The year in cardiovascular medicine 2020: arrhythmias

Summary of the progress in arrhythmias in 2020. RACE4 and ALL-IN indicated that integrated nurse-led care improves outcomes in AF patients.^{3  ,  4} The same was reported for early rhythm control therapy¹⁵ and cryoablation as initial AF treatment.^{25  ,  26} Subcutaneous ICD was non-inferior to classical transvenous ICD therapy in PRAETORIAN.⁵⁴ One mechanistic study showed that autoantibodies against misexpressed actin, keratin, and connexin-43 proteins create a blood-borne biomarker profile enhancing diagnosis of Brugada syndrome.⁵⁰ Another mechanistic study indicated that transseptal LV pacing yields similar improvement in contractility as His bundle pacing whilst being more easy to execute.⁴⁴ In PRE-DETERMINE a simple-to-use ECG risk score improved risk prediction in patients with ischemic heart disease possibly enhancing appropriate ICD therapy in high risk patients.⁵⁸