ISSN (Print): 1573-403X
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Volume 17, 6 Issues, 2021
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"Current Cardiology Reviews is an important review journal, which is essential reading in order to be kept informed and up-to-date with the latest development in the field."
Univ. of Leuven, Belgium
(University of Leeds - Leeds Institute of Cardiovascular and Metabolic Medicine Leeds, United Kingdom.)
Has contributed: “Assessing Coronary Blood Flow Physiology in the Cardiac Catheterisation Laboratory.”:
6 Abstract Ahead of Print are available electronically
27 Articles Ahead of Print are available electronically
Social media has transformed the face of cardiovascular medicine, as a platform for delivering educational content, building
collaborative research and clinical networks across the globe in real time, advocacy and peer review . Although in 2019 only,
1,111 American College of Cardiology members were found to use twitter , and this number is increasing day by day. Cardiovascular
healthcare professionals across the globe are increasingly utilizing social media for asynchronous learning at any
time or place, whereby interesting cases are discussed, research is disseminated and connections as well as collaborations with
like-minded clinicians and researchers with similar subspecialty expertise are formed. Social Media enables healthcare professionals
to unite their voices in their quest for knowledge and health care related matters by connecting with colleagues across
In 2020 the surface electrocardiogram (ECG) remains one of the most frequently used diagnostic tests in cardiology, surpassed
only by the stethoscope. ECGs are a frequently used diagnostic test during an initial patient presentation and can rapidly
shift the clinical pathway followed. ECGs are used in the diagnosis and management of a diverse set of acute and chronic diseases
and are useful for establishing management and prognosis. Accurate interpretation of ECG tracings is a core competency
in many disciplines within medicine and is essential knowledge for the internist, the emergency medicine practitioner and the
family doctor, to name only a few who interact with ECGs daily. In the setting of a known or suspected conduction disorder,
the ECG is essential to rapidly establish the diagnosis and initiating treatment, which in many cases can be life-saving. When
we were approached by Bentham Publishers to coordinate a special issue on the value of the surface ECG in conduction disorders,
we were thrilled to accept the challenge.
The first challenge was to identify topics within this frame that are of interest, or that create enough controversy or that have
evolved significantly during the last decade; to be part of a special volume. In this sense, we are happy to have collected topics
that deserved an update or a deeper view from an expert eye.
The second task was to compare our list and create a list of world-wide experts that could approach the topic under their
personal view. At the end of this process, we had a list of 9 topics and 9 groups of individuals from different parts of the world
ready to take on this challenge. These authors worked extremely hard to develop the manuscripts that are contained within this
The first paper is on Lyme carditis, led by Cynthia Yeung, an early-career researcher from Canada . Lyme carditis is a
new and rapidly evolving area of research and is an area that may be unfamiliar to many physicians . The second paper, “The
Wenckebach Phenomenon”, belongs to Professor Martin Green and colleagues . Professor Green has a special interest in the
Wenckebach Phenomenon and his expert knowledge of the subject is clearly demonstrated in this review [4, 5]. The third paper,
on the epsilon wave, belongs to Dr. Pyotr Platonov, current Annual Chair of the International Society for Computerized
Electrocardiology (ISCE), and Dr. Anneli Svensson from Sweden . In this paper, the epsilon wave as an extreme form of
depolarization delay is a presented and the history, mechanisms and implications of the epsilon wave is reviewed. The next
paper, reviewing Right Bundle Branch Blocks was taken on by Professor Takanori Ikeda from Japan . The third paper, reviewing
the Fascicular Blocks is authored by Dr. Marcelo Elizari from Argentina, a direct disciple of Mauricio Rosenbaum,
who was a leading figure in the original identification and publication of the hemiblocks [8, 9]. Dr. Elizari, current president of
the Argentine Academy of Medicine and former President of the Argentine Cardiology Society (SAC), reviews the process
behind their discovery and the pathophysiology of hemiblocks in this excellent paper. The next section, on conduction disease
in the setting of an acute ST-elevation myocardial infarction is lead by Dr. Kjell Nikus from Finland [10, 11]. Dr. Nikus is considered
a leader in the interpretation of the ECG in ischemic conditions. In this paper Dr. Nikus reviews the various conduction
abnormalities that occur in the setting on an acute ST-elevation myocardial infarction. The next paper, on vectorcardiography
and the main dromotropic disturbances was completed by Dr. Andres Perez-Riera from Brazil and colleagues . He has a
special interest in vectorcardiography and its uses which is apparent in this paper. The next section, on asymptomatic bradycardia,
is lead by Dr. Goksel Çinier from Turkey on behalf of the International Society of Electrocardiology Young Community
(ISE-YC) . The ISE-YC is an initiative established in 2019 that is dedicated to building a global network for young trainees,
physicians, and other healthcare professionals who are interested in the field of electrocardiology . This excellent paper
reviews the current evidence on the pathophysiology, diagnosis, evaluation and management of patients with asymptomatic
bradyarrhythmias. The final section is written by our group at Queen’s University in Kingston, Ontario, Canada and reviews
atrial conduction abnormalities . A recently published ECG risk score using only electrocardiographic P-wave analysis for
the prediction of patients at risk for atrial fibrillation is presented .
We greatly enjoyed working on this special edition of Current Cardiology Reviews. It was a major editorial effort which
involved several members of Bentham Science as well as our collaborators. Our special thanks go to the Editor-in-Chief of
Current Cardiology Reviews, Dr. Antonio Crisafulli, who took the time to personally review every paper in this edition as well
as the staff of Bentham Science.
Medicine continues to rapidly evolve, and the field of cardiology is notable for having one of the highest rates of innovation
and scientific progress in the area of diagnosis and imaging. Despite this, the 12-lead surface ECG remains an invaluable tool
in the diagnosis and management of conduction disorders, even in the era of advanced imaging techniques.
We would like to dedicate this volume to all of our colleagues as well as up and coming trainees in the field of cardiovascular
It is well established that diabetes mellitus is actually a multisystem disease responsible for a great burden of morbidity and
mortality globally since it causes several cardiovascular complications; macro as well as micro-vascular . This attitude is
mainly attributed to the fact that these patients show a high risk for the development of atherosclerotic lesions for various
causes such as hyperglycaemia, dyslipidemia and insulin resistance, resulting in impaired platelet function, endothelial, vascular
smooth muscle cell dysfunction and abnormal coagulation . Therefore it is easily assumed that individualized treatment
strategy is needed and for that cause stratification of cardiovascular risk among these patients has become a necessity. As a result,
several models have been developed over the last decades which highlighted specific risk factors for developing cardiovascular
disease including age more than 40 years, male gender, history of relative suffering from premature CHD, blood pressure
and high LDL levels, presence of microalbuminuria or obstructive sleep apnea .
Aging is a growing medical concern. Despite more people living longer, the economical impact is likely to be severe, and
pressures on healthcare providers are constantly growing to treat aging-related conditions and disorders. It is estimated, that in
the US, life expectancy will go from ~76 years of age in 2010 to 80 years in 2030 , a pattern that is similar to a host of industrialised
countries. Indeed, in the United Kingdom, recent analysis has shown that male life expectancy has increased from 69
years in 1970 to 78 years in 2010, and female life expectancy from 75 years to 82 years in the same time period . As a result,
incidence of aging-related diseases such as Cardiovascular Disease (CVD), dementia, and cancer is likely to increase substantially
. It is no surprise, therefore, that research into medical advancements and lifestyle behaviours and the impact of these
on aging populations has gathered a lot of interest in the academic community, as seen by the Physiological Society announcing
a year of ‘Understanding Ageing’ in 2015. This has led to the growth of research in aging, and also specifically cardiovascular
Lifestyle choices can have significant influence on how our cardiovascular system ages. We see individuals who are fitter
and regularly exercise, live longer than unfit/sedentary individuals [4, 5], which could be due to changes in our cardiovascular
system. Such favourable changes in our cardiovascular system with simple modifications in our lifestyle thus offers a significant
promise in helping to counteract the impact of aging on our bodies. This small collection of reviews, encompasses the effects
of diet, exercise and physical activity on the ‘aging cardiovascular system’, and provides some novel insights into the
mechanisms by which these affect our vascular and cardiac tissues.
The first review  puts forward the argument that resistance exercise could affect vascular aging via modulation of arterial
stiffness and Matrix Metalloproteinases (MMP). Older individuals display elevated levels of arterial stiffness (as measured by
pulse wave technology) compared to younger individuals , with recent evidence supporting the view that exercise can reduce
arterial stiffness in humans . Dr. Knox demonstrates some data to suggest that arterial remodelling with exercise may be a
result of altered MMP regulation, but more work is needed to observe this link in humans.
The second review  discusses the role of aging on the body’s endogenous endothelial repair capacity, via the reduction
and dysfunction of endothelial progenitor cells, and how exercise and dietary behaviour modulate both the number and function
of these cells. The effects vary from improving bone marrow niche environment and pro-apoptotic stimuli to promoting our
own stem/progenitor cell repair mechanisms on our ageing vasculature.
The subsequent review by Beaumont et al.  uses masters athlete’s as a model of lifelong exercisers, and the differences
in cardiac structure and function between master’s athlete’s and inactive older people. We observe that masters athletes display
better diastolic function than sedentary age-matched controls, which appears to be maintained into the 8th decade of life. Interestingly,
the review does not demonstrate much evidence on differences in systolic function, and a much debated measure of
systolic function, ejection fraction, does not appear to be different between sedentary controls and masters athletes, being suggestive
that lifelong exercise does not improve cardiac health via modulations in ejection fraction.
The final review in our collection, by Peace et al. , provides an insight into carotid and coronary arterial function, with
subsequent focus on the role of advancing age on both, and the potential for exercise to act as a countermeasure for the agingassociated
deleterious effects. They also purport that, since coronary artery function is difficult and incredibly invasive to
measure and quantify, that we can use carotid artery function as a surrogate, as it appears to show similar structural and functional
changes with disease conditions, offering clinicians and researchers a non-invasive global measure of arterial function
that could be used to determine risk of myocardial infarction, stroke, and other atherosclerotic-mediated events.
Together, these reviews provide evidence for the importance of lifestyle modifications and behaviour change to treat ageassociated
cardiovascular problems, which could subsequently have significant effects on healthcare burden and quality of life
of patients. However, translation of such work into practice is often poor at best, and thus strategies must be put into place by
governing bodies, healthcare providers, and clinicians to encompass such lifestyle strategies to treat disease.
In this issue of Current Cardiology Reviews, a mini-thematic review of the important role of Interventional Cardiology and
the cardiac cath lab in the management of cardiac arrest has been presented. Cardiac arrest is becoming an ever important topic
for multiple reasons. Science is expanding regarding cardiac arrest, which includes the understanding of the processes involved,
the appropriate use of new techniques and innovative devices in the management of these patients. The role of Interventional
Cardiologists in the management of these patients is also expanding. Thus this mini-thematic review summarizes how
Interventional Cardiologists and the Catheterization laboratory can have a major impact in improving the care of these patients,
ultimately increasing the survival of those suffering cardiac arrest.
In this review, Rao P and Kern KB have outlined ways in which communities can improve their local outcomes from out of hospital
cardiac arrest . Articles by Reddy S, Lee K, Kumar K and Lotun K have outlined the management of cardiac arrest
patients with both ST elevation and Non ST elevation myocardial infarction [2, 3]. No review on cardiac arrest patients is complete
without addressing post resuscitation care with targeted temperature control and addressing arrhythmias. Taimoor H and
Shetty R have reviewed the current guidelines of targeted temperature management . Prakash G and Hutchinson M have
addressed the management of arrhythmias and defibrillator implantation in the survivors of cardiac arrest . There is ample
positive data regarding immediate cardiac catheterization of cardiac arrest patients with ST Elevation myocardial infarction.
The Pearl Trial is underway to define the optimal management of cardiac arrest patients with non ST elevation myocardial.
Yadav K and Truong T have reviewed the important considerations for patients who have cardiac arrest while undergoing cardiac
procedures in the catheterization laboratory. Sundaram and Lotun have addressed the issue of refractory out of hospital
cardiac arrest especially the use of mechanical CPR devices and Extracorporeal Cardiopulmonary Resuscitation (ECPR) .
They have summarized a potential new approach for these patients, by mechanical support and performing coronary intervention
This mini-thematic review provides a comprehensive overview of the perspective of Interventional Cardiologists in the
management of cardiac arrest patient’s along with the post resuscitation management.