Volume 12 Issue 9, September 2015

Regulatory approval of high-risk cardiovascular devices is on the basis of clinical studies submitted with a premarket approval application. Failure to publish many of these studies in peer-reviewed literature, and major discrepancies between premarket approval submissions and those studies that are published, raise important questions for clinicians and other stakeholders.

Sudden cardiac death in elderly patients with recent myocardial infarction and reduced left ventricular ejection fraction can be substantially reduced using implantable cardioverter–defibrillators (ICDs) in appropriately selected, high-risk cardiac patients. Increased use of ICD therapy among eligible elderly patients will save lives.

Cardiovascular disease (CVD) remains a leading cause of death worldwide, but age-standardized CVD death rates are decreasing steadily. In this Review, Ezzati and colleagues use the available epidemiological data to examine regional and global changes in CVD mortality, as well as trends in smoking, alcohol consumption, diet, physiological risk factors, and improvements in medical care that might underlie these changes.

Gene therapy for cardiac arrhythmias is now undergoing clinical testing. In this Review, Bongianino and Priori discuss the principles of gene therapy and how this approach can be tailored and targeted to the heart. They then summarize the preclinical and clinical experience of gene therapy applied to acquired and inherited arrhythmias of the atria or ventricles.

Patients with cancer often experience concomitant cardiovascular disease that results from the malignant process itself, or from anticancer treatment. Treatment-induced cardiotoxicity can be either transient or irreversible, and is associated with arrhythmia, ischaemia, and myocardial infarction. The authors discuss the mechanisms by which anticancer treatments damage the heart, and suggest potential strategies on how to protect patients with cancer from anticancer therapy-induced cardiotoxicity.