Hypertrophic cardiomyopathy (HCM) is a genetically heterogeneous disorder primarily linked to rare variants in sarcomere genes, though recently certain non-sarcomeric genes have emerged as important contributors. Non-Mendelian genetic variants with reproducible moderate effect sizes and low penetrance-intermediate-effect variants (IEVs)-, can play a crucial role in modulating disease expression. Understanding the clinical impact of IEVs is crucial to unravel HCM's complex genetic architecture.

Minimalist treatment strategies for transcatheter aortic valve implantation (TAVI) have been widely adopted due to continued procedural evolution, but large randomized trials are lacking. The DOUBLE-CHOICE trial evaluated safety and efficacy of a minimalist approach (MA) compared with standard of care (SoC) for transfemoral TAVI.

Whereas antiphospholipid syndrome (APS) is best known for increasing the risk of macrovascular thrombosis, APS vasculopathy is characterized by the abnormal proliferation of endothelial and smooth muscle cells, leading to occlusion of small blood vessels in the skin, kidneys, and heart, among other organs. The underlying mechanisms remain unclear, and targeted treatment options for patients with APS are lacking.

Risk assessment plays a central role in the primary prevention of cardiovascular disease. The 2017 High Blood Pressure Clinical Practice Guideline incorporated quantitative risk assessment for the first time to guide the initiation of antihypertensive drug therapy and recommended calculation of 10-year risk of atherosclerotic cardiovascular disease with the Pooled Cohort Equations. Although the 2025 High Blood Pressure Guideline reaffirmed this overarching paradigm for risk-based initiation of antihypertensive drug therapy, it updated the recommended risk model to the Predicting Risk of Cardiovascular Disease Events equations, which estimate 10-year risk of total cardiovascular disease (including atherosclerotic cardiovascular disease and heart failure), and defined a new risk threshold for initiation of antihypertensive therapy in patients with stage 1 hypertension. This American Heart Association/American College of Cardiology scientific statement summarizes the rationale to recommend the use of the Predicting Risk of Cardiovascular Disease Events equations, the evidence base for the new threshold of 10-year risk of cardiovascular disease of ≥7.5%, and the population-level implications of these revised recommendations. This scientific statement also offers practical advice for implementing risk assessment as the first step in the comprehensive approach to hypertension management with shared decision-making between patients and clinicians. Remaining gaps in awareness and treatment of hypertension underscore the need for innovative strategies to improve implementation of and adherence to risk-based guideline recommendations, including automation of risk assessment in electronic health records, decision-support aids, and refinement of risk assessment, to equitably improve the initiation of antihypertensive drug therapy, blood pressure control, and outcomes.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmia, with pathogenic variants in the RYR2 gene responsible for 60% of clinically well-defined CPVT cases. Diagnosis of CPVT often occurs after a major cardiac event, posing a severe threat to the patient's life. A data set of patients with CPVT would improve the diagnosis and treatment of patients with CPVT.

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.