAD; sHKTx when eGFR <45/<30; palliative care integration | cardiorenal-syndrome, advanced-heart-failure, kidney-dysfunction, LVAD, heart-transplantation | 2026-04-25 |
| sources/BCNE-AHA-2025 | 2025 AHA Scientific Statement on BCNE: prior antibiotic exposure #1 cause; 2023 Duke-ISCVID criteria; metagenomic sequencing; 18F-FDG PET/CT; fastidious pathogen table (Coxiella/Bartonella/Whipple/M.chimaera/Fungi); empiric regimens; NBTE differential | infective-endocarditis, blood-culture-negative-endocarditis, molecular-diagnostics, fastidious-organisms, scientific-statement | 2026-04-25 |
| sources/mitochondrial-cv-aha-2025 | 2026 AHA Scientific Statement: mtDNA variation in CVD; heteroplasmy dynamics; ~30% cardiac involvement in mitochondrial disease; HCM dominant phenotype; MELAS/MERRF/MIDD/KSS syndromes; NGS best practices; TALE/zinc-finger gene editing; cGAS-STING inflammatory pathway | mitochondrial-genetics, cardiomyopathy, arrhythmia, genetic-testing, cardiovascular-disease | 2026-04-25 |
| sources/rnd-aha-2024 | 2024 AHA Scientific Statement: Renal denervation for hypertension; FDA approval (Spyral/Paradise Nov 2023); 22+ sham-controlled RCTs; 4–10 mmHg SBP reduction; patient selection, safety (no kidney impairment), shared decision-making | hypertension, resistant-hypertension, renal-denervation, catheter-based-therapy, sympathetic-nervous-system | 2026-04-25 |
| sources/vhd-mechanism-aha-2024 | 2024 AHA Scientific Statement: molecular mechanisms of VHD (CAVD, BAV, MVP, RHD); no effective medical therapy; Lp(a)/LDL-C osteogenic cascade; statin paradox; CHIP in CAVD; TGF-β in MVP; molecular mimicry in RHD; ongoing trials (pelacarsen, colchicine) | valvular-heart-disease, calcific-aortic-valve-disease, mitral-valve-prolapse, rheumatic-heart-disease, molecular-mechanisms | 2026-04-25 |
| sources/TV-Mx-AHA-2024 | 2024 AHA Scientific Statement: TV anatomy (Type I–IV leaflet nomenclature); 5-grade TR severity (massive/torrential); TRILUMINATE Pivotal RCT (win ratio 1.48, QoL benefit, no mortality gain); TriClip + EVOQUE FDA-approved; Cardioband annuloplasty; heterotopic replacement; lifetime management framework | tricuspid-regurgitation, valvular-heart-disease, transcatheter-interventions, right-heart-failure, multimodality-imaging | 2026-04-25 |
| sources/alcohol-cv-aha-2025 | 2025 AHA Scientific Statement: alcohol-CVD relationships across all conditions; heavy/binge drinking consistently harmful; MR does not confirm cardioprotective effect; AF causal dose-response (abstinence RCT); ACM dose-duration-TTNtv interaction; hypertension dose-response | alcohol-consumption, atrial-fibrillation, cardiomyopathy, hypertension, cardiovascular-risk | 2026-04-28 |
| sources/prepregnancy-aha-2023 | AHA 2023 Scientific Statement: prepregnancy CVH (Life's Essential 8) as critical window to reduce APOs and intergenerational CVD; graded CVH–APO dose-response; no large RCTs; multilevel interventions; racial/ethnic disparities | prepregnancy-cardiovascular-health, adverse-pregnancy-outcomes, maternal-health, health-disparities, lifes-essential-8 | 2026-04-28 |
| sources/ht-pregnancy-aha-2022 | AHA 2022 Scientific Statement: HDP diagnosis, BP goals, pharmacotherapy; ACOG ≥160/110 vs international ≥140/90 threshold controversy; preeclampsia sFlt-1/VEGF pathophysiology; HF HR 2.7, ESKD RR 6.6 long-term risk; Black maternal mortality 41/100k | hypertensive-disorders-of-pregnancy, preeclampsia, maternal-health, antihypertensive-therapy, blood-pressure-in-pregnancy | 2026-04-28 |
| sources/cv-pregnancy-aha-2020 | AHA 2020 Scientific Statement: cardio-obstetrics team framework; modified WHO classification (only prospectively validated); PPCM/IPAC (recovery first 6 months; major events EF <30%); SCAD/MINOCA in pregnancy; cerebrovascular (RCVS/PRES/ICH/CVT); anticoagulation table; contraception eligibility | cardio-obstetrics, cardiovascular-disease-in-pregnancy, peripartum-cardiomyopathy, maternal-health, anticoagulation-in-pregnancy | 2026-04-28 |
| sources/obesity-cv-aha-2021 | AHA 2021 Scientific Statement: obesity and CVD — visceral/epicardial fat as CVD risk markers; CAD diagnosis in obesity (PET preferred over SPECT); obesity paradox (post-PCI/CABG/HF); HFpEF more strongly associated than HFrEF; every 5-BMI-unit → 16% SCD risk +29% AF risk; ≥10% weight loss → 6-fold freedom from AF | obesity, cardiovascular-disease, heart-failure, atrial-fibrillation, coronary-artery-disease | 2026-04-29 |
| sources/noncoding-rna-aha-2020 | AHA 2020 Scientific Statement: all ncRNA classes (miRNA/snoRNA/Y-RNA/tsRNA/lncRNA/circRNA/exRNA) in CVD; computational tools; inclisiran/patisiran/anti-miR clinical pipeline; exRNA as CVD biomarkers | noncoding-RNA, microRNA, lncRNA, RNA-therapeutics, extracellular-RNA | 2026-04-29 |
| sources/HF-Precision-Medicine-AHA-2019 | AHA 2019 Scientific Statement: six-omics precision medicine in HF (genomics, pharmacogenomics, epigenomics, proteomics, metabolomics, microbiomics); ADRB1/GRK5/GNB3 beta-blocker pharmacogenomics; GUIDE-IT futility; TMAO as 5-year mortality predictor | precision-medicine, heart-failure, genomics, pharmacogenomics, omics | 2026-04-29 |
| sources/arrhythmia-cardio-oncology-aha-2021 | AHA 2021 Scientific Statement: arrhythmias in cancer (AF most common; ibrutinib RR 4.69; ICI-myocarditis-driven AF; QT prolongation up to 22%; MADIT-CHIC CRT trial); anticoagulation in cancer-AF; autonomic dysfunction in cancer survivors | arrhythmia, cardio-oncology, atrial-fibrillation, QT-prolongation, autonomic-dysfunction | 2026-04-29 |
| sources/cardio-oncology-drug-aha-2022 | AHA 2022 Scientific Statement: drug-drug interactions in cardio-oncology — pharmacodynamic (hypertension/CTRCD/ICI myocarditis/VTE/bleeding/QT) and pharmacokinetic (CYP1A2/2C8/2C9/2C19/2D6/3A4/P-gp/UGT enzyme tables); DOAC/warfarin/tamoxifen/TKI management | cardio-oncology, drug-drug-interactions, pharmacokinetics, cancer-therapy-toxicity, anticoagulation | 2026-04-29 |
| sources/Hormonal-Rx-AHA-2021 | AHA 2021 Scientific Statement: CV risks of breast cancer endocrine therapy (AI pooled RR 1.19 vs tamoxifen; ribociclib+tamoxifen avoid; CDK4/6 RR 1.39) and prostate cancer ADT (GnRH antagonist HR 0.44–0.46; AR-directed RR 1.36); ABCDE algorithm; racial disparities | cardio-oncology, breast-cancer, prostate-cancer, androgen-deprivation-therapy, cardiovascular-toxicity | 2026-04-29 |
| sources/minoca-aha-2019 | AHA 2019 Scientific Statement: MINOCA definition (4th Universal MI Definition); traffic-light diagnostic algorithm; six causes (plaque disruption/vasospasm/MVD/embolism/SCAD/supply-demand mismatch); SWEDEHEART statins HR 0.77, ACEi/ARBs HR 0.82, DAPT no benefit; 4.7% 12-month mortality | MINOCA, myocardial-infarction, coronary-vasospasm, SCAD, coronary-microvascular-dysfunction | 2026-04-29 |
| sources/pharmacological-provocation-europace-2025 | EHRA 2025 multi-society consensus: SCB testing (ajmaline preferred; false-positive rates by disease; indications/contraindications; clinical scenarios); epinephrine for CPVT when EST not feasible; adenosine for SVT/WPW; acetylcholine/ergonovine for CAS (COVADIS criteria); SCN5A carriers generally not tested | brugada-syndrome, pharmacological-provocation, sudden-cardiac-death, channelopathies, arrhythmia-diagnosis | 2026-04-30 |
| sources/PVC-ablation-jaccep-2024 | JACC:EP 2024 state-of-the-art review: PVC catheter ablation indications (symptomatic PVCs, PVC-induced CMP, PVC-triggered VF); ECG localization rules; activation/pace mapping/ECGI; RF/cryo/ethanol/PFA/stereotactic radioablation; site-by-site strategies (RVOT, LV summit, papillary muscles, Purkinje, intramural); 84% acute success, 2.4% major complications | premature-ventricular-complexes, catheter-ablation, ventricular-arrhythmias, electrophysiology, PVC-induced-cardiomyopathy | 2026-05-01 |
| sources/qwave-mri-jacc-imaging-2012 | JACC:Imaging 2012 prospective validation study (n=46, 5-year serial LGE-CMR): Q-wave presence determined by infarct size not transmurality; 23% non-diagnostic ECG at 1 week → 44% at 5 years post-STEMI; 6.2% LV mass cutoff; pseudo-normalization confirmed | myocardial-infarction, electrocardiography, late-gadolinium-enhancement, stemi, cardiac-mri | 2026-05-01 |
| sources/epi-adipose-arrhythmia-jacc-2021 | JACC 2021 state-of-the-art review: EAT arrhythmogenesis via structural infiltration (zigzag conduction, re-entry), electrotonic coupling (Cx43, RMP depolarisation), and paracrine secretome (TNF-α/IL-1β/IL-6 → APD prolongation, connexin downregulation, fibrosis); ECG correlates: P-wave/PR/QRS/TpTe | epicardial-adipose-tissue, arrhythmias, atrial-fibrillation, obesity, electrophysiology | 2026-05-01 |
| sources/circadian-scd-jmcc-2025 | JMCC 2025 narrative review: extrinsic (SCN/ANS) and intrinsic (BMAL1/CLOCK) circadian regulation of cardiac ion channel expression; Kcnh2/Gja1/Scn5a/Hcn4/Pkp2/Dsc2/Dsg2 as top REGs; KLF15→KChIP2 indirect pathway; LQT2 mutations shortening Kv11.1 t½ amplify time-of-day APD swings; loss of morning SCA peak in modern populations | circadian-rhythm, sudden-cardiac-death, cardiac-electrophysiology, ion-channels, arrhythmia-mechanisms | 2026-05-01 |
| sources/RYR2-CPVT-CircEP-2025 | Chang 2025 Circ:ArrhythmElectrophysiol: largest CPVT RYR2 database — 964 patients, 263 variants; domain-specific age of onset (CSol 8y, pore 8y, NTD 12y); variant-specific treatment response (R420Q vs R420W); structural mapping onto cryo-EM (PDB 7UA5); markslab-cpvtdb.org web app; proposes exons 37/42 added to hotspot II | CPVT, RYR2, ryanodine-receptor, variant-interpretation, sudden-cardiac-death | 2026-05-05 |
| sources/ACM-Genotype-Mx-JCE-2024 | Muller 2025 JCE: genotype-specific ACM diagnosis and management — 7-gene natural history (PKP2/DSP/DSG2/DSC2/JUP/TMEM43/PLN/DES); 2010 TFC inadequate non-PKP2; gene-specific risk calculators (ARVC/DSP/PLN); PKP2-flecainide RCT pending; AAV-PKP2 Phase I/II (Rocket/LEXEO/Tenaya); exercise is gene-specific (not harmful in PLN); Padua criteria limitations; family screening 33%+33% yield | arrhythmogenic-cardiomyopathy, genotype-phenotype, risk-stratification, gene-therapy, sudden-cardiac-death | 2026-05-05 |
| sources/scn5a-jaccep-2018 | Wilde & Amin 2018 JACC:CEP state-of-the-art: full clinical spectrum of SCN5A — LQT3 (INaL GOF), BrS (LOF, partial cardiomyopathy), SCN5A-DCM (3 pathomechanisms; conduction defects precede DCM 15-20 y), MEPPC (R222Q), overlap syndromes (1795insD); mutation-direction-specific management | SCN5A, channelopathies, long-qt-syndrome, brugada-syndrome, dilated-cardiomyopathy | 2026-05-05 |
| sources/modifier-genes-scd-ehj-2018 | Schwartz 2018 review of modifier genes explaining incomplete penetrance in LQTS and AMI-VF; NOS1AP, KCNH2-K897T, iPSC-CM approach | #modifier-genes, #long-qt-syndrome, #sudden-cardiac-death, #NOS1AP, #polygenic-risk-score | 2026-05-05 |
| sources/mybpc3-gene-2015 | Carrier 2015 review of MYBPC3 biology: mutation landscape, founder mutations, cMyBP-C structure/phosphorylation/PTMs, and early gene therapy (exon skipping, RNA trans-splicing, AAV replacement) | #MYBPC3, #hypertrophic-cardiomyopathy, #gene-therapy, #haploinsufficiency, #sarcomere | 2026-05-07 |
| sources/dronedarone-circ-2009 | Patel/Yan/Kowey 2009 review: dronedarone pharmacology (IK-Ach 100x, INa 10x vs amiodarone), DAFNE/EURIDIS-ADONIS/ERATO/ANDROMEDA(terminated)/ATHENA(24.2% RRR)/DIONYSOS trials; HF contraindication | #dronedarone, #atrial-fibrillation, #antiarrhythmic-drugs, #amiodarone, #heart-failure | 2026-05-07 |
| sources/flecainide-af-europace-2011 | Aliot 2011 review: flecainide class 1C pharmacology (PRR mechanism, RyR2 blockade), CAST reappraisal, cardioversion efficacy (up to 95% IV; 90% > propafenone > amiodarone), pill-in-the-pocket, Danish registry safety data; industry-funded (Meda) | #flecainide, #atrial-fibrillation, #antiarrhythmic-drugs, #proarrhythmia, #sodium-channel-blockade | 2026-05-07 |
| sources/amiodarone-thyroid-jcem-2021 | Ylli 2021 JCEM Approach-to-Patient: Type 1 AIT (iodine-driven/methimazole) vs Type 2 AIT (destructive/prednisone) vs mixed (both); AIH management; incidence 2–24% (not dose-dependent); 23% ICU mortality in thyroid storm; ETA thyroidectomy criteria; anticoagulant interactions (warfarin/rivaroxaban/apixaban) | #amiodarone, #thyroid-dysfunction, #thyrotoxicosis, #drug-toxicity, #antiarrhythmic-drugs | 2026-05-07 |
| sources/amiodarone-pulmonary-clin-chest-2004 | Camus 2004 Clin Chest Med authoritative review: 6 APT patterns (infiltrative/OP/fibrosis/nodules/ARDS/subclinical); 100–500× lung tissue accumulation; DLCO key monitoring marker; high-FiO₂ surgery ARDS trigger; prednisolone 0.75–1 mg/kg ≥6–12 months; 21–33% hospitalisation mortality; recurrence ~2/3 on rechallenge | #amiodarone, #drug-induced-lung-disease, #pulmonary-toxicity, #antiarrhythmic-drugs, #drug-toxicity | 2026-05-07 |
| sources/amiodarone-pulmonary-drugsafety-2010 | Papiris 2010 Drug Safety review: amiodarone effect vs toxicity distinction; 3-mechanism pathophysiology (cytotoxic/immune/angiotensin); full 9-pattern taxonomy (CEP/COP/AFOP/amiodaronoma/NSIP-like/IPF-like/DIP/ARDS/DAH); cumulative incidence 4.2%/7.8%/10.6% at 1/3/5 years; 3-fold APT risk per decade >60; KL-6 NPV 92% (sensitivity 25%); CT density >70 HU absent in 27–55%; BAL cellular breakdown; surgical biopsy avoid; corticosteroid taper ≤5 mg/day; ACE-I/ARB potentially protective | #amiodarone, #drug-induced-lung-disease, #pulmonary-toxicity, #antiarrhythmic-drugs, #drug-toxicity | 2026-05-07 |
| sources/gwas-arrhythmias-cmp-genes-2025 | Dababneh 2025 Genes review: GWAS and PRS utility in HCM/DCM/BrS/LQTS; inverse HCM-DCM risk loci (MYBPC3/ALPK3/FHOD3); BrS oligogenic with 21 loci (HEY2/MAPRE2); NOS1AP as LQTS modifier; PRS predicts disease risk independent of rare variant status; European-ancestry predominance limits generalisability | #polygenic-risk-score, #inherited-arrhythmias, #cardiomyopathy, #GWAS, #genetics | 2026-05-07 |
| sources/inherited-arrhythmias-nrdp-2020 | Schwartz/Ackerman/Antzelevitch/Wilde 2020 Nat Rev Dis Primers: the four major channelopathies in one Primer. SCD in 1–35-year-olds 1.3–3.2/100,000 with 40% structurally normal at autopsy; LQTS prevalence 1:2,534; LQT1 30–35%/LQT2 25–40%/LQT3 5–10%, 15–20% genotype-negative, 5–10% multiple mutations; ClinGen tags KCNE1 limited for isolated LQTS; calmodulin one-of-six alleles, 93% de novo; SQTS just >200 patients, 40% arrest by 40, 83% at rest; CPVT RYR2 65%, rare variant in 3% of healthy people, PKP2 in the panel; BrS SCN5A 20% and the only supported gene, HEY2 GWAS, >4/6 risk alleles; BrS mechanism argued by Antzelevitch (repolarisation) versus Wilde (depolarisation); gene-specific lifestyle; LCSD requires lower half of stellate plus T1–T4 and fails when incomplete; ICD 31% adverse events at 5 years; pregnancy LQT2 16% vs LQT1 <1%, fetal death 24.4% vs 3.4% by parent of origin | channelopathies, inherited-arrhythmias, long-qt-syndrome, brugada-syndrome, cpvt, short-qt-syndrome, sudden-cardiac-death, genetics | 2026-10-28 |
| sources/inherited-basis-cad-nejm-2026 | Schunkert/Natarajan/Samani 2026 NEJM CME review: inherited basis of CAD — FH (LDLR/APOB/PCSK9; 2-3× excess CAD risk at same LDL-C with genetic variant); 346 CAD GWAS loci; CAD PRS top 5% = 3-5× risk; intermediate-risk reclassification (1 event/340 screened); young-adult PRS (30-40% vs 10% CAD by age 70); Mendelian randomization validates LDL-C/Lp(a)/TG/BP and deprioritises HDL-C/CRP/vitamin D/uric acid; genetics-to-therapeutics: statins/PCSK9i/ezetimibe/bempedoic acid/LPA agents | coronary-artery-disease, polygenic-risk-score, familial-hypercholesterolemia, genetics, mendelian-randomization | 2026-05-16 |
| sources/gene-editing-cv-tcm-2025 | Abdul-Rahman 2025 TCM narrative review: CRISPR-Cas9/base editing/prime editing in ICCs; AAV mosaicism threshold >70%; risk-benefit framework (WPW — ablation superior; PRKAG2 syndrome — gene editing appropriate); disease table (HCM/Marfan/PAH/DMD/calmodulinopathy-LQTS/FH/PRKAG2); AI for target optimisation and safety | #gene-editing, #CRISPR-Cas9, #inherited-cardiac-conditions, #gene-therapy, #precision-medicine | 2026-05-07 |
| sources/precision-lqts-tcm-2024 | Neves/Ackerman 2024 TCM: 1,304-patient Mayo Clinic 20-year LQTS precision therapy cohort; 10–18 configurations per subtype; intentional nontherapy 18%; LCSD monotherapy 5%; IPAP/mexiletine for LQT2; propranolol>nadolol in LQT3; 0.3% mortality; >50% ICD extraction rate | #long-qt-syndrome, #precision-medicine, #beta-blockers, #left-cardiac-sympathetic-denervation, #antiarrhythmic-drugs | 2026-05-09 |
| sources/aav-gene-therapy-arrhythmia-hr-2024 | Mundisugih 2024 Heart Rhythm PRISMA meta-analysis: 26 preclinical studies; 22 novel targets; AAV9 92%; AF inducibility −81% (OR 0.19); VA inducibility −94% (OR 0.06); only PKP2 in clinical trial; 20% SCN5A base-editing threshold sufficient for LQT3; significant publication bias | #gene-therapy, #AAV-vectors, #atrial-fibrillation, #ventricular-arrhythmia, #channelopathies | 2026-05-09 |
| sources/genetics-va-fcvm-2022 | Wang/Tu 2022 Front Cardiovasc Med narrative review: 30+ gene reference table for non-structural VA; epigenetics — miR-19b multi-channel regulation, U1 snRNA/KCNH2 splicing, SCN5A H558R promoter methylation, KCNQ1OT1 imprinting, KChIP2/H3K4me3, SCN10A 3D enhancer-SCN5A promoter loop; TECRL mixed CPVT/LQTS phenotype; somatic RVOT-VT mutations (GNAI2/ADORA1/GNAS) | #ventricular-arrhythmia, #inherited-arrhythmias, #epigenetics, #channelopathies, #genetics | 2026-05-09 |
| sources/calm-fcvm-2018 | Badone/Crotti/Zaza 2018 Front Cardiovasc Med: calmodulinopathy mechanism review — CaM pre-bound pool (99% bound in cardiomyocytes); LQTS via CDI loss at Cav1.2 (C-lobe affinity mutations: CALM1-p.D130G/F142L, CALM2-p.D96V); CPVT via RyR2 destabilisation (CALM1-p.N98S/N54I, CALM3-p.A103V); high penetrance via pre-bound pool dominance (1:7 mutant:WT sufficient); verapamil reverses QT in hiPSC-CMs; no clinical trial data (2018) | #calmodulinopathy, #calcium-handling, #long-qt-syndrome, #CPVT, #channelopathies | 2026-05-10 |
| sources/cv-pregnancy-esc-2018 | Regitz-Zagrosek 2018 ESC Guideline: comprehensive CVD-in-pregnancy reference — mWHO classification (I–IV, 40–100% event rate for class IV); PPCM BOARD framework + bromocriptine dosing (2.5 mg OD/BID); non-selective beta-blockers Class I for LQTS/CPVT throughout pregnancy + 40 weeks postpartum; catheter ablation IIaC; LMWH drug of choice for VTE (IB); FDA drug categories abandoned (IIIC); PAH/prior PPCM with residual LV dysfunction/severe valve disease = mWHO IV | #pregnancy, #guidelines, #arrhythmias, #PPCM, #anticoagulation | 2026-05-10 |
| sources/cpvt-jcm-2024 | Aggarwal/Zarich 2024 Yale J Clin Med review: comprehensive CPVT clinical reference — Giudicessi diagnostic scorecard (reduces RyR2 VUS rate 48%→7%; ≥3.5 pts = ≥90% CPVT probability); nadolol HR 2.04 vs selective BB (symptomatic children) and HR 5.8 (216 RYR2-variant cohort); 15% non-adherence (60% evening events from missed doses); LCSD 63-patient multicenter series (86%→21% events; 92% reduction); triple therapy (nadolol+flecainide+LCSD) for sentinel SCA; ICD paradigm shift — 47% vs 15.8% adverse outcomes (ICD vs no-ICD); 99% VT shock failure; catheter ablation — LV basal anterior wall as dominant source (not RVOT); ivabradine/verapamil ineffective; dantrolene preclinical only | #catecholaminergic-polymorphic-ventricular-tachycardia, #sudden-cardiac-death, #ventricular-arrhythmias, #left-cardiac-sympathetic-denervation, #gene-therapy | 2026-05-10 |
| sources/lqts-jaccep-2022 | Krahn 2022 JACC:CEP state-of-the-art: practical LQTS diagnosis/risk/management — exercise 4-min QTc ≥445 ms (90%/90%); QTc ≥500 ms 0.5–1.3% SAE/yr; JLN 35% SCD by 40; ~25% apparent acquired LQTS carry pathogenic variant; nadolol 1 mg/kg/day; 15-20% HR blunting endpoint; ICD 2.8%/yr inappropriate shocks | #long-qt-syndrome, #channelopathies, #risk-stratification, #arrhythmia-management, #cardiac-electrophysiology | 2026-05-10 |
| sources/vericiguat-victoria-nejm-2020 | Armstrong 2020 NEJM VICTORIA: phase 3 RCT vericiguat vs placebo in worsening HFrEF (n=5050; median NT-proBNP 2816; 41% NYHA III/IV); primary composite CV death/HF hosp HR 0.90 (0.82–0.98) P=0.02; NNT ~24; no all-cause mortality benefit; total HF hosp HR 0.91 P=0.02; anemia 7.6% vs 5.7%; no SGLT2i co-treatment data | #heart-failure, #vericiguat, #HFrEF, #clinical-trial, #nitric-oxide-cGMP | 2026-05-10 |
| sources/dcm-precision-hfreview-2022 | Orphanou 2022 Heart Failure Reviews: DCM precision medicine — Pinto 2016 relative diagnostic criteria (Major/Minor, definite/probable/possible); exercise echo LVEF >11% increase: 80% sens/90% spec for DCM vs athletic heart; genotype-specific LVRR (TTN higher; LMNA/FLNC/DES/DMD lower); "apparent healing phenomenon" 15% normalize → 5% deteriorate at 15 years; LMNA/FLNC high-intensity sports prohibited even phenotype-negative; SCN5A pR222Q GOF → Na-channel blocker response; gene reference table 20+ genes | #dilated-cardiomyopathy, #genetics, #precision-medicine, #risk-stratification, #arrhythmia-management | 2026-05-10 |
| sources/arni-paragon-hf-nejm-2019 | Solomon 2019 NEJM PARAGON-HF RCT: sacubitril–valsartan vs valsartan in HFpEF (LVEF ≥45%, n=4796, 35 months); primary composite RR 0.87 (P=0.06) — negative; NYHA improvement OR 1.45; renal protection HR 0.50; subgroup signal: lower LVEF (45–57%) and women | heart-failure, HFpEF, sacubitril-valsartan, clinical-trial, angiotensin-neprilysin-inhibition | 2026-05-11 |
| sources/arni-paradigm-hf-nejm-2014 | McMurray 2014 NEJM PARADIGM-HF RCT: sacubitril–valsartan (LCZ696) vs enalapril in HFrEF (LVEF ≤40%, n=8,399, 27 months, stopped early); primary composite HR 0.80 (P<0.001), NNT 21; CV death HR 0.80 NNT 32; all-cause death HR 0.84; HF hosp HR 0.79; KCCQ +1.64 pts; less renal impairment/hyperkalemia/cough vs enalapril; established ARNI as Class I HFrEF pillar | heart-failure, HFrEF, sacubitril-valsartan, clinical-trial, angiotensin-neprilysin-inhibition | 2026-05-11 |
| sources/pci-hf-revived-bcis2-nejm-2022 | Perera 2022 NEJM REVIVED-BCIS2 RCT: PCI + OMT vs OMT alone in ischaemic LV dysfunction (LVEF ≤35%, n=700, viability ≥4 segments, 40 UK centres, median 41 months); primary HR 0.99 (P=0.96) — no benefit; LVEF no difference at 6m or 12m; KCCQ +6.5 pts at 6m (above MCID) eroded to NS at 24m; challenges myocardial hibernation paradigm; 2023 AHA/ACC CCD guideline: PCI does not confer survival benefit in ischaemic cardiomyopathy | ischemic-cardiomyopathy, percutaneous-coronary-intervention, heart-failure, myocardial-viability, revascularization | 2026-05-11 |
| sources/icd-crt-auc-2025 | Russo 2025 JACC ACC/AHA/HRS 8-society AUC: 335 scenarios across 12 device domains (ICD secondary/primary prevention, S-ICD, CRT, LVAD+ICD, post-transplant ICD, CCM, leadless pacing, CSP); modified Delphi 17-member panel; key ratings: NICM primary prevention ICD A(7–9) after ≥3mo GDMT; age ≥85 M(5–6); LVEF ≤35% LBBB QRS ≥150ms CRT A(9); S-ICD primary prevention A(7) (PRAETORIAN/UNTOUCHED); CCM all M(4–5); DANISH caveat re: pre-SGLT2i/ARNI GDMT | implantable-cardioverter-defibrillator, cardiac-resynchronization-therapy, appropriate-use-criteria, heart-failure, arrhythmia | 2026-05-11 |
| sources/takotsubo-nejm-2015 | Templin/Ghadri 2015 NEJM International Takotsubo Registry (n=1750; 26 centres; 9 countries): 89.8% women; physical triggers 36% > emotional 27.7%; 28.5% no trigger; neuropsychiatric comorbidity 55.8%; in-hospital complications 21.8% = ACS; LVEF 40.7%; death 5.6%/yr; MACCE 9.9%/yr; ACEi/ARB improve survival; beta-blockers NO benefit; men: death 12.9% vs women 5.0%/yr | #takotsubo-cardiomyopathy, #heart-failure, #cardiomyopathy, #prognosis, #brain-heart-axis | 2026-05-10 |
| sources/BB-SMARTDECISION-NEJM-2026 | Choi/Kang/Kim 2026 NEJM SMART-DECISION RCT (n=2540; 25 Korean centres; LVEF ≥40%; no HF; ≥1 year BB; median 4.7 yr post-MI; BB discontinuation vs continuation; HR 0.80, 95% CI 0.57–1.13; upper CI 1.13 < NI margin 1.4; P=0.001 for NI): beta-blocker discontinuation noninferior to continuation for composite death/recurrent MI/HF hospitalisation in stable post-MI patients with preserved EF | beta-blockers, myocardial-infarction, secondary-prevention, noninferiority-trial, coronary-artery-disease | 2026-05-16 |
| sources/bb-mi-nejm-2026 | Kristensen/Rossello/Ibanez; Beta-Blocker Trialists' Collaboration 2026 NEJM IPD meta-analysis (n=17,801; 5 RCTs: REBOOT, REDUCE-AMI, BETAMI, DANBLOCK, CAPITAL-RCT; LVEF ≥50%; median 3.6 yr follow-up): beta-blockers vs no beta-blockers; composite death/MI/HF HR 0.97 (95% CI 0.87–1.07; P=0.54); all secondary endpoints null; consistent across all subgroups; I²=20%; definitively no benefit in preserved-EF post-MI without other BB indications | beta-blockers, myocardial-infarction, preserved-ejection-fraction, meta-analysis, coronary-artery-disease | 2026-05-16 |
| sources/lqts-nejm-2025 | Schwartz/Crotti 2025 NEJM narrative review: LQTS genetic basis (KCNQ1 ~50%/KCNH2 ~40%/SCN5A ~10% = 90% of cases), gene-specific triggers and ECG patterns, Schwartz score, exercise stress test as only useful provocation test, epinephrine challenge NOT recommended; therapy cornerstones: propranolol/nadolol (metoprolol NOT recommended), LCSD (90% ICD shock reduction in electrical storms), mexiletine (70% LQT2 responders, acute oral drug test), ICD in ~5% vs ~50% in some US centres; triple therapy with yearly reassessment; acquired LQTS predictors (age <40/QTc >440/arrhythmic events); KCNE1-D85N and SCN5A-S1103Y rare variants; SupRep validated in calmodulinopathy | long-qt-syndrome, channelopathies, sudden-cardiac-death, genotype-specific-therapy, ion-channels | 2026-05-16 |
| sources/potcast-nejm-2025 | Jøns/Bundgaard/POTCAST Study Group 2025 NEJM RCT (n=1,200; ICD patients; baseline K ≤4.3 mmol/L; 3 Danish centres; median 39.6 months; open-label; event-driven superiority): targeting K 4.5–5.0 mmol/L via KCl + MRA + diet + diuretic reduction; primary composite (sustained VT, appropriate ICD therapy, arrhythmia/HF hosp, all-cause death) 22.7% vs 29.2%; HR 0.76 (95% CI 0.61–0.95; P=0.01; NNT=12.3); appropriate ICD therapy/VT HR 0.75; arrhythmia hosp HR 0.63; all-cause death HR 0.85 NS; benefit regardless of whether target K range achieved — mechanism = avoidance of low-normal K; first large RCT of potassium targeting for arrhythmia prevention | ventricular-arrhythmias, potassium, ICD, mineralocorticoid-receptor-antagonist, arrhythmia-prevention | 2026-05-16 |
| sources/pipeline-mi-nejm-2025 | Tonet/Raisi/Campo 2025 NEJM PIpELINe RCT (n=512; median age 80; SPPB 4–9; 7 Italian sites; 12-month multidomain rehab vs usual care post-MI; primary composite CV death/unplanned CV hosp HR 0.57 P=0.01; HF hosp HR 0.20; CV death NS; no serious AEs; compliance 71%) | #myocardial-infarction, #cardiac-rehabilitation, #frailty, #elderly, #secondary-prevention | 2026-05-16 |
| sources/sotatercept-zenith-nejm-2025 | Humbert/McLaughlin/Hoeper 2025 NEJM ZENITH phase 3 DBRCT (n=172; WHO FC III/IV; REVEAL Lite 2 ≥9; max double/triple PAH therapy; sotatercept 0.3→0.7 mg/kg SC Q21d vs placebo); stopped early for efficacy; primary composite HR 0.24 (P<0.001); PAH hosp 9.3% vs 50%; all-cause death HR 0.42 (NS); epistaxis 44%; telangiectasia 26% | #pulmonary-arterial-hypertension, #sotatercept, #activin-signaling, #high-risk-PAH, #clinical-trial | 2026-05-16 |
| sources/sotatercept-hyperion-nejm-2025 | McLaughlin/Hoeper/Humbert 2025 NEJM HYPERION phase 3 DBRCT (n=320; WHO FC II/III; diagnosis <1 year; REVEAL Lite 2 ≥6 or COMPERA 2.0 ≥2; double/triple background therapy ≥90d; stopped early — equipoise loss); primary composite clinical worsening HR 0.24 (P<0.001); NNT=5 at 12mo; exercise testing deterioration dominant (5% vs 29%); death balanced (4.4% vs 3.8%); epistaxis 32%; telangiectasia 26%; serious bleeding 3.8% vs 1.9% | #pulmonary-arterial-hypertension, #sotatercept, #early-diagnosis, #clinical-worsening, #clinical-trial | 2026-05-16 |
| sources/vt-ablation-vanish2-nejm-2025 | Sapp/Tang/Parkash/VANISH2 Study Team 2025 NEJM RCT (n=416; ischemic cardiomyopathy; prior MI; clinically significant VT; all ICD recipients; no prior AAD for VT; 22 centres Canada/USA/France; median 4.3 years): first-line catheter ablation vs antiarrhythmic drug therapy (sotalol or amiodarone); primary composite (death/ICD shock/VT storm/treated VT) HR 0.75 (95% CI 0.58–0.97; P=0.03); mortality HR 0.84 NS; VT storm HR 0.95 NS; treated sub-threshold VT HR 0.26 (P<0.001); drug-arm nonfatal adverse events 21.6% vs ablation 3.4%; ablation 30-day death 1.0%; first large RCT supporting first-line ablation over AADs in ischemic VT | ventricular-tachycardia, catheter-ablation, ischemic-cardiomyopathy, antiarrhythmic-drugs, randomized-controlled-trial | 2026-05-16 |
| sources/genotype-lifespan-nejm-2023 | Jensson/Stefansson/Sulem 2023 NEJM population WGS cohort (n=57,933 Icelanders; deCODE Genetics): 4.0% (1 in 25) carry ≥1 actionable genotype in ACMG SF v3.0 genes; carriers median survival −1 yr; cancer group −3 yr (BRCA2/BRCA1/PALB2 dominant); cardiovascular group neutral overall — but LDLR −6.47 yr and MYBPC3 −2.18 yr individually; KCNQ1/TGFBR2 cause-of-death associated; MYBPC3 cardiomyopathy death OR 14.04 (composite diluted to NS); 10 new ACMG candidate genes (MYL4/PKD1/PKD2/F5-Leiden-hom/F2-hom); BRCA1 VUS reclassified pathogenic via RNA splicing evidence | actionable-genotypes, ACMG-secondary-findings, population-genomics, lifespan, genetics | 2026-05-17 |
| sources/peripartum-cmp-nejm-2024 | Arany Z 2024 NEJM review: PPCM definition (LVEF <45%, last month pregnancy/5 months post-delivery); vasculohormonal model (prolactin 16-kDa fragment + placental sFlt-1 trigger cardiac vascular damage); ~15% carry DCM-predisposing variants (2/3 TTN) — PPCM on shared genetic spectrum with DCM; bromocriptine under investigation in REBIRTH trial (NCT05180773, n=200, expected 2026); 4× higher incidence in Black women, 2× worse outcomes; mortality up to 20%; LVAD/transplant in up to 10%; wearable defibrillator preferred over ICD given frequent recovery | peripartum-cardiomyopathy, cardiomyopathy, heart-failure, pregnancy, genetics | 2026-05-17 |
| sources/acoramidis-attrcm-attributecm-nejm-2024 | Gillmore/Fox/ATTRibute-CM Investigators 2024 NEJM Phase 3 double-blind RCT (n=632; 90.3% ATTRwt; acoramidis 800 mg BID vs placebo; 30 months): 4-step hierarchical (death/CV hosp/NT-proBNP/6MWT) win ratio 1.8 (95% CI 1.4–2.2; P<0.001); CV hosp RR 0.496 (P<0.001); 6MWT +39.6 m; KCCQ-OS +9.94 pts; serum TTR +7.01 mg/dL; 30-month survival 80.7% vs 74.3% (curves diverged at ~19 months; log-rank NS); SAEs 54.6% vs 64.9%; acoramidis mimics T119M protective variant via enthalpic H-bonding; >90% TTR stabilization; second approved TTR stabilizer (Attruby, BridgeBio) | attr-cardiomyopathy, TTR-stabilizer, acoramidis, randomized-controlled-trial, heart-failure | 2026-05-17 |
| sources/colchicine-ami-clear-nejm-2025 | Jolly/d'Entremont/Yusuf 2025 NEJM CLEAR trial (n=7,062; 104 centres; 14 countries; 95.1% STEMI; 2×2 factorial; median 3 years; 649 events): colchicine 0.5 mg/day vs placebo — primary composite (CV death/recurrent MI/stroke/ischemia-driven revasc) HR 0.99 (95% CI 0.85–1.16; P=0.93) — no benefit; CRP confirmed reduced −1.28 mg/L (biological effect proven); diarrhea 10.2% vs 6.6%; no excess serious infections; noncardiovascular death numerically lower with colchicine; null result contradicts COLCOT and LoDoCo2; ESC Class IIa and FDA approval pre-dated these data | colchicine, acute-myocardial-infarction, anti-inflammatory-therapy, secondary-prevention, randomized-controlled-trial | 2026-05-18 |
| sources/copd-hfpef-eschf-2025 | Xu/Gu/Zhu/Feng et al. 2025 ESC Heart Failure systematic review and meta-analysis (11 studies, 3 post-hoc RCTs + 8 observational, n=18,602; PRISMA 2020; literature to April 2023): COPD as independent prognostic risk factor in HFpEF — all-cause hospitalization RR 1.66 (95% CI 1.47–1.87; I²=0%); all-cause mortality RR 1.62 (95% CI 1.34–1.95; I²=75%); post-discharge mortality RR 2.57 (95% CI 1.34–4.93); CV mortality RR 1.59 (I²=0%); SGLT2i dual benefit (HFpEF + COPD exacerbation reduction); ARNI dual mechanism (bronchodilation + cardiac remodelling); heterogeneity source Berry et al. (LVEF>40% definition) | HFpEF, COPD, heart-failure, comorbidities, prognosis | 2026-05-18 |
| sources/lc-amyloidosis-nejm-2024 | Sanchorawala V. 2024 NEJM review: AL amyloidosis — pathogenesis (lambda 75–80%; t(11;14) 50%; IGLV germline tropism); epidemiology (10–12 cases/million/year; 5-yr survival 15%→48%); diagnosis (fat-pad + marrow 85%; mass spectrometry gold standard for AL vs ATTR typing: Sn 88%/Sp 96%); Mayo 2004/2012/European staging; daratumumab-CyBorD first-line (ANDROMEDA: 78% VGPR+); SCT 10–20% eligible (CR 40%, median OS 7.6 yr); venetoclax for t(11;14) relapse; birtamimab and anselamimab antifibril phase 3 trials ongoing | al-amyloidosis, plasma-cell-dyscrasia, cardiac-amyloidosis, daratumumab, amyloid-staging | 2026-05-18 |
| sources/masld-nejm-2025 | Targher/Valenti/Byrne 2025 NEJM review: MASLD (formerly NAFLD) — 38% adult prevalence; 65% in T2DM; DALYs ×2.2 (1990→2021); CVD leading cause of death (×1.5 CV events, ×1.2–1.5 AF and HF risk, ×2.2 T2DM risk); FIB-4 staging (<1.30 low / 1.30–2.67 indeterminate / >2.67 high risk); resmetirom first FDA-approved (March 2024; MAESTRO-NASH: MASH resolution 62.9% vs 34.3%); semaglutide ESSENCE phase 3 superior on both histologic endpoints; tirzepatide SYNERGY-NASH (MASH resolution 56–62%; fibrosis 51–55%); retatrutide triple agonist (−80% liver fat); FGF21 analogues (SYMMETRY: cirrhosis reversal 29% vs 11%); SGLT2i dapagliflozin (fibrosis reduction 45% vs 20%); no head-to-head comparisons; TM6SF2 variant dissociates liver from CV risk | MASLD, metabolic-syndrome, cardiovascular-risk, GLP-1-agonists, resmetirom | 2026-05-18 |
| sources/cancer-rx-cv-acc-2025 | Ganatra/Barac 2025 ACC CCG (JACC 2026;87:654–682): CV toxicity management for BTK inhibitors (ibrutinib AF 3–16%, HTN 71.6% new; diltiazem/amiodarone 6–9× ibrutinib levels; dabigatran contraindicated; Factor Xa preferred), ICI (myocarditis incidence 0.04–1.14%; Salem abatacept+ruxolitinib 3.4% vs 60% mortality; CPK 99% sensitivity rising 20 days pre-clinical; cTnT >32× ULN = 9× MACE risk), and VEGF inhibitors (dual antihypertensives if ≥160/100; BP target <130/80; ACE-I+amlodipine preferred; LMWH for GI/GU VTE; Khorana/COMPASS-CAT for prophylaxis); introduces "permissive cardiovascular toxicity" concept | cardio-oncology, BTK-inhibitors, immune-checkpoint-inhibitors, VEGF-inhibitors, cardiovascular-toxicity | 2026-05-24 |
| sources/weight-mx-acc-2025 | Gilbert/Gulati/Gluckman et al. 2025 ACC CCG (JACC 2025;86(7):536–555): NuSH therapy framework (liraglutide/semaglutide/tirzepatide) for cardiologists; patients should NOT "try and fail" lifestyle before pharmacotherapy; weight thresholds: 10–15% for CVD reduction, >15% for CV mortality/HFpEF; SELECT (semaglutide 2.4mg + CVD + no T2DM, n=17,604): MACE HR 0.80; SUMMIT (tirzepatide HFpEF): HR 0.62 composite; multidisciplinary comorbidity de-escalation table (antihypertensives/diuretics/T2DM meds/CPAP); compounded NuSH discouraged; US annual cost semaglutide $14,080 / tirzepatide $8,126; SURMOUNT-MMO ongoing (2027) | obesity-management, NuSH-therapy, GLP-1-receptor-agonist, cardiovascular-prevention, weight-management | 2026-05-25 |
| sources/pcsk9-inhibitors-nrc-2018 | Sabatine MS. 2018/2019 Nature Reviews Cardiology review: PCSK9 genetics (gain/loss-of-function variants); evolocumab/alirocumab mAb pharmacology; HoFH genotype-specific response; FOURIER (evolocumab n=27,564 HR 0.85 primary/HR 0.80 secondary) and ODYSSEY Outcomes (alirocumab n=18,924 HR 0.85) CVOTs; very-low LDL-C safety down to <10 mg/dL; inclisiran siRNA Phase II (ORION-1 ~50% LDL-C reduction Q6 months); PCSK9 vaccine and CRISPR future directions | #PCSK9-inhibitors, #cardiovascular-outcomes, #LDL-cholesterol, #dyslipidemia, #lipid-lowering-therapy | 2026-05-23 |
| sources/pcsk9-jaha-2022 | Punch/Klein/Diaba-Nuhoho/Morawietz/Garelnabi 2022 JAHA contemporary review: PCSK9 roles beyond LDL-C — atherosclerosis pathophysiology (Ox-LDL, foam cells, myeloperoxidase, HDL oxidation); PCSK9 and TLR4/NF-κB inflammatory signalling (preclinical cell culture + murine ApoE-/- data); PCSK9-resistin CRD structural homology (unique 3-jelly-roll CRD; resistin binds TLR4 + CAP1 via same domain); PCSK9-CAP1 binding confirmed (HEK293); LDL-R-independent hypothesis unconfirmed clinically (evolocumab: no CRP effect in FOURIER; no plaque composition change in one imaging study); AT04A vaccine + alirocumab murine plaque data | #PCSK9-inhibitors, #atherosclerosis, #inflammation, #oxidative-stress, #TLR4-NF-κB | 2026-05-24 |
| sources/immunization-acc-2025 | Heidenreich/Bhatt/Nazir et al. 2025 ACC CCG (JACC 2025;86(21):2085–2098): adult immunizations in CVD — influenza (annual; MACE RR 0.64 in 6 RCTs; IAMI HR 0.72 post-MI; 6× acute MI risk with infection; Class I/A CCD guideline); pneumococcal (PCV20/PCV21 preferred; HTN alone not qualifying; all adults ≥50y or 19–49y with CHD/HF/DM/smoking); COVID-19 (annual 2024-2025 formulation; 3× severe disease risk in CVD; mRNA myocarditis 1–19 cases/million, benign course); RSV (one-time ≥60–75y; ~80% efficacy year 1; protein subunit GBS 7–9/million); zoster (Shingrix 2-dose ≥50y; MI/stroke/HF/arrhythmia benefit lasting 8yr by South Korean study n>1 million); NUDGE-FLU trial: cardiovascular-focused messaging most effective strategy for vaccination uptake | #vaccination, #cardiovascular-prevention, #influenza, #immunization, #preventive-cardiology | 2026-05-25 |
| sources/cardiogenic-shock-acc-2025 | Sinha/Morrow/Kapur et al. 2025 ACC CCG (JACC 2025;85:1618–1641): evaluation and management of CS — SUSPECT CS mnemonic; SCAI A–E staging; Level 1/2/3 CS center tiers; PAC hemodynamic profiling (congestion profiles + PAPi); norepinephrine first-line; DOREMI (dobutamine vs milrinone, neutral); DanGer Shock (microaxial flow pump STEMI-CS, first positive tMCS RCT, 12.7% absolute 180-day mortality reduction); IABP-SHOCK II and ECLS-SHOCK (negative); Recognize/Rescue→Optimize→Stabilize→De-Escalate/Exit framework; tMCS weaning protocol | #cardiogenic-shock, #mechanical-circulatory-support, #heart-failure, #acute-myocardial-infarction, #hemodynamic-monitoring | 2026-05-25 |
| sources/cardiogenic-shock-nejm-2026 | Thiele/Hassager 2026 NEJM review (N Engl J Med 2026;394:62-77; trial PIs): non-AMI CS now outnumbers AMI-CS; mortality by phenotype (mixed 48%>AMI 41%>new HF 31%>secondary 31%>acute-on-chronic HF-CS 25%); 71% AMI-CS patients are frail; only 5% all CS + 32% STEMI-CS meet DanGer Shock eligibility; DanGer Shock HR 0.74 at 180d + sustained 10 years; 4-trial VA-ECMO IPD meta-analysis negative + more complications; Altshock-2 (IABP HF-CS, n=101) negative; CULPRIT-SHOCK (culprit-only PCI preferred; 45.9% vs 55.4%); transseptal LV unloading RCT neutral; MAP 55 vs 65 mmHg trial ongoing; dopamine>arrhythmias vs norepinephrine; levosimendan fails VA-ECMO weaning | #cardiogenic-shock, #mechanical-circulatory-support, #acute-myocardial-infarction, #heart-failure, #revascularization | 2026-05-25 |
| sources/cardiogenic-shock-aha-2017 | van Diepen/Katz et al. 2017 AHA scientific statement (Circulation 2017;136:e232–e268): foundational CS framework — hemodynamic phenotype classification (cold/wet ~2/3; cold/dry 28%; normotensive 5.2%; RV CS 5.3%); CS spiral pathophysiology; hub-and-spoke regionalized care model (≥107 cases/year threshold); phenotype-specific vasoactive guide; SHOCK trial historical context; CRRT (KDIGO Stage 2 threshold; continuous preferred); INTERMACS profile 1-2 38% 30-day MCS mortality; bridge-to-bridge strategy; Impella RP/CentriMag RV support; palliative care framework; predates SCAI staging, DanGer Shock, ECLS-SHOCK | #cardiogenic-shock, #mechanical-circulatory-support, #heart-failure, #systems-of-care, #hemodynamic-monitoring | 2026-05-25 |
| sources/mcs-ehj-2014 | Werdan/Gielen/Hochman 2014 EHJ review (Eur Heart J 2014;35:156–167): post-IABP-SHOCK II reassessment of MCS in CSMI — central thesis: hemodynamic improvement ≠ survival benefit unless MCS initiated before MODS; MODS (APACHE II/SAPS II) + SIRS biomarkers (IL-6, RAGE) > CI for mortality prediction; cardiac power output/index = strongest hemodynamic mortality correlate; 4-category device framework; IABP mechanism/Cochrane HR 1.04/Sjauw PCI-treated 6% increased mortality; EUROSHOCK registry (Impella 2.5; n=120; 64.2% mortality); ISAR-SHOCK (Impella 2.5 vs IABP: better hemodynamics, neutral mortality); 3-trial LVAD meta-analysis (better hemodynamics, RR 1.06 mortality, RR 2.35 bleeding); VA-ECMO: no RCTs, 60% vs 35% single-center; predates DanGer Shock, ECLS-SHOCK | #cardiogenic-shock, #mechanical-circulatory-support, #intra-aortic-balloon-pump, #acute-myocardial-infarction, #hemodynamic-monitoring | 2026-05-25 |
| sources/arrhythmia-monitoring-stroke-acc-2024 | Spooner/Messé/Chaturvedi et al. 2024/2025 ACC ECDP (JACC 2025;85:657–681): three-population post-stroke AF monitoring framework — (1) cardioembolic/already-anticoagulated → monitoring limited; (2) small/large-vessel stroke → 2–4 weeks monitoring, ICM in HF+LA enlargement subgroup (23.4% vs 5.0% AF detection); (3) ESUS/cryptogenic → 2–4 weeks mandatory if OAC candidate, ICM in select cases; OAC threshold: AF ≥5 min + CHA₂DS₂-VASc ≥3 (Class 2b/B); ICM detection 12–16% at 1yr, 30% at 36 months (CRYSTAL-AF); LOOP trial no ITT stroke reduction (HR 0.80; NS); CHASE-LESS and AS5F best post-stroke AF risk scores; consumer devices supplementary only; ESUS anticoagulation trials (NAVIGATE-ESUS/RE-SPECT ESUS/ARCADIA) all negative — AF identification required | atrial-fibrillation, stroke-prevention, cardiac-monitoring, anticoagulation, guidelines | 2026-05-25 |
| sources/co-indicator-anesthanalg-2010 | Reuter/Huang/Edrich/Shernan/Eltzschig 2010 Anesth Analg review (110:799–811): indicator-dilution CO monitoring — Stewart-Hamilton equation; IB-PATD (PAC; 40-year standard; measures RV CO; 22% change threshold for significance; 9 error sources including TR, respiratory cycling, injectate warming, catheter conductive loss); CPATD (Vigilance II/Q2plus; 9–12 min response lag); TCPTD/PiCCO (PAC-free; femoral arterial thermistor; GEDV and EVLW additional variables; GEDV superior to filling pressures as preload estimate; EVLW-guided protocols shorten extubation/ICU stay); LiDCO (lithium dilution; peripheral venous feasible; contraindicated in lithium therapy/pregnancy/weight <40 kg) | #hemodynamic-monitoring, #cardiac-output, #thermodilution, #pulmonary-artery-catheter, #critical-care | 2026-05-27 |
| sources/CRISPR-Cas9-NEJM-2025 | First-in-human trial of CTX310, a lipid-nanoparticle–encapsulated CRISPR-Cas9 drug product designed to make a permanent loss-of-function edit in hepatic ANGPTL3 from a single intravenous infusion.… | #CRISPR-Cas9, #angptl3, #gene-editing, #lipid-lowering-therapy, #familial-hypercholesterolemia | 2026-10-15 |
| sources/TRIC-I-HF-NEJM-2026 | TRIC-I-HF is the first randomized trial to show that transcatheter tricuspid-valve repair improves hard clinical outcomes rather than quality of life alone.… | #tricuspid-regurgitation, #heart-failure, #valvular-heart-disease, #randomized-controlled-trial, #right-heart-failure | 2026-10-15 |
| sources/AIR-STEMI-NEJM-2026 | AIR-STEMI is the first randomized trial to show that guiding complete revascularization in STEMI by functional coronary angiography — angiography-derived FFR,… | #stemi, #multivessel-pci, #complete-revascularization, #angiography-based-physiology, #randomized-controlled-trial | 2026-10-15 |
| sources/Syncope-ASPIRED-NEJM-2026 | ASPIRED asked whether starting 14-day ambulatory ECG monitoring at the index emergency-department visit improves outcomes in patients whose syncope remains unexplained after ED assessment.… | #syncope, #cardiac-monitoring, #randomized-controlled-trial, #electrocardiography, #emergency-medicine | 2026-10-15 |
| sources/CDT-PE-PRAGUE-26-NEJM-2026 | PRAGUE-26 tested conventional catheter-directed thrombolysis against anticoagulation alone in intermediate-high–risk acute pulmonary embolism, as defined by the 2019 ESC guidelines,… | #pulmonary-embolism, #catheter-directed-fibrinolysis, #intermediate-risk, #randomized-controlled-trial, #right-ventricular-failure | 2026-10-15 |
| sources/acute-pe-esc-2019 | This is the fourth ESC guideline on acute pulmonary embolism and the document that established the four-tier risk classification (high / intermediate-high / intermediate-low / low) which has organised… | #pulmonary-embolism, #venous-thromboembolism, #guidelines, #risk-stratification, #anticoagulation | 2026-10-15 |
| sources/single-af-nejm-2026 | SINGLE-AF is the first randomized trial to test directly what guidelines have always answered by extrapolation: whether oral anticoagulation benefits patients with atrial fibrillation at intermediate… | #atrial-fibrillation, #anticoagulation, #stroke-prevention, #risk-stratification, #randomized-controlled-trial | 2026-10-15 |
| sources/padn-hf-ph-nejm-2026 | PADN-HF-PH is the first adequately-powered randomized trial of transcatheter pulmonary-artery denervation in group 2 pulmonary hypertension — PH caused by left heart disease,… | #pulmonary-hypertension, #heart-failure, #pulmonary-artery-denervation, #randomized-controlled-trial, #right-ventricular-failure | 2026-10-15 |
| sources/lipid-staree-nejm-2026 | STAREE answers the question lipid guidelines have never had randomized evidence for: whether to start a statin for primary prevention in adults aged 70 and over.… | #dyslipidemia, #primary-prevention, #ASCVD, #ldl-c, #randomized-controlled-trial | 2026-10-15 |
| sources/co-ccmj-2015 | A principle-by-principle review of every commercially relevant way to measure cardiac output,… | #cardiac-output, #hemodynamic-monitoring, #critical-care, #thermodilution, #fick-principle | 2026-10-16 |
| sources/afburden-aha-2018 | The argument of this statement is in its title: cardiology had been studying atrial fibrillation as a binary — present or absent — and treating it as such,… | #atrial-fibrillation, #stroke-prevention, #subclinical-atrial-fibrillation, #risk-stratification, #cardiac-monitoring | 2026-10-16 |
| sources/lbbap-jacc-2019 | This is the paper that introduced left bundle branch pacing (LBBP) to the wider electrophysiology literature,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-resynchronization-therapy, #His-Purkinje-system, #heart-failure | 2026-10-16 |
| sources/coi-lbbap-hrs-2024 | The conventional way to confirm left bundle branch capture is interruptive: the operator stops screwing the lead, tests pacing output, reads the ECG and electrogram, then advances again.… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #electrogram, #septal-perforation | 2026-10-16 |
| sources/lbbap-9-partition-hrs-2020 | Left bundle branch pacing had no agreed fluoroscopic method — operators had no standard target to aim at,… | #left-bundle-branch-pacing, #conduction-system-pacing, #fluoroscopy, #his-bundle-pacing, #cardiac-pacing | 2026-10-16 |
| sources/impedance-lbbap-jce-2022 | The problem this addresses is procedural: confirming left bundle branch capture normally requires interrupting the implant — stop rotating, test at different outputs, read the pacing characteristics,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #impedance, #electrogram | 2026-10-16 |
| sources/lbb-capture-criteria-hrs-2021 | Every previously proposed ECG criterion for left bundle capture — QRS duration, V6 R-wave peak time — shared a defect the authors name directly: they were arbitrary, never validated,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #electrocardiography, #physiological-pacing | 2026-10-16 |
| sources/lvsp-vs-lbbp-cepc-2022 | This review is organised around a single physiological distinction that the field sometimes blurs: "the difference between LVSP and LBBP is capture of the LBB in LBBP and only myocardial capture in LV… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #conduction-system-pacing, #cardiac-resynchronization-therapy, #physiological-pacing | 2026-10-16 |
| sources/programmed-septal-stim-lbbp-jce-2020 | Deep septal pacing that captures the left bundle branch is almost always accompanied by simultaneous capture of the adjacent septal myocardium, producing a fused,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #electrocardiography, #effective-refractory-period | 2026-10-16 |
| sources/melos-lbbap-ehj-2022 | MELOS is the study that turned left bundle branch area pacing from a collection of single-centre series into a characterised technique,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #heart-failure, #pacemaker-complications | 2026-10-16 |
| sources/ice-guided-plbb-circep-2023 | Every other LBBAP paper in this wiki describes where to place the lead;… | #left-bundle-branch-pacing, #conduction-system-pacing, #intracardiac-echocardiography, #cardiac-pacing, #randomized-controlled-trial | 2026-10-16 |
| sources/stylet-lbbap-jce-2022 | This registry asks whether left bundle branch area pacing (LBBAP) can be performed with ordinary stylet-driven pacing leads (SDL) rather than the specialised lumenless lead (Medtronic SelectSecure 383… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #pacemaker-complications, #physiological-pacing | 2026-10-16 |
| sources/denker-pes-lbbap-jce-2020 | A patient undergoing left bundle branch pacing had an ambiguous result: reducing pacing output produced no change in QRS morphology,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #electrocardiography, #effective-refractory-period | 2026-10-16 |
| sources/denker-hps-refractoriness-circ-1983 | The textbook model of cardiac refractoriness held that the His-Purkinje system and ventricular muscle behave in parallel — both shortening as the basic cycle length shortens.… | #effective-refractory-period, #cardiac-electrophysiology, #his-purkinje-system, #cycle-length, #reentry | 2026-10-16 |
| sources/lbbap-implant-jce-2019 | This is the canonical "how to implant an LBBP lead" reference, written by the Fuwai group that helped originate the transventricular-septal approach.… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #physiological-pacing, #lead-implantation | 2026-10-16 |
| sources/ecg-lbbap-criteria-jaccep-2025 | Identifying left bundle branch capture during LBBAP is the field's persistent bottleneck,… | #left-bundle-branch-pacing, #conduction-system-pacing, #electrocardiography, #cardiac-pacing, #left-ventricular-septal-pacing | 2026-10-16 |
| sources/lbbp-vs-lvsp-criteria-jaccep-2021 | Every other capture-criteria source in this wiki decides whether the left bundle was captured by reading the surface ECG — most often by watching for a QRS transition as output is decremented,… | #left-bundle-branch-pacing, #conduction-system-pacing, #left-ventricular-septal-pacing, #electrocardiography, #cardiac-pacing | 2026-10-16 |
| sources/lbbap-avb-hrs-2019 | This is the Fuwai group's early case series of permanent LBBAP in 33 patients with atrioventricular block — an indication-specific extension of a technique that had until then been reported mainly as… | #left-bundle-branch-pacing, #conduction-system-pacing, #atrioventricular-block, #cardiac-pacing, #physiological-pacing | 2026-10-17 |
| sources/continuous-pacing-lvsp-cjc-2023 | This paper's method is its argument: by pacing continuously and uninterrupted while the lead is being screwed in — using a rotatable connector (the "John Jiang connecting cable") that keeps current fl… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #conduction-system-pacing, #electrocardiography, #cardiac-pacing | 2026-10-17 |
| sources/lbbp-vs-lvsp-criteria-fcm-2022 | Between 60% and 90% of implants labelled "left bundle branch pacing" are confirmed to capture the left bundle at the time of implantation — which means up to one third are actually left ventricular se… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #conduction-system-pacing, #electrocardiography, #cardiac-pacing | 2026-10-17 |
| sources/lumenless-vs-stylet-leads-jcm-2024 | Almost all early left bundle branch area pacing was done with one lead — the Medtronic SelectSecure 3830, a 4.1 Fr lumenless lead with a fixed isodiametric helix — and the field's technique,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #pacing-leads, #pacemaker-complications | 2026-10-17 |
| sources/lbb-anatomy-jacccase-2020 | This paper answers a question the implanting literature usually assumes rather than examines: where, exactly, is the left bundle branch,… | #left-bundle-branch-pacing, #cardiac-anatomy, #conduction-system-pacing, #his-bundle-pacing, #cardiac-pacing | 2026-10-17 |
| sources/v6-v1-interpeak-europace-2022 | Every ECG criterion for left bundle capture had been built on the absolute V6 R-wave peak time, measured from the pacing stimulus.… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #conduction-system-pacing, #electrocardiography, #cardiac-pacing | 2026-10-17 |
| sources/lvsp-vs-lbbp-dyssynchrony-hrs-2021 | Three pacing strategies look similar on the surface ECG but differ in what they do to ventricular depolarisation: nonselective His bundle pacing (nsHBp),… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #conduction-system-pacing, #cardiac-pacing, #electrocardiography | 2026-10-17 |
| sources/ecg-score-lbb-capture-europace-2023 | The two leading ECG criteria for left bundle capture — V6-RWPT and the V6–V1 interpeak interval — had never been tested in an independent population.… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #conduction-system-pacing, #electrocardiography, #cardiac-pacing | 2026-10-17 |
| sources/fixation-beats-hrs-2020 | Deep septal lead implantation has an awkward feedback problem: the operator must advance far enough to reach the left bundle, but not so far as to perforate,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #lead-implantation, #electrocardiography | 2026-10-17 |
| sources/coi-lead-depth-hrs-2022 | When the LBBP lead is screwed into the septum, the trauma produces a current of injury (COI) on the unipolar intracardiac electrogram — ST-segment elevation relative to the intrinsic R wave.… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #pacemaker-complications, #lead-implantation | 2026-10-17 |
| sources/lbb-current-of-injury-jce-2020 | This is the first systematic study of current of injury at the left bundle branch itself.… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #lead-implantation, #pacemaker-complications | 2026-10-17 |
| sources/longterm-lbbap-circep-2021 | This is the largest long-term LBBP cohort published to date, and it is the study the field cites for the claim that LBBP thresholds are low and stable.… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #cardiac-resynchronization-therapy, #pacemaker-complications | 2026-10-17 |
| sources/m-beat-jce-2022 | During rapid lead deployment, mechanical irritation generates premature ventricular complexes (PVCs) whose morphology tracks the helix position;… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #electrocardiography, #lead-implantation | 2026-10-17 |
| sources/septal-perforation-hrs-2022 | Septal perforation is the complication every LBBP operator fears, but its electrophysiological signature had not been characterised.… | #left-bundle-branch-pacing, #conduction-system-pacing, #pacemaker-complications, #cardiac-pacing, #lead-implantation | 2026-10-17 |
| sources/right-bundle-branch-pacing-hrs-2023 | The right bundle branch is an accessible right-sided pacing target, but it had never been formally described: no criteria, no prevalence, no outcomes. This paper supplies all three.… | #right-bundle-branch-pacing, #conduction-system-pacing, #his-bundle-pacing, #cardiac-pacing, #electrocardiography | 2026-10-17 |
| sources/bipolar-lbbp-hrs-2022 | Left bundle branch pacing is programmed bipolar as often as unipolar, yet its capture physiology had been described almost entirely in unipolar terms.… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #electrocardiography, #cardiac-resynchronization-therapy | 2026-10-17 |
| sources/contrast-guided-lbbap-hrs-2021 | LBBP implantation has no reliable entry-site landmark before the lead is deep in the septum: unlike HBP, there is no LBB potential to find from the right side,… | #left-bundle-branch-pacing, #conduction-system-pacing, #cardiac-pacing, #lead-implantation, #fluoroscopy | 2026-10-17 |
| sources/lbbp-vs-rvp-europace-2020 | This is one of the few studies to compare LBBP directly with right ventricular pacing, and it is candid about the result: LBBP produced a much narrower paced QRS (132 vs 178 ms) and stable,… | #left-bundle-branch-pacing, #conduction-system-pacing, #right-ventricular-pacing, #cardiac-pacing, #pacemaker-complications | 2026-10-17 |
| sources/tricuspid-regurgitation-lbbap-hrs-2023 | Tricuspid regurgitation is a known cost of transvenous pacing, but LBBP's specific contribution had been reported only once, at ~11%.… | #left-bundle-branch-pacing, #conduction-system-pacing, #tricuspid-regurgitation, #cardiac-pacing, #pacemaker-complications | 2026-10-17 |
| sources/pacing-induced-cmp-hrs-2014 | Right ventricular pacing produced a ≥10% LVEF fall to <50% in 19.5% of 257 eligible patients over 3.3 years — male sex (HR 2.15) and native QRS ≥115 ms (90% specific) predicted it, and 13% of those pacing only 20–39% were affected.… | #right-ventricular-pacing, #pacing-induced-cardiomyopathy, #heart-failure, #cardiac-pacing, #biventricular-pacing | 2026-10-17 |
| sources/icd-programming-hrs-2019 | 2019 focused update to the 2015 ICD programming consensus: VVI 40 / DDD with pacing-minimisation; delayed detection (30/40 intervals at 188–231 bpm) or high-rate strategy (200–255 bpm); ATP at ~88% VT CL before shocks; SVT limit ~230 bpm; manufacturer-specific settings for Abbott, BIOTRONIK, Boston Scientific, Medtronic, MicroPort and S-ICD.… | #implantable-cardioverter-defibrillator, #ICD-programming, #tachycardia-detection, #antitachycardia-pacing, #defibrillation-testing | 2026-10-17 |
| sources/CompletePCI-Elderly-FIRE-NEJM-2023 | FIRE RCT (n=1,445, ≥75 y): physiology-guided complete revascularization vs culprit-only in MI — death/MI/stroke/ischaemia-driven revascularization 15.7% vs 21.0% (HR 0.73; P=0.01); CV death/MI HR 0.64; all-cause death HR 0.70; safety composite 22.5% vs 20.4% (NS); 50.9% of assessed nonculprit vessels left untreated.… | #myocardial-infarction, #complete-revascularization, #percutaneous-coronary-intervention, #elderly-patients, #coronary-physiology | 2026-10-17 |
| sources/dronedarone-jce-2008 | 2008 pre-approval review of dronedarone: non-iodinated amiodarone analogue (t½ 1–2 days); DAFNE 800 mg/day 55% RRR; EURIDIS/ADONIS 64.1% vs 75.2% recurrence at 12 months; ERATO −11.7 bpm rest / −24.5 bpm exercise; ATHENA 24.2% RRR; ANDROMEDA 8% vs 3.8% mortality in severe HF — predates PALLAS and label restrictions.… | #dronedarone, #atrial-fibrillation, #antiarrhythmic-drugs, #rhythm-control, #heart-failure | 2026-10-17 |
| sources/ffrangio-allrise-nejm-2026 | ALL-RISE RCT (n=1,930): FFRangio (angiography-derived FFR, no wire/adenosine) noninferior to pressure-wire physiology — death/MI/revascularization 6.9% vs 7.1% (HR 0.98; upper 97.5% CI 2.1 pp vs 3.5-pp margin); faster assessment and less fluoroscopy/contrast; more lesions significant (43.0% vs 37.0%) and more PCI (44.3% vs 35.4%).… | #fractional-flow-reserve, #angiography-derived-physiology, #percutaneous-coronary-intervention, #intermediate-coronary-lesions, #noninferiority-trial | 2026-10-17 |
| sources/HCM-NEJM-2025 | Braunwald 2025 review of HCM: ~1 in 500; ~70% obstructive; ≥8 sarcomeric genes (MYBPC3 45%, MYH7 35%); CMR/LGE risk; SCD <0.5%/yr with ICDs; AF in ~25%; myectomy 30-day mortality 0.4%; mavacamten/aficamten; nonobstructive and paediatric disease; gene therapy and AI — omits ODYSSEY-HCM.… | #hypertrophic-cardiomyopathy, #cardiac-myosin-inhibitors, #sudden-cardiac-death, #genetics, #echocardiography | 2026-10-17 |
| sources/semaglutide-stephfpef-dm-nejm-2024 | STEP-HFpEF DM RCT (n=616): semaglutide 2.4 mg in obesity-HFpEF + T2DM — KCCQ-CSS +7.3 points, weight −6.4 pp, 6MWD +14.3 m, win ratio 1.58, CRP ratio 0.67; HF events 7 vs 18 (HR 0.40, not powered); serious AEs 17.7% vs 28.8%; benefit attenuated in SGLT2i users.… | #semaglutide, #GLP-1-receptor-agonist, #heart-failure-preserved-ejection-fraction, #obesity, #type-2-diabetes | 2026-10-17 |
| sources/lvdiastolic-echo-jaccimaging-2020 | Nagueh 2020 review of LV diastolic function: relaxation, recoil and stiffness mapped to e′, E/e′, SR_IVR/SR_E, DT and LA strain; E/e′ <8/>14 thresholds and caveats; 2016 ASE/EACVI four-parameter algorithm; titin isoforms (N2B in HFpEF, N2BA in HFrEF); special populations and prognosis.… | #echocardiography, #diastolic-function, #left-ventricular-filling-pressure, #heart-failure-preserved-ejection-fraction, #doppler | 2026-10-17 |
| sources/lbbap-beginners-guide-hrs-2019 | The Wenzhou group's original "how to do it" guide to permanent LBBP: five signs of LBB capture (paced RBBB, LBB potential 20–30 ms, Stim-LVAT, selective/nonselective EGM, direct His/LBB potential) and a composite rule — criteria 1+2 plus one of the latter three; transseptal sequence from "w" pattern to fulcrum sign; programming rules for CRT ports and anodal capture.… | #left-bundle-branch-pacing, #conduction-system-pacing, #lead-implantation, #cardiac-pacing, #capture-criteria | 2026-10-19 |
| sources/crp-lbbap-jice-2023 | ECG-belt assessment of ventricular electrical heterogeneity in 20 LBBAP patients: optimised LBBAP cut SDAT 47%, LVAT 28%, LV dispersion 61% and RV dispersion 50% but QRS duration only 16%; selective, nonselective, anodal and LV septal capture did not differ; anodal capture shortened QRS yet worsened LVAT and LV dispersion; LVEF 33→46%.… | #left-bundle-branch-area-pacing, #cardiac-resynchronization-therapy, #ventricular-electrical-heterogeneity, #body-surface-mapping, #conduction-system-pacing | 2026-10-19 |
| sources/qrs-area-crt-jcm-2021 | QRS-area-guided LV lead placement in 52 patients/188 pacing sites: lateral (−48 µVs) and anterolateral (−43 µVs) pacing reduced QRS area most and gave the largest %ΔLVdP/dtmax (24%); proximal electrode pair better than distal (−39 vs −17 µVs); ΔQRS duration unchanged by site; within-patient median R 0.76 between ΔQRS area and haemodynamics.… | #cardiac-resynchronization-therapy, #qrs-area, #vectorcardiography, #left-ventricular-lead-placement, #hemodynamics | 2026-10-19 |
| sources/iclas-hfmref-hrs-2025 | I-CLAS HFmrEF (n=1004, 16 centres): CSP vs BVP — composite death/HFH 22% vs 34% (HR 0.64), HFH 13% vs 23% (HR 0.64), mortality NS; LBBB subgroup HR 0.49; paced QRS 129 vs 144 ms; complications and LVEF change similar.… | #cardiac-resynchronization-therapy, #conduction-system-pacing, #heart-failure-mildly-reduced-ejection-fraction, #left-bundle-branch-area-pacing, #heart-failure-hospitalization | 2026-10-19 |
| sources/iclas-lbbap-crt-hrs-2025 | I-CLAS LBBAP vs BVP in LVEF ≤50% (n=2579; PS-matched 1560): composite 22.2% vs 30.8% (HR 0.81), HFH 13.6% vs 21.8% (HR 0.63), mortality NS; LVEF +11.5% vs +8.9%; complications 3.5% vs 6.5%; paced QRS 129 vs 143 ms.… | #cardiac-resynchronization-therapy, #left-bundle-branch-area-pacing, #biventricular-pacing, #heart-failure-hospitalization, #propensity-score-matching | 2026-10-19 |
| sources/lbbap-atp-jaccep-2026 | Canine ischaemia-reperfusion model (n=6, 79 VT episodes): LBBA ATP terminated 70.2% vs 47.3% with RV ATP (RR 1.44), without more acceleration/VF; earlier Purkinje activation (18.8 vs 39.8 ms) and one-beat-earlier crossover point (4.1 vs 5.1).… | #antitachycardia-pacing, #left-bundle-branch-area-pacing, #ventricular-tachycardia, #implantable-cardioverter-defibrillator, #purkinje-system | 2026-10-19 |
| sources/lbbap-crt-jacc-2023 | LBBAP vs BVP in LVEF ≤35% (n=1778, 15 centres): death/HFH 21% vs 28% (adjusted HR 1.495 for BVP), HFH 12% vs 19%, mortality NS; paced QRS 128 vs 144 ms; LVEF +13% vs +10%; echo response 73.9% vs 65.4%; complications 3.8% vs 7.5%.… | #left-bundle-branch-area-pacing, #cardiac-resynchronization-therapy, #biventricular-pacing, #heart-failure-hospitalization, #echocardiographic-response | 2026-10-19 |
| sources/lbbp-lvsp-crt-jaccep-2024 | Prospective registry (n=415): LBBP vs LVSP vs BIVP — freedom from HFH/death 76.6% vs 48.4% vs 43.6%, driven by HFH; LVSP and BIVP similar; LBBP paced QRS 117.5 ms and LVEF +8% vs +1.5% vs +3%; LBBP achieved in 82% of intended cases.… | #left-bundle-branch-pacing, #left-ventricular-septal-pacing, #cardiac-resynchronization-therapy, #biventricular-pacing, #conduction-system-pacing | 2026-10-19 |
| sources/leadr-lbbap-hrs-2025 | LEADR LBBAP: 4.7-F lumenless defibrillation lead in LBBA (n=316 attempts, 95.6% success) — stable thresholds through 12 months; 96.8% freedom from lead-related major complications at 12 months; appropriate therapy 7.9%, inappropriate shocks 2.1%; LOT-CRT subgroup LVEF 29.7→38.1% and QRS 170.6→157.5 ms.… | #left-bundle-branch-area-pacing, #defibrillation-lead, #cardiac-resynchronization-therapy, #implantable-cardioverter-defibrillator, #lead-safety | 2026-10-19 |
| sources/left-bundle-crt-ehj-2026 | LEFT-BUNDLE-CRT RCT (n=176, typical LBBB, 11 Spanish centres): CRT response 94.6% BiVP vs 89.7% LBBAP in ITT (RR 0.95, 95% CI 0.88–1.02) — non-inferiority not met; on-treatment 92.8% vs 91.3% (RR 0.98) met the margin but exploratory; crossovers 20.7% vs 9.8%.… | #left-bundle-branch-area-pacing, #cardiac-resynchronization-therapy, #randomized-controlled-trial, #biventricular-pacing, #non-inferiority | 2026-10-19 |
| sources/lot-crt-circep-2023 | LOT-CRT vs BiV-CRT in IVCD (n=85, 24 months): QRS reduction 42.7 vs 21.9 ms; LVEF 37% vs 30.5% at 2 years; echo response 60% vs 31.6%; composite CV death/HFH 6.7% vs 25.5% (HR 0.33).… | #lot-crt, #intraventricular-conduction-delay, #left-bundle-branch-pacing, #cardiac-resynchronization-therapy, #biventricular-pacing | 2026-10-19 |
| sources/lot-crt-circep-2024 | CSPOT acute haemodynamic study (n=48; 60% IVCD): LOT-CRT gave the greatest QRS shortening (29.5 ms) but LV dP/dtmax similar to BVP (25.8% vs 26.4%), both above LBBAP (19.3%); incremental LOT benefit concentrated in QRS ≥171 ms with deep septal pacing; anodal capture in 54% reduced haemodynamic benefit.… | #lot-crt, #cardiac-resynchronization-therapy, #acute-hemodynamics, #left-bundle-branch-area-pacing, #deep-septal-pacing | 2026-10-19 |
| sources/lot-crt-hrs-2021 | International LOT-CRT feasibility study (n=112, 81% success): QRS 182→144 ms vs BVP 170 ms and LBBAP 162 ms; LVEF 28.5→37.2%; clinical response 76%; LBB capture associated with better echo and clinical response than LV septal capture.… | #lot-crt, #left-bundle-branch-area-pacing, #cardiac-resynchronization-therapy, #qrs-narrowing, #heart-failure | 2026-10-19 |
| sources/lot-crt-hrs-2025 | CSPOT echocardiographic substudy (n=34 vs 34 propensity-matched BVP): LVEF +16.1% vs +6.1%, LVESV −43.5% vs −20.9%; adjusted differences +7.5% and −18.4% remain significant; DOT-CRT outcomes similar to successful LOT-CRT; baseline QRS ≥171 ms predicts greater benefit.… | #lot-crt, #cardiac-resynchronization-therapy, #echocardiographic-response, #non-specific-intraventricular-conduction-delay, #deep-septal-pacing | 2026-10-19 |
| sources/lot-crt-vt-ane-2026 | Case report: 78-year-old woman with pacing-induced cardiomyopathy upgraded to LOT-CRT (QRS 185→132 ms) developed QT prolongation, T-wave inversion and PVC-triggered VF on day 1 without a reversible cause; no recurrence on propranolol over 10 days.… | #conduction-system-pacing, #left-bundle-branch-area-pacing, #ventricular-fibrillation, #proarrhythmia, #case-report | 2026-10-19 |
| sources/lot-europace-2026 | CSPOT AV/VV timing analysis (n=48): a 60 ms deviation from optimal AV delay reduces LV dP/dtmax benefit by ~30%; optimal PAV by dP/dtmax LBBAP 152 / LOT-CRT 171 / BVP 167 ms; PAV ≈ 0.54–0.56 × Ap–LBBs + 4–8 ms; VV = 0 optimal for LOT-CRT and BVP.… | #left-bundle-branch-area-pacing, #lot-crt, #atrioventricular-delay, #interventricular-delay, #cardiac-resynchronization-therapy | 2026-10-19 |
| sources/mri-lbbap-hrs-2025 | MADURAI LBBP (n=225, LB-NICM, LVEF ≤35%): LGE-CMR scar <10% treated without ICD had 6.9% vs 26.1% composite death/HFH/VT-VF; echo response 78.2% vs 15.7%; LVEF normalisation 82.2% vs 25% at 2 years; scar predicted ICD therapy (OR 13.19).… | #left-bundle-branch-pacing, #late-gadolinium-enhancement, #nonischemic-cardiomyopathy, #cardiac-resynchronization-therapy, #risk-stratification | 2026-10-19 |
| sources/scar-csp-jce-2023 | In silico trial on 24 heart meshes: severe LV His-Purkinje slowing attenuates CSP benefit and favours CRT/HOT-CRT/LOT-CRT; slow myocardium favours CSP; septal scar makes CSP ineffective while CRT works; lateral wall scar makes CRT ineffective while CSP works.… | #conduction-system-pacing, #cardiac-resynchronization-therapy, #computational-modeling, #myocardial-scar, #his-purkinje-system | 2026-10-19 |
| sources/his-atp-vt-jce-2023 | Canine ischaemia-reperfusion study (6 dogs, 83 VT episodes, 128 ATP trials): His-bundle ATP vs RV apical ATP — termination 23 vs 25 trials (36% vs 38–39%, NS), VT acceleration 6 vs 14 (p=0.05), degeneration to VF 1 vs 7 (p=0.02); incomplete epicardial capture 25% vs 43% (p=0.05); first test of conduction-system ATP; non-selective His capture at 2× threshold; acute preclinical endpoints only.… | #antitachycardia-pacing, #his-bundle-pacing, #ventricular-tachycardia, #conduction-system-pacing, #purkinje-system | 2026-10-24 |
| sources/vt-dcm-hrs-2018 | Ebert/Zeppenfeld/Hindricks 2019 Heart Rhythm contemporary review: DCM VT risk stratification (TWA/fQRS highest OR but low sens/spec; PVS PPV 29.2%, NPV 86.9%), substrate (patchy midwall/epicardial fibrosis; anteroseptal vs inferolateral patterns with ECG prediction), LGE present 40–50% and midwall LGE predicts SCD at LVEF ≥40%, genetics (LMNA/PLN/SCN5A/DES/FLNC), ICD (DANISH; therapy-reduction programming −30% mortality in meta-analysis), AAD (amiodarone first; avoid flecainide/sotalol in HFrEF), RFCA (acute success 38–73%, 1-year recurrence 46–60%, non-inducibility key endpoint).… | #ventricular-tachycardia, #dilated-cardiomyopathy, #risk-stratification, #catheter-ablation, #nonischemic-cardiomyopathy | 2026-10-24 |
| sources/cpvt-exome-circep-2017 | Landstrom 2017 Circ Arrhythm Electrophysiol: clinical WES referrals (n=6,517) vs ExAC controls (n=60,706) vs CPVT cases (n=155); rare RYR2/CASQ2 variants in 8.8% of WES vs 6.0% controls vs 60.1% robust cases; 97.7% of WES variants VUS; WES variants co-localise with control residues 60.4% vs case residues 7.9% and only 10.5% fall in canonical RyR2 hotspots (cases 80.2%); among 140 variant-positive referrals with low pre-test suspicion, none had clinical CPVT; targeted CPVT panel preferred over WES; signal-to-noise ~10:1.… | #catecholaminergic-polymorphic-ventricular-tachycardia, #genetic-testing, #incidental-variants, #RYR2, #variants-of-uncertain-significance | 2026-10-24 |
| sources/wct-bmj-2021 | Ding & Mahida 2021 Heart Education in Heart: WCT >120 ms differential (VT, SVT with aberrancy, antegrade AP, pacing, artefact); AV dissociation specificity ~100% but sensitivity 22%; morphology, axis, concordance, QRS duration and baseline comparison; likelihood-ratio table; Wellens/Kindwall/Brugada/Vereckei/Pava/LLA/Pachón performance; VT score, WCT formula and Bayesian approaches; independent reproducibility poor and ~1 in 10 WCTs defy differentiation.… | #wide-complex-tachycardia, #ventricular-tachycardia, #supraventricular-tachycardia, #electrocardiography, #ECG-algorithm | 2026-10-24 |
| sources/vt-ablation-nicm-jacc-2016 | Gökoglan 2016 JACC prospective non-randomised NICM scar-VT cohort (n=93; 57 standard vs 36 endo-epicardial homogenisation): acute non-inducibility 69.4% vs 42.1% (p=0.01); VA-free survival 63.9% vs 38.6% at 14 months (p=0.031); adjusted HR 0.48; rehospitalisation 8.3% vs 26.3%; complications 5.6% vs 21%; recurrences linked to septal/midmyocardial or perivalvular scar; operator-selected groups and inconsistent effect-size reporting.… | #ventricular-tachycardia, #catheter-ablation, #nonischemic-cardiomyopathy, #scar-homogenization, #epicardial-ablation | 2026-10-24 |
| sources/pfa-vt-circ-2025 | Reddy 2025 Circulation VCAS first-in-human high-voltage focal PFA for scar-related VT (26 patients, 2 centres): 92% acute success; 93% non-inducible after ablation; 180-day freedom from VT/VF/ICD shock 81.8% (95% CI 67.1–99.8); VT/VF burden −98%; endocardial-only PFA abolished epicardial potentials in 9/9; safety events 11.5%, transient haemolysis, one CRT-D software reset; single-arm, 6-month follow-up.… | #pulsed-field-ablation, #ventricular-tachycardia, #catheter-ablation, #scar-related-vt, #transmural-ablation | 2026-10-24 |
| sources/vt-ablation-jaccep-2019 | Guandalini/Marchlinski 2019 JACC EP state-of-the-art review: historical evolution from surgical subendocardial resection to RF and substrate mapping; activation/entrainment/pace/substrate techniques with circuit-component table; 2019 consensus indications; SMASH-VT, VTACH, CALYPSO, VANISH and SMS trial data; late referral (63%; early referral HR 0.37); unstable VT, core isolation and mechanical support; NICM (HELP-VT 40.5% vs 57.0%); emerging deeper-lesion and alternative-energy technologies.… | #ventricular-tachycardia, #catheter-ablation, #substrate-mapping, #entrainment-mapping, #ablation-technology | 2026-10-24 |
| sources/epicardial-vt-ablation-jaccep-2024 | Raad & Supple 2024 JACC EP state-of-the-art review: epicardial VT ablation patient selection by cardiomyopathy (NICM 32–63%, ARVC, Chagas, Brugada, LQTS, sarcoid, myocarditis); ECG criteria (PdW ≥34 ms, V2 IDT ≥85 ms, SRS ≥121 ms, MDI ≥0.55; Valles 4-step Sn 96/Sp 93); CMR/ICE imaging; subxiphoid Tuohy, needle-in-needle, CO2 insufflation and surgical window; epicardial mapping (unipolar <8.3 mV RV/<5.5 mV LV, fat vs scar, CF 4–9 g); complications (haemopericardium 5–14%, phrenic 0–1%, pericarditis up to 30%, abdominal injury 0–1%).… | #epicardial-ablation, #ventricular-tachycardia, #catheter-ablation, #pericardial-access, #complications | 2026-10-24 |
| sources/pfa-af-ehra-2026 | Kühne et al. 2026 Europace joint EHRA/HRS/APHRS/LAHRS/CHRS scientific statement on PFA for AF: biophysics (membrane electroporation, reversible stunning, thermal interface, 6–8 mm ventricular depth ceiling); harmonised catheter classification (regional >12 mm, large-tip focal 4–12 mm, focal ≤4 mm) and platform tables; dosing; sedation, imaging, EAM, CIED and LAAO interactions; step-by-step workflow; five RCTs (ADVENT, SINGLE SHOT CHAMPION, BEAT PAROX-AF, INSIGHT PFA, SPHERE Per-AF — non-inferiority, superiority only once, shorter procedure times); registries (MANIFEST-PF/17K, EU-PORIA); blanking period; adverse events (no oesophageal fistula in >500,000 procedures, haemolysis/AKI, coronary spasm, 14% silent cerebral events); emerging non-PV applications; training pathway and gaps.… | #pulsed-field-ablation, #atrial-fibrillation, #electroporation, #catheter-ablation, #scientific-statement, #pulmonary-vein-isolation | 2026-10-25 |
| sources/pfa-vt-case-series-jacep-2023 | Lozano-Granero & Hirokami 2023 JACC EP 3-case series of VT ablation with an off-label 31-mm pentaspline PFA catheter at 2.0 kV bipolar: aneurysm VT storm terminating after 5 of 18 applications and a small lateral-wall substrate rendered non-inducible after 9, but 12 endocardial applications in arrhythmogenic cardiomyopathy created dense scar yet rebound VT requiring epicardial RF; 30% and 56% electrogram attenuation; 6.0 ± 1.2 mm depth ceiling in scar; repetition dependence and limited LV manoeuvrability.… | #pulsed-field-ablation, #ventricular-tachycardia, #catheter-ablation, #arrhythmogenic-right-ventricular-cardiomyopathy, #lesion-depth | 2026-10-25 |
| sources/lattice-tip-preclinical-circep-2024 | Nies/Koruth 2024 Circ Arrhythm Electrophysiol swine study (14 animals) of lattice-tip PFA at difficult ventricular targets: papillary lesions 5.8 ± 1.0 mm with intact chordae and no MR at 21 days (3.9 mm with intermittent contact); transmural moderator band ablation; transatrial CO2/saline epicardial access 7/7 on full heparin; epicardial monopolar 30.4 × 23.5 × 9.1 mm with 20% transmurality and spared coronary branches; bipolar two-catheter delivery 14.3 ± 4.7 mm with 87% transmurality but transient complete heart block within 1 cm of the aortic cusp; MRI–necropsy depth correlation r=0.88.… | #pulsed-field-ablation, #ventricular-tachycardia, #preclinical, #papillary-muscle, #bipolar-ablation, #transmural-ablation | 2026-10-25 |
| sources/lattice-tip-vt-europace-2024 | Peichl 2024 Europace prospective 18-patient series of VT ablation with the Sphere-9/Affera dual-energy lattice tip (LVEF 34%, 66% prior failed ablation, 22% electrical storm): 4,500 points and ~18 min mapping per chamber, 12 ± 7 RF and 8 ± 9 PF applications, 89% acute non-inducibility, 78% three-month VA-free survival; coronary spasm in 3 of 4 epicardial patients (tip-to-artery 7 ± 3 mm, resolved with nitrates) but no phrenic palsy; epicardial PF not transmural; myocardial capture during PF; hsTnT 36 → 995 ng/L.… | #pulsed-field-ablation, #ventricular-tachycardia, #catheter-ablation, #lattice-tip, #coronary-vasospasm, #dual-energy-ablation | 2026-10-25 |
| sources/lattice-tip-rf-lesion-jce-2019 | Kitamura/Jaïs 2019 J Cardiovasc Electrophysiol ovine LV lesion study of the Sphere-9 9-mm expandable spherical irrigated RF tip (11 sheep, 20 vs 25 lesions): lesion volume 1,707 ± 771 vs 563 ± 398 mm³ and depth 10.3 ± 2.9 vs 5.5 ± 2.4 mm against a conventional irrigated tip; effective surface area 275 vs 28 mm² allowing 169 W at low current density; surface electrograms abolished in 17/20 (85%); no steam pops vs one; authors proposed that 10-mm lesions could make epicardial ablation "anecdotal", never tested.… | #catheter-ablation, #ventricular-tachycardia, #radiofrequency-ablation, #lesion-depth, #lattice-tip, #preclinical | 2026-10-25 |
| sources/lattice-tip-rf-lesion-circep-2019 | Shapira-Daniels/Anter 2019 Circ Arrhythm Electrophysiol preclinical multimodality biophysics of the temperature-controlled lattice catheter: ex vivo depth 6.7/8.3/10.0 mm at 30/60/120 s vs 4.8/5.4/6.1 mm for a 40 W linear tip, 300–700% greater volume, ~15× current at half the density; bipolar lattice 15.8 ± 4.1 mm with 80% vs 0% transmurality; in vivo 10.5 vs 6.5 mm; +15.1 °C higher intramuscular temperature at 7 mm; steam pops 5.7% vs 18.4%; angle-independent contact footprint; surface thermocouples underestimate subendocardial temperature.… | #catheter-ablation, #ventricular-tachycardia, #radiofrequency-ablation, #lesion-depth, #lattice-tip, #preclinical, #bipolar-ablation | 2026-10-25 |
| sources/avaar-registry-europace-2025 | Sacher 2025 Europace AVAAR registry — all 126 ventricular arrhythmia ablations (VT 99, PVC 23, VF 4) with the AFFERA lattice tip at all 18 European centres: 84% acute success, 72% free of recurrence at 5.6 ± 3.7 months (de novo 80% vs redo 68%), 6% major and 14% minor acute complications (2 strokes, 2 major bleeds, tamponade with coronary laceration, cardiogenic shock, shaft-rupture VF), 6% major events day 1–30 including 3 deaths; coronary spasm, haemolysis without AKI, LVAD electromagnetic interference and false-tendon avulsion; non-randomised, no control.… | #pulsed-field-ablation, #ventricular-tachycardia, #catheter-ablation, #registry, #safety, #lattice-tip | 2026-10-25 |
| sources/Handbook-HA-2024 | Handbook of Internal Medicine, 9th ed (Hospital Authority, Hong Kong; v9.1 June 2026) — Cardiology chapter C1–C41 plus four adjacent topics. CPR/ACLS protocol with arrest drug doses; tachy- and bradyarrhythmia algorithms with cardioversion energies; UA/NSTEMI and STEMI including fibrinolytic weight bands, ST-elevation thresholds by age and sex and reperfusion-failure criteria; acute pulmonary oedema; hypertensive crisis with the 25%-first-hour rule and IV agent doses; aortic dissection (100–120 mmHg, rate before pressure); chronic HF on the AHA 2022 four-category classification; PE; cardiac tamponade; IE prophylaxis regimens with clindamycin withdrawn; perioperative evaluation with DOAC interruption, DAPT timing and CIED advice; DOAC dosing and reversal with local availability; hypertension in old age; orthostatic hypotension; syncope. Reference base 2014–2022, no COR/LOE grading. | #heart-failure, #acute-coronary-syndrome, #arrhythmia, #resuscitation, #aortic-dissection, #cardiac-tamponade, #perioperative, #hospital-authority | 2026-10-25 |
| sources/AD-AHA-2022 | 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease (Circulation 2022;146:e334–e482) — the first US guideline covering the whole aorta. Redefines the thoracic aorta as dilated at 4.0 cm and aneurysmal at 4.5 cm; lowers the sporadic root/ascending repair threshold from 5.5 to 5.0 cm in experienced teams; growth of ≥0.5 cm in 1 year or ≥0.3 cm/year over 2 years as an independent trigger; full AAS section (type A operative strategy, type B TEVAR at 2b for high-risk uncomplicated, IMH and PAU algorithms); pregnancy thresholds and delivery mode; first-degree relative screening. Of 260 recommendations most are Level C, and the 5.0 cm threshold is conditional on an unmeasurable team-quality qualifier | #aortic-disease, #guideline, #thoracic-aortic-aneurysm, #abdominal-aortic-aneurysm, #acute-aortic-syndrome, #bicuspid-aortic-valve, #heritable-thoracic-aortic-disease, #tevar | 2026-10-25 |
| sources/AD-PAD-ESC-2024 | 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases (Eur Heart J 2024;45:3538–3700) — the first ESC guideline to treat peripheral arterial and aortic disease as one entity (PAAD). ABI ≤0.90 diagnostic; PAD managed as a coronary equivalent with LDL-C <1.4 mmol/L, SBP 120–129 mmHg and SGLT2i/GLP-1RA both Class I/A in T2DM; aspirin or clopidogrel alone (I/A) with long-term DAPT, ticagrelor and anticoagulant monotherapy all III, and low-dose rivaroxaban plus aspirin IIa; SET Class I/A and revascularisation IIb in claudication but exercise contraindicated in CLTI with wounds; aortic thresholds 55 mm ascending (I), 52 mm low-risk (IIa), 50 mm BAV root phenotype (I), 60 mm TAAA (I); AAS anti-impulse target SBP <120 and HR ≤60 | #peripheral-artery-disease, #aortic-disease, #guideline, #clti, #thoracic-aortic-aneurysm, #abdominal-aortic-aneurysm, #acute-aortic-syndrome, #bicuspid-aortic-valve | 2026-10-25 |
| sources/AD-JACC-2021 | Vilacosta 2021 JACC state-of-the-art review arguing acute aortic syndrome has four constituents by adding incomplete dissection (intimal tear without false lumen, ~5% of cases) to dissection, intramural haematoma and penetrating ulcer. Proposes an unvalidated three-step diagnostic algorithm — pretest probability, then the alerting triad of aortic pain with normal ECG, normal troponin and raised D-dimer, then CT of the entire aorta — plus a mimic table (thrombosed dissection, aortitis, mural thrombus, ulcer-like projection, intramural blood pool). Argues IMH is dissection with a thrombosed false lumen, that 30–50% of type A patients die before hospital, and that outcomes track to individual surgeon volume; notes fluoroquinolone association with dissection | #acute-aortic-syndrome, #aortic-dissection, #intramural-haematoma, #penetrating-aortic-ulcer, #diagnostic-algorithm, #d-dimer, #aorta-team | 2026-10-25 |
| sources/AD-EHJ-2023 | Rylski, Schilling and Czerny 2023 Eur Heart J review reframing dissection therapy around entry location and propagation rather than the Stanford letter alone. Introduces the TEM classification (type, entry E0–E3, malperfusion M0–M3 with clinical + and radiological −) and the GERAADA operative risk score; argues non-A non-B (7–11% of dissections) is its own category, that TEVAR in arch-entry non-A non-B carries up to 26% retrograde type A conversion and should be avoided in favour of frozen elephant trunk; INSTEAD/ADSORB underpinning IIa TEVAR in uncomplicated type B (91% vs 19% false lumen thrombosis); Endo-Bentall anatomically feasible in two-thirds but never implanted; aggrecan and soluble ST2 as candidate biomarkers | #aortic-dissection, #type-a-dissection, #type-b-dissection, #non-a-non-b, #tem-classification, #frozen-elephant-trunk, #tevar | 2026-10-25 |
| sources/5thMI-AHA-2026 | Fifth Universal Definition of Myocardial Infarction (2026), joint ESC/ACC/AHA/WHF consensus replacing the numerical type 1–5 taxonomy with primary, secondary and procedure-related MI. Non-atherosclerotic coronary pathology (SCAD, embolism, vasospasm) and late stent or graft failure move into primary MI; type 3 is abolished; the 48-hour procedural window becomes 30 days and the 5x/10x URL thresholds are abandoned as diagnostic criteria in favour of an imaging-confirmed complication or new regional wall motion abnormality (5x/35x survive only as 'likely' triggers). Introduces sex-specific 99th percentile URLs as the sole definition of injury, acute and chronic injury boxes, MINOCA redefined as myocardial injury with non-obstructive coronaries (a working diagnosis, MI confirmed in only 22%–27% on CMR), sudden-death and low-resource pathways, and ICD-11 BA41 stem plus sixth-digit codes. No COR/LOE grading anywhere | #myocardial-infarction, #universal-definition, #high-sensitivity-cardiac-troponin, #MINOCA, #ICD-11, #consensus | 2026-10-25 |
| sources/CRP-ESC-2026 | First dedicated ESC guideline on cardiac rehabilitation (Eur Heart J 2026;47:5631–5729), endorsed by ESPRM and WONCA. Redefines CR as an unqualified multimodal multidisciplinary intervention across Phases 0–III and elevates functioning and HRQoL to independent primary outcomes. Thirty recommendation tables across 15+ populations; minimum standard 24 sessions over 12 weeks; ventilatory thresholds preferred over %HRpeak/%HRR/%VO2peak and MET-based classification discouraged; dose–response with no plateau; frailty or comorbidity as a reason to withhold CR is Class III. ACS/CCS I A for CV mortality and MI; HFrEF, HFpEF, LVAD/HTx, post-TAVI aortic stenosis and post-ICD/CRT I B1; AF, PAH and cancer IIa B1. Endorses telerehabilitation and hybrid delivery, yet the HF network meta-analysis found only centre-based CR reduced HF hospitalisation and mortality (~60%). European capacity one place per seven patients in need, automatic referral plus liaison OR 8.41 | #cardiac-rehabilitation, #secondary-prevention, #exercise-training, #telerehabilitation, #guideline, #equity | 2026-10-25 |
| sources/CVD-CKD-ESC-2026 | First dedicated ESC/ERA guideline on cardiovascular disease and chronic kidney disease: CKD as a cardiovascular risk state and CVD as a kidney risk state, organised around STAMP on CKD. Mandates eGFR plus spot uACR screening in every patient with CVD, CGA staging with G5 as kidney failure, and KFRE in G3–G5. Four-pillar cardiorenal stack with trial-derived thresholds (ACEi/ARB I A; SGLT2i eGFR ≥20 I A; finerenone eGFR ≥25 with uACR ≥3 I A; semaglutide I A), ACEi plus ARB III A, and a <30% eGFR dip treated as expected rather than injury. BP target 120–129 at eGFR ≥30 (I A); fire-and-forget statin I A below eGFR 60; routine antiplatelet without ASCVD III B1. HF, ACS, CCS, PAD, stroke, VTE and AF each get CKD-specific rules, including stroke and bleeding scores abandoned below eGFR 30 (III), DOAC over VKA at eGFR ≥30 (I A), never delaying contrast procedures (I C), proactive IV iron in haemodialysis (I B1) and no primary-prevention ICD on dialysis (III C) | #chronic-kidney-disease, #cardiovascular-risk, #esc-guidelines, #sglt2-inhibitors, #finerenone, #albuminuria, #dialysis, #anticoagulation | 2026-10-25 |
| sources/periop-aha-2026 | 2026 reaffirmation of the 2024 AHA/ACC perioperative guideline under the ACC/AHA dynamic-surveillance model — a Surveillance Committee reviewed evidence to March 2026 and found nothing that changed a recommendation; every recommendation, figure, table and reference is identical to 2024, and the 40 tables' 103 recommendations are unchanged. Records the reaffirmation as a distinct citable document with a new DOI, a named Surveillance Committee and a governance shift towards continuous surveillance. Adds no evidence review: the literature search remains August 2022–March 2023, and the text still describes itself as superseding the 2014 guideline. The clinical content is carried by sources/periop-aha-2024 | #perioperative-medicine, #noncardiac-surgery, #guideline-reaffirmation, #MINS | 2026-10-25 |