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.
Atrial fibrillation (AF) has become the most common arrhythmia worldwide and its incidence is increasing. Treatment strategies for symptomatic patients include stroke prevention, management of cardiovascular comorbidities, and direct treatment of AF itself. With regard to interventional AF treatment, a novel technique called pulsed field ablation has emerged. Large registry data in more than 15,000 patients have demonstrated a high efficacy in reducing the burden of AF with a very high safety. This review provides an overview of the technical aspects of pulsed field ablation and the published clinical data.
Thrombosis remains a significant clinical challenge with potential life-threatening consequences. Despite advancements in anticoagulants, concerns about bleeding and the delicate balance of thrombotic risks persist, especially in patients with specific comorbidities such as renal insufficiency, cirrhosis, and those with medical devices. The search for effective anticoagulant therapies that can prevent thrombotic events while minimizing bleeding risks, has led to the emergence of factor XI (FXI) inhibition as a promising approach.
HFpEF is rapidly increasing in incidence and prevalence, accounting for approximately 50% of all new cases of heart failure. It has a significant impact on patients’ quality of life and is associated with a high risk of hospitalization and death. The diagnosis of HFpEF is challenging, and many patients with HFpEF are likely to be unrecognized or misdiagnosed. So far, HFpEF management relies on patient education and treatment of comorbidities. However, the use of SGLT-2 inhibitors has recently demonstrated a significant reduction in the composite outcome of heart failure hospitalizations and cardiovascular mortality in HFpEF, and is now considered as the first-line therapy.
Digitalization of the healthcare sector is changing its landscape. Artificial intelligence is bound to have a major impact on care providers and their interactions with their patients. As promising as new technologies may be, there will be side effects. New technologies will place new and higher demands on its users and will require an extremely high level of expertise to check plausibility. Alongside increases in efficiency and effectiveness, the demands on the humans in healthcare will also rise.
