The safety and efficacy of pulsed field ablation for pulmonary vein and posterior wall isolation in atrial fibrillation ablation are well established; however, evidence regarding its use in extra-pulmonary vein areas remains limited. The aim of this study was to assess the feasibility and durability of pulsed field ablation for coronary sinus (CS) and left atrial appendage (LAA) isolation and mitral isthmus (MI) ablation.

Atrial fibrillation (AF) is a progressive disease involving both structural and functional remodeling. Although over the past decade, digital twin-guided therapy has been proposed and applied, accounting for cardiomyocyte functional remodeling remains challenging. We aimed to investigate the contribution of functional remodeling at the cellular level to AF pathogenesis in patients with fibrotic remodeling and to develop novel techniques to predict the location of reentrant drivers.

Atrial tachyarrhythmia recurrence remains the primary end point of clinical trials evaluating therapeutic pharmacological and nonpharmacological interventions for atrial fibrillation (AF). We sought to examine the relationship between the timing of first atrial tachyarrhythmia recurrence and subsequent AF burden.

Identification of fast ventricular tachycardia (FVT; cycle length <320 ms) isthmuses is often hindered by hemodynamic instability during sustained FVT and by rate-dependent (functional) scar properties. Comparing ultra-high-density voltage heterogeneity maps (0.1-1.5 mV) of the scar area during sinus rhythm (SR) and FVT may delineate the rate-dependent components of the FVT isthmus (FVTI) and improve substrate identification during SR.

Myocardial infarction (MI) is a high-prevalence disease that threatens human survival and quality of life worldwide. Considerable evidence has suggested that periodontitis (PD) is detrimental to MI. However, the direct impact of PD on MI is unclear; which oral pathobionts contribute to and how microbial signals regulate the pathogenesis of MI remain obscure.

In hypertrophic obstructive cardiomyopathy, left ventricular mass index (LVMi) regresses following septal myectomy, but the specific dynamics, mechanisms (involving cellular and extracellular compartments), and related factors remain unclear.

Randomized trials have clearly demonstrated the benefits of anticoagulant therapy in patients with atrial fibrillation who are at high risk of ischemic stroke. However, less is known about the benefit of anticoagulation in low-risk patients, and exactly how low baseline stroke risk justifies further attempts to reduce it with direct oral anticoagulants (DOACs) remains unclear.

The benefits of switching from warfarin to direct oral anticoagulants in atrial fibrillation remain unclear.

Racial differences in the use and outcomes of intravascular imaging (IVI) and invasive physiology (IP) during percutaneous coronary intervention (PCI) are underreported in the United States.

Congenital heart disease (CHD) is the most common heterogeneous birth defect, with prevalence varying across populations. A comprehensive meta-analysis could refine the genetic risk estimates and enhance our understanding of CHD susceptibility.

The purpose of this study was to assess the feasibility and prognostic value of cardiac output (CO) reserve assessment using exercise echocardiography in Fontan patients. We hypothesized that adults with Fontan palliation had lower CO reserve compared with controls, and impaired CO reserve was associated with greater congestion (NT-proBNP [N-terminal pro-B-type natriuretic peptide]) and cardiovascular events (death/transplant/heart failure hospitalization) in Fontan patients.

Bradyarrhythmia is a common and potentially serious cause of syncope, often difficult to detect due to its intermittent nature. Traditional ECG monitoring methods either provide low diagnostic accuracy or delay diagnosis, increasing the risk of recurrence. We hypothesized that a deep learning-enabled, 24-hour, single-lead ECG could detect past episodes of bradyarrhythmia.

Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome characterized by left ventricular diastolic dysfunction, elevated filling pressures, and normal ejection fraction (left ventricular ejection fraction ≥50%) in the absence of an underlying disease process. Its prevalence is increasing, driven by an aging population and rising comorbidities including obesity, diabetes, and hypertension. Given the benefit of emerging HFpEF therapies, such as glucagon-like peptide-1 inhibitors, early and accurate diagnosis is critical to improve outcomes. The diagnosis of HFpEF, however, can be challenging to make, and clinical practice relies heavily on echocardiographic evidence of diastolic dysfunction. There is a need for additional noninvasive diagnostic strategies to facilitate earlier HFpEF diagnosis to improve clinical outcomes. Emerging evidence suggests that cardiac magnetic resonance (CMR) imaging may have clinical value in enhancing HFpEF diagnosis and prognosis. Moreover, CMR tissue characterization by parametric mapping sequences (T1/T2 mapping and extracellular volume quantification) makes CMR a powerful tool for evaluating HFpEF mimickers, specific diseases that cause the clinical syndrome of heart failure in the setting of normal ejection fraction, which may confound HFpEF diagnosis. Finally, novel imaging sequences, such as magnetic resonance spectroscopy, diffusion tensor imaging, and elastography, are being developed to characterize metabolism and hemodynamics in vivo and may provide insight into HFpEF pathophysiology. The diagnostic and prognostic values of CMR-derived indices of diastolic dysfunction and the use of CMR to distinguish between HFpEF and its mimickers, as well as the use of novel CMR sequences in HFpEF, are reviewed herein.

Hypertrophic cardiomyopathy (HCM) is a naturally occurring cardiac disorder afflicting humans, cats, rhesus macaques, pigs, and rarely dogs. The disease is characterized by maladaptive left ventricular wall thickening. Over 1500 sarcomere-coding mutations explain HCM in humans, whereas only 3 have been reported in cat breeds. To date, no mutations have been described in dogs. HCM in a nuclear family of Golden Retrievers was identified following the sudden cardiac death of 3 related puppies <2 years of age from 2 dam-offspring repeat matings.

Surgery is an essential treatment for selected patients with infective endocarditis (IE). Despite indications for surgery, not all patients undergo surgery. Most previous IE cohorts have examined a selected group of patients from primary tertiary centers. Thus, the aims of this study were to describe the use of surgery by indication and to assess mortality in a nationwide cohort of patients with left-sided IE.

Inflammatory, myocarditis-like episodes precede and are associated with higher risk of sustained ventricular arrhythmias and heart failure in patients with pathogenic or likely pathogenic desmoplakin (DSP) variants. Whether the recurrence and treatment of myocarditis-like episodes influence the outcomes in this population is unknown. This study aimed to assess the prognostic impact of the recurrence and treatment of myocarditis-like episodes in patients with pathogenic or likely pathogenic DSP variants.

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have shown beneficial effects in heart failure (HF) management, but data on their use in geriatric populations with high comorbidity remain limited. This observational study aimed to assess the real-world efficacy and safety of SGLT2i in elderly patients with HF.

Sarcopenia is associated with adverse outcomes in patients with end-stage heart failure. Muscle mass can be quantified via manual segmentation of computed tomography images, but this approach is time-consuming and subject to interobserver variability. We sought to determine whether fully automated assessment of radiographic sarcopenia by deep learning would predict heart transplantation outcomes.

The 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America guidelines introduced elevated natriuretic peptide (NP) levels as a criterion for defining stage B heart failure (HF), or pre-HF, to identify individuals at greatest risk for future HF. Given the known NP deficiency in obesity, we aimed to assess whether a single NP cut point would disproportionately up-classify individuals with versus without obesity to stage B HF.

Socioeconomic inequities in access to heart transplantation, including those based on insurance coverage and race or ethnicity, are well documented. During the COVID pandemic, the federal government declared a Public Health Emergency (PHE), which prevented states from disenrolling people from Medicaid. We sought to determine whether this policy was associated with changes in the insurance or racial composition of the heart transplant waiting list.