Stereotactic arrhythmia radioablation and its implications for modern cardiac electrophysiology: results of an EHRA survey.

Stereotactic arrhythmia radioablation (STAR) is a treatment option for recurrent ventricular tachycardia/fibrillation (VT/VF) in patients with structural heart disease (SHD). The current and future role of STAR as viewed by cardiologists is unknown. The study aimed to assess the current role, barriers to application, and expected future role of STAR. An online survey consisting of 20 questions on baseline demographics, awareness/access, current use, and the future role of STAR was conducted. A total of 129 international participants completed the survey [mean age 43 ± 11 years, 25 (16.4%) female]. Ninety-one (59.9%) participants were electrophysiologists. Nine participants (7%) were unaware of STAR as a therapeutic option. Sixty-four (49.6%) had access to STAR, while 62 (48.1%) had treated/referred a patient for treatment. Common primary indications for STAR were recurrent VT/VF in SHD (45%), recurrent VT/VF without SHD (7.8%), or premature ventricular contraction (3.9%). Reported main advantages of STAR were efficacy in the treatment of arrhythmias not amenable to conventional treatment (49%) and non-invasive treatment approach with overall low expected acute and short-term procedural risk (23%). Most respondents have foreseen a future clinical role of STAR in the treatment of VT/VF with or without underlying SHD (72% and 75%, respectively), although only a minority expected a first-line indication for it (7% and 5%, respectively). Stereotactic arrhythmia radioablation as a novel treatment option of recurrent VT appears to gain acceptance within the cardiology community. Further trials are critical to further define efficacy, patient populations, as well as the appropriate clinical use for the treatment of VT.

Mind the Gap! Working Toward Gender Equity in Pediatric and Congenital Heart Disease: Present and Future.

Evidence from medicine and other fields has shown that gender diversity results in better decision making and outcomes. The incoming workforce of congenital heart specialists (especially in pediatric cardiology) appears to be more gender balanced, but past studies have shown many inequities. Gender-associated differences in leadership positions, opportunities presented for academic advancement, and recognition for academic contributions to the field persist. In addition, compensation packages remain disparate if evaluated based on gender with equivalent experience and expertise. This review explores these inequities and has suggested individual and institutional changes that could be made to recruit and retain women, monitor the climate of the institution, and identify and eliminate bias in areas like salary and promotions.

El Cardiólogo y la Cardiología del Futuro: visión y propuestas de la Sociedad Española de Cardiología para la cardiología del siglo XXI / Cardiologists and the cardiology of the future. Vision and proposals of the Spanish Society of Cardiology for the cardiology of the 21st Century

«La Cardiología del Futuro» es un proyecto de la Sociedad Española de Cardiología (SEC) que tiene como objetivos definir hacia dónde, desde la posición actual, deben dirigirse las políticas de acción de la SEC, analizar las tendencias y los cambios del entorno que influirán en la práctica de la cardiología en España, definir el perfil de los cardiólogos necesarios en el futuro, proponer las políticas para alcanzar los objetivos que se deriven de las necesidades identificadas, y establecer el papel que ha de desempeñar la SEC en el desarrollo y la implantación de esas políticas. En este artículo se presentan la metodología y los hallazgos más relevantes del informe final de este proyecto y las líneas estratégicas de actuación de la SEC en el futuro inmediato, derivadas del análisis realizado

The Cardiology of the Future is a project of the Spanish Society of Cardiology (SEC) whose objectives are as follows: to define the action policies of the SEC; to analyze the trends and changes in the environment that will influence the practice of cardiology in Spain; to define the profile of the cardiologists needed in the future; to propose policies to achieve the objectives resulting from the identified needs; and to identify the role of the SEC in the development and implementation of these policies. This article describes the methodology and the most relevant findings of the final report of this project and the strategic lines to be developed by the SEC in the immediate future, resulting from the analysis performed

O que o cardiologista precisa saber sobre achados torácicos na tomografia / What cardiologist needs to know about extracardiac findings on tomography

A angiotomografia das artérias coronárias é um método diagnóstico não invasivo que pode ser utilizado para avaliação da doença arterial coronariana em pacientes selecionados e pode fornecer informações quanto às demais estruturas incluídas no campo de visão tomográfico. Por vezes são identificados achados extracardíacos que, em sua maior parte, representam achados incidentais de relevância variável. A adequada detecção, interpretação e comunicação de achados extracardíacos relevantes pode, em última análise, beneficiar pacientes na detecção precoce de doenças das quais não se suspeitava, sem a necessidade de dose adicional de radiação. Revisaremos achados extracardíacos e discutiremos os principais temas deste assunto: nódulos pulmonares; doenças difusas do parênquima pulmonar; alteração das vias aéreas; espaço pleural; aorta; artérias pulmonares; linfonodos; mediastino; fígado; esôfago/estômago; adrenal; mamas; cavidade peritoneal; baço; ossos. Finalmente, a excelência na capacitação, busca, detecção e adequada interpretação dos achados de imagem extracardíacos tem impacto significativo no cuidado com o paciente

Coronary artery angiotomography is a noninvasive diagnostic method that can be used to evaluate coronary artery disease in selected patients, and may provide information on other structures included in the tomographic field of vision. Extracardiac findings are occasionally identified, the majority of which represent incidental findings of varying relevance. Adequate detection, interpretation and reporting of relevant extracardiac findings may ultimately benefit patients through early detection of unsuspected diseases without the need for additional doses of radiation. Extracardiac findings will be reviewed, and main topics of the subject discussed: pulmonary nodules; diffuse pulmonary parenchyma disease; airway disease; pleural space; aorta; pulmonary arteries; lymph nodes; mediastinum; liver; esophagus/stomach; adrenal; breasts; peritoneal cavity; spleen; and bones. Finally, excellence in training, searching, detecting and adequate interpretation of extracardiac imaging findings has a significant impact on patient care