
Understanding Painful Left Bundle Branch Block Syndrome: Where Does the Evidence Lead Us?
Author Sub-editor: Dr Hnin Zaw Dr Hnin Zaw is a cardiology registrar from the East of England Deanery with a specialist interest in electrophysiology and
• 2025 European Society of Cardiology (ESC ) guidelines include a new Class IIa recommendation for considering intervention in asymptomatic patients with severe aortic stenosis, if the procedural risk is low.
• This recommendation is based on four trials comparing early intervention to conservative management in this patient group.
• Positive outcomes in these trials were driven mainly by a reduction in unplanned hospitalisations rather than mortality. A meta-analysis also demonstrated a reduction in stroke in the early intervention group.
• The studies were heterogenous and included several design limitations that have been explored in critical reviews. There is also a lack of data regarding patient selection for early intervention.
Dr Atmadeep Banerjee is an ST4 Cardiology Registrar in the Kent, Surrey and Sussex deanery. He graduated from Calcutta National Medical College, India, before completing his Foundation training and Internal Medicine Training in the Severn and KSS deaneries respectively. He has research experience as an NIHR Associate PI in the PROTECT-HF study. He has an interest in Medical Education, and has received award nominations for his contribution towards teaching. As an IMT, he won the University Hospitals Sussex Trainee Excellence Award in 2025.

Author Sub-editor: Dr Hnin Zaw Dr Hnin Zaw is a cardiology registrar from the East of England Deanery with a specialist interest in electrophysiology and

Author Sub-editor: Dr Tha Htet Nyi Dr Tha Htet Nyi is a cardiology registrar in South London Deanery with subspecialty interests in multimodal cardiac imaging and

Author Sub-editor: Dr Chi Ho Fung Dr Chi Ho Fung graduated with Distinction from Imperial College School of Medicine in 2019 with an Intercalated Bachelor

Authors Heartbeat Sub-Editor: Alexandar Drampalou I am Dr.Alexandar Drampalou ,a cardiologist currently specializing in cardiac magnetic resonance (CMR) at Guy’s and St Thomas’ Hospital and

Authors Heartbeat Sub-Editor: Marina Zafeiri Dr Marina Zafeiri is an IMT3 in the Wessex deanery, with a strong interest in Cardiology. She graduated from Athens

Author Sub-editor: Dr Joshua Rowland Dr Joshua Rowland is a cardiology registrar working in the North West Deanery. He graduated from the University of Manchester