Volume 11 Issue 5, May 2014

Data from a prospective, European registry of patients undergoing catheter ablation of atrial fibrillation have now been published. The 1-year outcomes of this large, multinational study highlight variation in the concomitant use of antiarrhythmic drugs, and the need for rigorous clinical follow-up after ablation, with extended electrocardiographic monitoring.

The NXT trial supports the value of computational fluid dynamics applied to the digitally reconstructed coronary tree as a noninvasive method of identifying ischaemia-generating stenoses. The results of the study also suggest that old indices of angiographic severity used in clinical practice, such as percent diameter stenosis, might become obsolete.

Myocardial infarction initiates an inflammatory response that is required for repair of, but also contributes to, heart failure. In this Review, Nikolaos Frangogiannis, outlines our current understanding of the inflammatory response in the infarcted heart, and highlights potential therapies that might counterbalance the destructive effects of this immune response.

Robotically assisted techniques have been used in cardiovascular medicine since the late 1990s. The benefits of these approaches include increased procedural speed and accuracy, and reduced surgical trauma and exposure to radiation and contrast agents. However, learning curves and high costs have limited the widespread use of this technology. In this Review, Bonatti and colleagues outline the fields of application of robotic technology in cardiovascular medicine, the systems currently in use, and future directions in the field.

Epidemiological studies of cardiovascular disease generally, and coronary heart disease specifically, have provided the basis for clinical trials that document the efficacy of risk-factor interventions, and are the basis of preventive cardiology. In this Review, Nathan Wong discusses the evolution of CHD epidemiology from the 1940s to the present, and examines the contributions of large population studies to the field.

Asian individuals have a higher risk of stroke associated with atrial fibrillation (AF) than white patients. The use of the vitamin K antagonist warfarin is low in Asian countries, owing to the challenge of controlling anticoagulation and the high-risk of haemorrhage with warfarin in Asians. The non-vitamin K antagonist, oral anticoagulant drugs offer a solution to these challenges. In this article, Sabir et al. discuss the use of these agents in the management of AF in Asian populations.

Adherence to medication is a prerequisite for treatment to be effective, but fewer than half of patients are adherent to long-term therapies for cardiovascular diseases, such as antihypertensive drugs and statins. In this Perspectives article, Tajouri and colleagues propose that multifaceted, individually tailored strategies that harness incentives schemes and modern technology are required to improve both adherence to medication and patient health.