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We present the case of a young male presenting with a wide complex tachycardia. The diagnostic approach based on the electrocardiogram findings is discussed. The final diagnosis could be made following an adenosine challenge at baseline, underlying the use of this drug for diagnostic purposes even in the absence of ongoing tachycardia.
Bempedoic acid is a fairly small molecule acting as a prodrug which is converted into the active compound bempedoyl-CoA in the liver. This active metabolite of bempedoic acid inhibits the enzyme ATP citrate lyase leading to low-density lipoprotein (LDL) reduction.
The CLEAR (Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen) Harmony trial showed that bempedoic acid reduced LDL cholesterol (LDL-C) by 12.6–16.5% and the CLEAR Tranquility and Serenity showed a reduction of LDL-C in statin-intolerant patients by a mean of 21% in monotherapy and 38% in combination with ezetimibe.
Despite an extensive body of literature, there are still many gaps in the evidence surrounding the lifetime management of aortic stenosis (AS) and upstream interventions to prevent or slow down the progression of the disease are yet to be developed.
His bundle pacing is the most physiological form of pacing as it replicates the patient’s natural ventricular activation. Its adoption has significantly grown over the last years. However, the technique has several limitations, including suboptimal thresholds. Left bundle branch area pacing has been introduced more recently and has gained much interest as it also delivers physiological pacing but with more favorable electrical parameters. However, there are also several unresolved issues with this technique. This article compares these strategies and highlights their advantages and disadvantages to provide guidance on which technique to select for a specific patient.
