Cardiac Amyloidosis: New Treatments Hold Promise for Early Intervention
A 2024 Australia–New Zealand Expert Consensus Statement on Cardiac Amyloidosis (CA) is now published in Heart, Lung and Circulation. CA is a multi-system condition in which amyloid proteins deposit in multiple organs, including the heart, where this infiltration can lead to symptoms of heart failure, conduction block, and arrhythmias. Endorsed by CSANZ, and co-authored by Bart, Fatkin, Thomas, and others, the Statement outlines recent advances in non-invasive diagnosis, and targeted, disease modifying therapies, including gene editing techniques. The Statement advocates for early referral to a specialist amyloidosis centre for advanced testing and therapy, and active enrolment into clinical trials.

Robotic-Assisted PCI: Initial Australian Clinical Experience
As part of the run-in phase for an upcoming randomised clinical trial, Sydney-based researchers have reported their early experience with robotic-assisted percutaneous coronary intervention (R-PCI). All procedures—in 21 patients with a total of 24 lesions—were performed with the CorPath GRX second-generation robot; and, in most cases, were safe and effective, with manual conversion required in four cases. Robotic assistance is designed to allow “millimetre”, and thus more accurate, manipulation via the operator touchscreen; however, some manual inputs at the patient bedside are still necessary, such as when achieving vascular access and performing diagnostic angiography. Among their findings, the researchers observed a short learning curve; with increasing operator and assistant experience, there was less radiation exposure.

Before Cardiac Catheterisation: To Fast or Not To Fast?
Although cardiac catheterisation is recognised as the current gold standard test for diagnosing and managing carotid artery disease what is less established is whether fasting is necessary before the procedure. A single-centre prospective cohort study conducted at the Auckland City Hospital, New Zealand (and during the COVID-19 pandemic, no less), has determined that the local policy of no longer fasting patients before the procedure was well-regarded and preferred by the surveyed patients themselves, and seemed safe. The study authors said larger, multicentre studies would be warranted to support an international policy change from fasting to not fasting before cardiac catheterisation.

Compiled by Dr Ann Gregory, Commissioning Editor, Heart, Lung and Circulation.