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The quest for a practical total artificial heart (TAH) stems from the large number of patients with advanced heart failure, and the limited number of donor hearts available for transplantation. In this Perspectives article, Cohn et al. give their expert insight into the development of TAHs over the past 50 years. They describe the evolution from positive-displacement, pulsatile pumps to continuous-flow devices, and give their opinion on the most promising avenues for future innovation.
Randomized clinical trials are the gold-standard clinical trial design, because they can control for confounding factors. However, they also limited by large financial costs and rigid selection criteria. A possible solution to these limitations is the registry-based randomized clinical trial (RRCT). In this Perspectives article, James et al. discuss the features of RRCTs, and how this trial design can be used to conduct studies efficiently and cost-effectively.
Preparicipation screening for cardiovascular disease in young competitive athletes is a controversial topic. Moreover, young people not engaged in competitive sports can harbour the same conditions that cause sudden death in athletes. In this Perspectives article, Maron et al. question whether arbitrarily excluding individuals from potentially life-saving clinical screening because they do not engage in competitive sports programmes is ethical.
