14^th World Heart Congress

Heart arrhythmia refers to an irregular heartbeat, occurring when the electrical impulses that control heartbeats function improperly. This can cause the heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly. While some arrhythmias are harmless, others can lead to serious complications such as stroke, heart failure, or sudden cardiac arrest. There are various types of arrhythmias, including atrial fibrillation (AFib), which causes rapid and uncoordinated heartbeats in the atria, and ventricular tachycardia, which can be life-threatening if not treated promptly. Causes of arrhythmias include heart disease, high blood pressure, electrolyte imbalances, excessive caffeine or alcohol intake, stress, smoking, and certain medications. Some people may have a genetic predisposition to arrhythmias. Symptoms vary depending on the type and severity of the arrhythmia. Common signs include palpitations, dizziness, shortness of breath, chest pain, fainting, and fatigue. Diagnosis involves tests such as electrocardiograms (ECG), Holter monitoring, and echocardiograms. Treatment options depend on the cause and severity and may include lifestyle modifications, medications, pacemakers, catheter ablation, or implantable cardioverter-defibrillators (ICDs). Regular heart check-ups and managing risk factors can help prevent and control arrhythmias, ensuring better heart health.

Personalized medicine in cardiovascular treatment tailors medical care to an individual’s genetic profile, lifestyle, and specific health conditions. Unlike the traditional "one-size-fits-all" approach, personalized medicine considers genetic variations, biomarkers, and environmental factors to optimize prevention, diagnosis, and treatment strategies for heart diseases. Advancements in genetics and molecular biology have led to targeted therapies for conditions like hypertension, heart failure, and arrhythmias. For example, genetic testing can identify patients who may respond better to certain blood pressure medications or anticoagulants, such as warfarin, minimizing adverse effects. Additionally, biomarkers help detect cardiovascular diseases early, allowing for proactive interventions. Pharmacogenomics, a key aspect of personalized medicine, analyzes how an individual’s genes affect their response to medications. This enables doctors to prescribe the most effective drugs with the right dosage, reducing the risk of complications. For patients with high cholesterol, PCSK9 inhibitors offer a tailored alternative to statins for those who don’t respond well to traditional treatments. Advances in artificial intelligence and wearable technology also contribute to personalized cardiovascular care by providing real-time monitoring and predictive analytics. As research continues, personalized medicine promises more precise, efficient, and effective treatments, ultimately improving patient outcomes and reducing cardiovascular disease burdens.

Pediatric cardiology is a specialized branch of medicine focused on diagnosing and treating heart conditions in infants, children, and adolescents. It covers a wide range of congenital (present at birth) and acquired heart diseases, including congenital heart defects, arrhythmias, cardiomyopathies, and rheumatic heart disease. Early detection and intervention are crucial to improving outcomes and ensuring normal growth and development. Congenital heart defects (CHDs) are among the most common birth defects, affecting nearly 1% of newborns. Conditions like atrial septal defects, ventricular septal defects, and tetralogy of Fallot require careful monitoring and, in some cases, surgical intervention. Advances in fetal echocardiography allow for early diagnosis, sometimes even before birth, enabling prompt treatment after delivery. Pediatric cardiologists use various diagnostic tools, including echocardiograms, electrocardiograms (ECGs), and cardiac MRIs, to assess heart function. Treatment options range from medications and catheter-based interventions to open-heart surgery. For severe cases, heart transplantation may be necessary. Recent innovations, such as minimally invasive procedures and 3D-printed heart models for surgical planning, have improved survival rates and quality of life for children with heart conditions. With continuous advancements, pediatric cardiology plays a vital role in ensuring a healthier future for children with heart disease.

Cardiac pharmacology and therapeutics focus on the study and application of medications used to treat cardiovascular diseases, including hypertension, heart failure, arrhythmias, and coronary artery disease. These medications help regulate heart function, improve circulation, and reduce the risk of complications such as heart attacks and strokes. There are several major classes of cardiovascular drugs. Antihypertensives, such as beta-blockers, ACE inhibitors, and calcium channel blockers, help control blood pressure. Antiarrhythmic drugs, including amiodarone and lidocaine, manage irregular heart rhythms. Anticoagulants and antiplatelet agents, like warfarin and aspirin, prevent blood clots and reduce the risk of stroke and heart attacks. Statins lower cholesterol levels to prevent atherosclerosis, while diuretics help reduce fluid retention in heart failure patients. Pharmacogenomics plays an increasing role in cardiac therapeutics by tailoring drug selection and dosage based on an individual’s genetic makeup. This approach minimizes adverse effects and enhances treatment efficacy. Additionally, emerging biologics and targeted therapies, such as PCSK9 inhibitors for cholesterol management, provide new options for patients who do not respond to traditional medications. As cardiovascular diseases remain a leading cause of mortality, advancements in cardiac pharmacology continue to improve patient outcomes through safer, more effective, and personalized treatments.

Minimally invasive cardiac procedures have revolutionized heart disease treatment by offering safer alternatives to traditional open-heart surgery. These techniques use small incisions, catheters, and advanced imaging to diagnose and treat cardiovascular conditions with reduced recovery time, lower risks, and minimal scarring. One of the most common procedures is percutaneous coronary intervention (PCI), also known as angioplasty, where a catheter is inserted into a blocked artery to restore blood flow, often with the placement of a stent. Transcatheter aortic valve replacement (TAVR) is another groundbreaking procedure used to treat aortic stenosis, allowing valve replacement without open surgery. MitraClip is a minimally invasive solution for mitral valve regurgitation, improving heart function without major surgery. Electrophysiology procedures, such as catheter ablation, treat arrhythmias by targeting and eliminating abnormal electrical pathways in the heart. Implantable devices like pacemakers and defibrillators can also be placed using minimally invasive techniques. These advancements have significantly improved patient outcomes, reducing hospital stays and recovery periods. As technology advances, robotic-assisted surgeries and new catheter-based interventions continue to refine minimally invasive cardiac care, making it an increasingly preferred option for patients with heart disease.

Regenerative medicine and stem cell therapy offer promising solutions for treating heart disease by repairing damaged heart tissue and restoring function. Unlike traditional treatments that manage symptoms, these approaches aim to regenerate heart muscle and improve overall cardiac health. Stem cell therapy involves using stem cells—typically derived from bone marrow, umbilical cord blood, or induced pluripotent stem cells (iPSCs)—to repair injured heart tissue. When introduced into the heart, these cells can stimulate tissue regeneration, reduce inflammation, and promote new blood vessel growth (angiogenesis). Research has shown potential benefits for conditions such as heart failure, myocardial infarction (heart attack), and cardiomyopathies. Another innovative approach in regenerative medicine is tissue engineering, where bioengineered cardiac patches and 3D-printed heart tissues help replace damaged areas. Gene therapy is also being explored to enhance the heart’s ability to repair itself by activating specific regenerative pathways. While clinical trials have demonstrated promising results, challenges such as cell survival, immune response, and integration into heart tissue remain. However, with ongoing research and technological advancements, regenerative medicine and stem cell therapy have the potential to transform cardiovascular treatment, offering hope for patients with severe or irreversible heart disease.

Wearable technology and remote monitoring have transformed cardiovascular healthcare by enabling continuous heart monitoring, early disease detection, and personalized treatment adjustments. These devices help patients and doctors track heart health in real time, improving outcomes and reducing hospital visits. Popular wearable devices include smartwatches with ECG (electrocardiogram) capabilities, such as the Apple Watch and Fitbit, which detect irregular heart rhythms like atrial fibrillation (AFib). Chest patches and wearable ECG monitors provide more detailed heart activity tracking, while smart rings and blood pressure monitors measure vital signs like heart rate variability and oxygen levels. Remote monitoring devices, such as implantable loop recorders and wireless pacemakers, allow cardiologists to continuously track heart function without requiring frequent clinic visits. For heart failure patients, remote pulmonary artery pressure monitors help detect fluid buildup, preventing hospitalizations. Artificial intelligence (AI) enhances wearable technology by analyzing large amounts of heart data, predicting risks, and offering personalized health insights. These innovations empower patients to take control of their heart health while providing doctors with real-time data for better decision-making. As wearable and remote monitoring technologies advance, they will continue to play a crucial role in preventing and managing cardiovascular diseases efficiently.

Obesity is a major risk factor for cardiovascular disease (CVD), significantly increasing the likelihood of conditions such as hypertension, heart disease, stroke, and heart failure. Excess body fat, particularly visceral fat around the abdomen, contributes to metabolic and inflammatory changes that negatively affect heart health. Obesity is closely linked to hypertension due to increased blood volume and resistance in the arteries. It also raises cholesterol levels, leading to atherosclerosis (narrowing of the arteries) and increasing the risk of heart attacks and strokes. Additionally, obesity is a primary driver of type 2 diabetes, which further elevates cardiovascular risk by damaging blood vessels and impairing circulation. Other obesity-related heart risks include sleep apnea, which can cause irregular heart rhythms (arrhythmias) and high blood pressure, and chronic inflammation, which weakens blood vessels over time. Lifestyle modifications, such as adopting a healthy diet, engaging in regular physical activity, and maintaining a healthy weight, are crucial for reducing cardiovascular risk. In some cases, medical treatments like weight-loss medications or bariatric surgery may be necessary. Managing obesity effectively can significantly lower the risk of heart disease and improve overall cardiovascular health, leading to a longer and healthier life.

The gut-heart connection highlights the crucial role of gut health in cardiovascular disease (CVD) risk. Emerging research suggests that the gut microbiome—trillions of bacteria and other microorganisms in the digestive tract—affects heart health through metabolism, inflammation, and immune function. One key factor in this connection is gut-derived metabolites. For example, certain gut bacteria break down dietary nutrients like choline and carnitine (found in red meat and eggs) into trimethylamine N-oxide (TMAO), a compound linked to increased arterial plaque formation and a higher risk of heart disease. Conversely, beneficial gut bacteria help produce short-chain fatty acids (SCFAs) from fiber, which reduce inflammation, improve blood vessel function, and lower blood pressure. Dysbiosis, an imbalance in the gut microbiome, has been associated with obesity, diabetes, and hypertension, all of which contribute to CVD. Factors such as poor diet, antibiotic overuse, and chronic stress can disrupt gut health, leading to systemic inflammation that damages the heart and blood vessels. Maintaining a healthy gut through a fiber-rich diet, probiotics, and fermented foods may support heart health. As research continues, targeting the gut microbiome could become a novel approach for preventing and managing cardiovascular diseases.

A heart transplant is a life-saving procedure for patients with end-stage heart failure, but it comes with potential complications that require careful management. These complications can be immediate, short-term, or long-term and may impact the success of the transplant. One of the most serious risks is organ rejection, where the immune system attacks the new heart. To prevent this, patients take lifelong immunosuppressive medications, but these drugs increase susceptibility to infections by weakening the immune response. Graft failure, where the transplanted heart does not function properly, can occur early (primary graft dysfunction) or later due to chronic rejection. Other complications include coronary allograft vasculopathy (CAV), a condition where the coronary arteries narrow over time, leading to heart failure or sudden cardiac arrest. Kidney damage is another concern, as immunosuppressants can harm kidney function. Patients may also experience high blood pressure, diabetes, and weight gain due to medication side effects. Psychological challenges, such as anxiety and depression, can affect transplant recipients as they adjust to lifelong medical care. Regular monitoring, adherence to medications, and a healthy lifestyle are essential to minimizing complications and ensuring the long-term success of a heart transplant.

Heart disease in women is a leading cause of death, yet it remains underdiagnosed and often presents with different symptoms than in men. While chest pain is a common warning sign for both sexes, women may also experience atypical symptoms such as shortness of breath, nausea, fatigue, dizziness, and back or jaw pain, which can lead to delayed diagnosis and treatment. Several unique risk factors increase heart disease risk in women. Hormonal changes, particularly after menopause, reduce protective estrogen levels, leading to higher blood pressure, cholesterol, and arterial plaque buildup. Pregnancy-related conditions, such as gestational diabetes and preeclampsia, also raise the long-term risk of cardiovascular disease. Autoimmune disorders, which are more common in women, have been linked to heart complications as well. Women often develop microvascular disease, affecting small arteries rather than major coronary arteries, making detection more challenging. Psychosocial factors, such as high stress, anxiety, and depression, also contribute to cardiovascular risk. Prevention includes adopting a heart-healthy lifestyle, managing blood pressure and cholesterol, and undergoing regular screenings. Increased awareness, research, and gender-specific approaches to diagnosis and treatment are essential for improving heart health outcomes in women.

Artificial intelligence (AI) and machine learning (ML) in cardiology are transforming heart disease diagnosis, treatment, and prevention by enhancing data analysis, improving accuracy, and personalizing patient care. These technologies analyze vast amounts of medical data, including electrocardiograms (ECGs), imaging scans, and electronic health records, to detect patterns that may be overlooked by human clinicians. AI-powered algorithms have significantly improved early diagnosis of heart conditions. For example, AI can analyze ECGs to detect arrhythmias like atrial fibrillation or predict the risk of sudden cardiac arrest. In cardiac imaging, ML enhances echocardiograms, CT scans, and MRIs, allowing for more precise identification of structural abnormalities and coronary artery disease. AI also plays a role in predictive analytics, helping to assess a patient’s likelihood of developing heart disease based on genetic, lifestyle, and clinical data. Additionally, robot-assisted surgeries use AI to enhance precision in minimally invasive heart procedures. Wearable technology integrated with AI enables real-time heart monitoring, providing early warnings for conditions like high blood pressure and heart failure. As AI continues to evolve, it holds great potential for improving patient outcomes, reducing healthcare costs, and personalizing treatments, making cardiology more efficient and proactive.

Artificial hearts and mechanical circulatory support (MCS) devices play a crucial role in treating patients with end-stage heart failure who are awaiting a heart transplant or are ineligible for one. These advanced technologies help maintain blood circulation and improve survival rates in critically ill patients. A total artificial heart (TAH) is a device that completely replaces the heart, taking over both pumping functions of the ventricles. It is used for patients with severe biventricular failure who cannot survive with traditional therapies. Modern TAHs, such as the SynCardia Total Artificial Heart, provide a temporary or long-term solution for patients waiting for a transplant. More commonly, ventricular assist devices (VADs) support the failing heart by assisting either the left ventricle (LVAD), right ventricle (RVAD), or both (BiVAD). LVADs, such as the HeartMate 3, help pump blood from the left ventricle to the aorta, relieving strain on the heart. These devices can be a bridge to transplant (BTT) or a destination therapy (DT) for patients who are not eligible for transplantation. Although artificial hearts and VADs improve survival and quality of life, complications like blood clots, infections, and device malfunctions require careful monitoring. Advances in technology continue to enhance their safety and effectiveness, offering new hope for heart failure patients.

Cardiac rehabilitation (CR) is a medically supervised program designed to improve heart health and recovery after heart attacks, heart surgery, or heart failure. It combines exercise training, education, and lifestyle counseling to help patients regain strength, reduce cardiovascular risk, and improve overall well-being. Traditional CR programs focus on structured exercise, dietary guidance, smoking cessation, stress management, and medication adherence. Patients work with cardiologists, physiotherapists, dietitians, and mental health professionals to create personalized recovery plans. Studies show that CR significantly lowers the risk of future heart events and hospitalizations. Recent patient care innovations have expanded access and effectiveness. Telehealth and virtual cardiac rehab programs allow patients to participate from home, using wearable devices to monitor heart rate, blood pressure, and physical activity remotely. AI-driven coaching platforms provide real-time feedback and motivation. Other innovations include personalized rehabilitation plans based on genetic and biomarker analysis, helping tailor treatments for better results. Additionally, community-based and mobile CR units improve access for underserved populations. By integrating technology, behavioral science, and personalized medicine, modern cardiac rehabilitation enhances patient engagement and long-term adherence, leading to better recovery, reduced readmissions, and improved quality of life for heart patients.