It has been almost seven decades since the initial development of the first implantable cardiac pacemakers in the late 1950’s, with immense and rapid technological development subsequently leading to dramatic changes in the design and use of cardiac implantable electronic devices (CIED’s) around the globe. The last two decades in particular have seen the introduction of ... Continue Reading

Atrial fibrillation, defined as a supraventricular arrhythmia with uncoordinated activation and ineffective contraction, is the most common arrhythmia in the United States, and it continues to increase in incidence and prevalence. Two potential sequelae of atrial fibrillation are risk of stroke and significant symptoms that lower quality of life. So, in general, goals of ... Continue Reading

Ventricular tachycardia (VT) remains a leading cause of morbidity and mortality in patients with structural heart disease. Implantable cardioverter-defibrillators (ICDs) reduce sudden cardiac death but do not prevent recurrent VT, which leads to hospitalizations and impaired quality of life. Catheter ablation has emerged as a central strategy in VT management, with multiple ... Continue Reading

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide, driving stroke, heart failure, cognitive decline, and premature death, while profoundly affecting quality of life.¹ Catheter ablation is now a cornerstone for rhythm control, often outperforming antiarrhythmic drugs in selected patients.² Yet in real-world practice, ablation and pharmacologic therapy ... Continue Reading

Atrial fibrillation (AF) and heart failure (HF) are intertwined at so many levels, and each is both a major cause of and result of the other. This interplay is complex and incorporates many pathological mechanisms, but needless to say, the patient presenting with both AF and HF is an important cohort worth a more detailed review. One of the key issues is trying to sort out ... Continue Reading

A healthy young woman suddenly feels her heart pounding in her chest during a stressful work meeting. She becomes lightheaded, her smartwatch shows a heart rate of 190 beats per minute, and by the time she reaches urgent care, the episode has stopped. She has had similar infrequent events before, but now they seem to be occurring more often. For many patients this is their ... Continue Reading

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide and confers roughly a fivefold increase in ischemic stroke risk.1 In non-valvular AF (NVAF), thrombus arises predominantly in the left atrial appendage (LAA), which accounts for the vast majority of cardioembolic sources. “Valvular AF” is a specific term: it refers to AF in the setting of moderate–severe ... Continue Reading

Modern day cardiology care is a multidisciplinary subspecialty, encompassing the heart’s pump function, its blood supply via the coronary arteries, valvular integrity, and the electrical system. The field of cardiology is constantly evolving and is a true collaborative endeavor. Cardiac electrophysiology (EP) is the discipline dedicated to identifying and treating disorders of ... Continue Reading

Atrial fibrillation (AF) was described in animals in the 17th century by William Harvey and then confirmed as an electrocardiographic diagnosis by William Einthoven in 1906. Symptoms of AF are both somewhat generic and highly variable. These can include palpitations, fatigue, dyspnea, chest discomfort, lightheadedness and anxiety. At other times, patients don't have any ... Continue Reading

Dysautonomia is a condition where the autonomic nervous system is dysfunctional. In other words, automatic mechanisms are not working properly — think blood pressure, heart rate, body temperature, digestion of food, etc. Postural orthostatic tachycardia syndrome (POTS) is one type of dysautonomia.1 POTS can be triggered by multiple conditions, including hormonal changes, ... Continue Reading

An 82-year-old grandmother falls and cannot move her legs. A 33-year-old computer programmer with no medical problems suddenly develops severe back pain. A 24-year-old daycare worker suddenly cannot breathe. These are all patients with very different clinical scenarios but have one explanation. They are affected by acute thoracic aortic syndrome. In most cases, this syndrome ... Continue Reading

Hypertrophic cardiomyopathy is a genetic disorder characterized by the thickening of the left ventricle in the absence of a secondary cause. Once thought to be a rare disease, it’s now estimated that hypertrophic cardiomyopathy occurs in 1 out of every 200 individuals.   Since the underlying genetic cause of this disease was first discovered in the 1990s, there have ... Continue Reading

Considerations for return-to-play On March 11, 2020, just prior to the tip-off for the Utah Jazz versus Oklahoma City Thunder game, the National Basketball Association season was abruptly halted in dramatic fashion after it was disclosed one player had tested positive for SARS-CoV-2. In subsequent and rapid fashion, other iconic American sporting events were canceled and ... Continue Reading

In the 1960s and 1970s, Grady Memorial Hospital was the major teaching hospital of Emory University’s medical school, such that most of the students and medical residents (and subsequently subspecialty residents and/or fellows) were based at Grady. With Dr. Willis J. Hurst as both Chairman of Medicine and Chief of Cardiology, a great deal of attention was focused on the ... Continue Reading