The past year in heart rhythm: atrial fibrillation ablation, anticoagulation, LAA closure, ventricular arrhythmias and devices, each summarised in the MedShorts 360 format with its date and source.
CardiologySix pivotal RCTs show primary-prevention ICDs reduce sudden cardiac death and cardiovascular mortality in nonischaemic HFrEF.
CardiologyEight trials with 7,434 patients show LAAC lowers non-procedural major bleeding but raises ischaemic stroke compared with oral anticoagulation.
CardiologyPooling SURVIVE-VT, VANISH-2 and MANTRA-VT, ablation reduced appropriate ICD shocks by 24% vs antiarrhythmic drugs.
CardiologyPooling 6,515 participants, tirzepatide showed no significant link with AF; overall arrhythmia odds were higher but events were rare.
CardiologyAn 8-month low-calorie diet cut weight by 9.7% vs 3.1%, but AF symptoms, burden and remodelling did not change.
CardiologyIn 75,536 matched CKD patients, GLP-1 RA users developed AF less often (6.9% vs 12.4%) and had fewer heart failure and kidney events.
CardiologyIn 210 patients with paroxysmal AF, freedom from recurrence was 63% with PFA vs 49% with cryoballoon.
CardiologyAcross 17 studies, higher rates of pulmonary vein isolation were associated with lower progression.
CardiologyEight RCTs with 1,333 patients show early ablation reduced recurrence, shocks, hospitalisation and death combined (HR 0.66).
CardiologyThirteen studies with 1,983 patients show PVI plus posterior wall isolation offers no benefit over PVI alone and lengthens procedures.
CardiologyIn 965 patients, omitting testing guided by the PRAETORIAN score did not increase failed first shocks.
CardiologyFirst-line PFA gave 56% treatment success at 12 months vs 30% with antiarrhythmic drugs.
CardiologySingle-procedure success at 12 months was 77.2% with PFA and 77.6% with optimised radiofrequency ablation, with fewer serious complications after PFA.
CardiologyAdding liraglutide to risk factor modification for 3 months before ablation raised 1-year freedom from AF to 81% vs 54%.
CardiologyIn 3,000 AF patients, device closure was non-inferior to NOACs for cardiovascular death, stroke or embolism, with bleeding 10.9% vs 19.0% at 3 years.
CardiologySix studies found similar stroke rates with continued vs stopped OAC, and numerically more bleeding when continued.
CardiologyIn 912 older patients at high stroke and bleeding risk, LAA closure was not non-inferior to physician-directed medical therapy.
CardiologyAn integrated, personalised lifestyle intervention cut the primary endpoint rate by 51% in the year after ablation.
CardiologyCoffee drinkers randomised to keep drinking coffee had 39% lower risk of AF or flutter recurrence than those told to abstain.
CardiologyAcross 20 studies and 4,638 patients, PFA lowered recurrence (OR 0.68) and shortened procedures.
CardiologySix months of smartwatch monitoring detected new AF in 9.6% vs 2.3% with standard care.
CardiologyAfter rhythm control normalised ejection fraction, 90% maintained LVEF ≥50% six months after withdrawing HF therapy.
CardiologyAcross 271,808 patients, OAC discontinuation did not raise thromboembolism overall and reduced major bleeding by 65%.
CardiologyAcross 27 studies, AI-based ECG analysis reached AUCs of 0.93–0.99 for sudden cardiac death prediction.
CardiologyAcross 24 RCTs with 40,694 participants, GLP-1 RAs and co-agonists reduced incident AF (RR 0.82).