The assessment and management of patients with type 2 myocardial infarction: an international Delphi study.

Aims: Type 2 myocardial infarction due to myocardial oxygen supply-demand imbalance is associated with poor outcomes. There are no guidelines to inform care for these patients. The consensus on the assessment and management of type 2 myocardial infarction is gained.

Exploring the Relationship between Group 2 Pulmonary Hypertension and Complete Heart Block: A United States Population Based Study.

Background: Existing literature highlights unfavorable outcomes for patients with cardiac conduction disorders and Pulmonary Hypertension (PH). However, limited data exist on complete heart block (CHB) outcomes in the context of group 2 PH.

Aims: To utilize a large national inpatient dataset to evaluate the association between group 2 PH and hospitalization outcomes in patients with CHB.

Physiology assessment in bifurcation percutaneous coronary intervention: Insights from PROGRESS-BIFURCATION registry.

Fractional flow reserve (FFR) and non-hyperemic pressure ratios (NHPR) are established physiologic indices that can help inform the need for percutaneous coronary intervention (PCI), however, their use in patients undergoing bifurcation PCI is uncertain. The PROGRESS-BIFURCATION study is an ongoing multi-center, international registry conducted across six centers. Among 2494 bifurcation lesions treated (2271 patients), only 158 (6.

Clinical, procedural, and follow-up outcomes of percutaneous coronary intervention-related stroke: insight from the PROGRESS-COMPLICATIONS registry.

Background: Stroke is an infrequent but potentially severe complication of percutaneous coronary intervention (PCI).

Methods: The authors describe the clinical features, angiographic characteristics, and procedural and follow-up outcomes of PCI-related stroke in the PROGRESS-COMPLICATIONS registry.

Results: Of 22 503 patients who underwent PCI at 2 tertiary care centers between 2016 and 2023, 157 (0.

Paced electrical alternans with syncope: Time for emergent pericardiocentesis?

Left bundle branch area pacing (LBBAP) is now a common implantation strategy for both pacing and resynchronization based device therapies. While LBBAP has been (somewhat paradoxically) demonstrated to be effective in cases of preexisting left bundle branch (LBB) block, and criteria for LBB capture have been established; minimal focus has been towards the intrinsic refractory rate of the LBB. Herein, we demonstrate a case of LBBAP rate exceeding the refractory period of the LBB, resulting in alternating LBBAP capture and non-selective septal pacing.

Cardiac CT for Aortic Stenosis: Novel Quantitative Techniques for Comprehensive Patient Assessment.

In recent years, the landscape for the diagnosis and management of patients with aortic stenosis (AS) has rapidly changed, with a dramatic increase in therapeutic options and substantial advances in different imaging modalities. Multidetector CT (MDCT) has become an essential imaging tool for evaluating the feasibility of both surgical and interventional treatments for patients with severe AS. Novel MDCT imaging acquisition protocols, postprocessing tools, and technological advances offer not only detailed anatomic information for adequate procedural planning but also comprehensive quantitative evaluation of the myocardium for assessment of remodeling and function, both of which have prognostic and therapeutic implications.

Challenges of using natriuretic peptides to screen for the risk of developing heart failure in patients with diabetes: a report from the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Committee on Clinical Applications of Cardiac Bio-Markers (C-CB).

Background: Several guidelines groups have made recommendations about how to use natriuretic peptides (NPs) to screen patients with diabetes for incipient heart failure. This group is at risk for undetected and stage B heart failure, where structural heart disease is present despite the absence of clinical signs and symptoms. These recommendations are based on trial data that suggest there are therapeutic options to benefit these patients.

Functional Assessment of Intravascular Lithotripsy for Stent Underexpansion.

Background: Stent underexpansion from severe calcification leads to adverse outcomes. While intravascular lithotripsy (IVL) is effective pre-stenting, its role in treating stent underexpansion remains unclear.

Methods: We conducted a multicenter, retrospective study of patients undergoing percutaneous coronary intervention (PCI) with IVL from January 2019 to 2025.

Multiple Versus Single Vessel CTO PCI in the Same Hospitalization: Data From the PROGRESS-CTO Registry.

Percutaneous coronary intervention (PCI) of multiple chronic total occlusions (CTOs) during a single procedure is infrequently performed and remains understudied. We compared the characteristics and outcomes of patients who underwent multiple versus single CTO PCIs during the same procedure. We analyzed data from 16,550 patients (16,876 CTO PCIs) from a large, multicenter registry.

Impact of Advanced Heart Failure Duration on Left Ventricular Functional Improvement After Left Ventricular Assist Device Implantation.

Left ventricular recovery (LV) in patients with advanced heart failure (HF) supported by a durable left ventricular assist device (LVAD) is uncommon but clinically significant. There is limited understanding on the timing of LV recovery in relation to LVAD implantation. A total of 383 HF patients who underwent LVAD implantation were evaluated for LV functional improvement defined as an absolute increase in left ventricular ejection fraction (LVEF) of greater than or equal to 20% post-LVAD placement.

Atrioventricular Conduction Disturbances in Patients Undergoing Transcatheter Tricuspid Valve Intervention: A Multidisciplinary Consensus.

Tricuspid regurgitation (TR) is a highly prevalent valve disease, and cardiac surgery has been used in patients with severe symptomatic TR undergoing surgery for other cardiac lesions or less frequently for isolated TR. More recently, transcatheter therapies, particularly transcatheter edge-to-edge repair and valve replacement, have emerged as therapeutic alternatives in those considered at high to extreme risk for surgery. Because of the anatomical proximity of the tricuspid valve (TV) and the atrioventricular conduction system, the risk for high-degree atrioventricular block and permanent pacemaker implantation remains important, as they are common adverse events after transcatheter valve replacement.

Cardio-Embolic Stroke in a 14-Year-Old Boy Due to SCN5A-Associated Atrial Standstill.

Background: Atrial standstill is a rare pathologic phenomenon characterized by absence of electrical and mechanical activity of one or both atria. SCN5A gene mutations are associated with a myriad of clinical cardiac phenotypes including sinus node dysfunction and atrial standstill.

Case Summary: We present a case of a 14-year-old boy who suffered acute embolic stroke in the setting of SNC5A-associated atrial standstill.

Validation of the V-RESOLVE Score for Side Branch Occlusion in the PROGRESS-BIFURCATION Registry.

Background: We validated the Visual estimation for Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion (V-RESOLVE) score for predicting side branch occlusion (SBO) in an independent registry.

Aims: We sought to evaluate the predictive performance of the V-RESOLVE score.

Methods: We compared the characteristics, V-RESOLVE scores, and outcomes of 791 patients (937 bifurcation PCIs) who underwent provisional bifurcation PCI performed at five centers between 2014 and 2024 from the PROGRESS-BIFURCATION registry.

Acute Kidney Injury Requiring Dialysis Following Percutaneous Coronary Intervention: Insights From the PROGRESS-COMPLICATIONS Registry.

Background: Acute kidney injury (AKI) requiring dialysis is a potentially life-threatening complication of percutaneous coronary intervention (PCI).

Aims: To assess the clinical and procedural characteristics and the outcomes of patients with AKI requiring dialysis after PCI.

Methods: We examined the clinical, procedural characteristics and outcomes of AKI requiring dialysis after PCI from a contemporary PCI complication registry (NCT05100940).

Disproportionate Left Ventricular Enlargement in Mitral Valve Prolapse: Prevalence, Predictors, and Association With Outcomes.

Background: Left ventricular (LV) end-systolic enlargement in severe degenerative mitral-regurgitation (MR) is a class I surgical trigger. Whether it occurs disproportionately to less-than-severe MR due to mitral valve prolapse and is associated with mortality are unknown. We aimed to analyze prevalence and association with survival of disproportionate LV enlargement in less-than-severe MR.

Invasive Versus Conservative Management Among Older Adult Patients With Non-ST-Segment-Elevation Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials.

Background: Older adult patients have been underrepresented in the pivotal trials comparing an invasive versus conservative management for non-ST-segment-elevation myocardial infarction (NSTEMI).

Methods: We performed an electronic search of MEDLINE, Embase, and Cochrane databases through September 2024 for randomized controlled trials comparing invasive versus conservative management of NSTEMI in patients aged ≥70 years.

Results: The final analysis included 7 randomized controlled trials with 2997 patients.

Coronary Computed Tomography Angiography to Guide Percutaneous Coronary Intervention: Expert Opinion from a SCAI/SCCT Roundtable.

Coronary computed tomography angiography (CCTA) has emerged as an important tool for planning percutaneous coronary intervention (PCI). While it has traditionally been employed for diagnostic purposes, increasing evidence and real-world experience suggest that CCTA can be used for the preprocedural planning of PCI and can inform patient triage, shared decision making, case complexity, and resource use. This approach mirrors how computed tomography angiography is routinely used to plan structural interventions.

Clinical Outcomes for Closure of Iatrogenic Atrial Septal Defects Following Transseptal SAPIEN Mitral Valve-in-Valve Procedures.

Background: Iatrogenic atrial septal defects (iASD) are created during transseptal (TS) mitral valve-in-valve (MViV) implantation to facilitate access. Although most iASD remain untreated, the outcomes of closing iASD during TS MViV are unclear. This study evaluates outcomes of concomitant iASD closure during TS MViV.