News & Comment

In ST-segment elevation myocardial infarction, the role of interventional modification of thrombi in the coronary arteries before stenting is controversial. However, innovations in stroke intervention have sparked renewed interest in thrombus modification approaches. We discuss current and emerging techniques to extract or disperse thrombi, aiming to reduce downstream embolization, microvascular obstruction and myocardial injury.

Atrial fibrillation is the most common sustained arrhythmia and imposes a substantial burden on patients and health-care providers. Clinical evidence suggests that antiarrhythmic therapy to restore and maintain sinus rhythm (rhythm control) can reduce adverse cardiovascular outcomes in patients with new-onset atrial fibrillation. As a result, a paradigm shift towards rhythm control over rate control therapy is emerging, increasing the clinical need for effective and safe antiarrhythmic drugs.

A molecular autopsy is undertaken in cases of sudden cardiac death with no definitive cause found after conventional autopsy, with the aim of identifying a pathological genetic variant that could account for the death. Greater awareness of malignant arrhythmias in the absence of structural changes in inherited cardiomyopathies has increased the applicability of molecular autopsies, and resulted in improved care of families but new challenges for clinicians.

Heart valve replacement in newborn babies remains an unsolved problem because currently used heart valve implants do not grow. This lack of implant growth mandates serial re-operations until adult-size valve implants can be fitted. Partial heart transplantation is a new approach to solve this problem by transplanting only the part of the heart that contains the necessary valve.