Background and Objectives: Atrial fibrillation (AF) is one of the most common supraventricular arrhythmias in the adult population worldwide and it is frequently associated with heart failure (HF). The coexistence of these conditions increases morbidity, mortality and reduces quality of life in these patients. Therefore, it is important to delay the onset of AF in HF patients in order to avoid complications. The study aims to assess whether HF treatment influences AF onset. Materials and Methods: This retrospective observational study included 260 patients, 144 patients with heart failure treated with sodium–glucose cotransporter 2 inhibitors (SGLT2i) and 116 patients with heart failure without SGLT2i treatment (control group) hospitalized at least twice in the Cardiology Department of the “Pius Brinzeu” Emergency County Hospital between 2022 and 2024. Results: Treatment with SGLT2i was associated with a lower prevalence of atrial fibrillation in patients with heart failure. Conclusions: The study highlights the cardiovascular benefits of SGLT2 inhibitors and suggests a potential effect on the onset of AF in heart failure patients.

Background and Objectives: Systolic blood pressure (SBP) variability has been increasingly associated with cardiovascular outcomes, including stroke. This study aimed to evaluate the association between visit-to-visit SBP variability and the risk of ischemic and hemorrhagic stroke. Materials and Methods: A prospective cohort study was conducted on a set of 208 hypertensive patients over a period of three years, from August 2021 to September 2024, at the County Emergency Hospital “Pius Brinzeu”, Timișoara. Patients included in the study were stroke-free. SBP variability was quantified as the standard deviation of SBP measurements obtained quarterly. Results: This study demonstrated that systolic blood pressure (SBP) variability serves as a robust predictor of stroke incidence, underscoring its important role in cerebrovascular risk. The study cohort had an average age of 65.3 ± 9.1 years, with 53.4% males and 46.6% females. Patients in the highest SBP variability group had a 1.21-fold increased risk (21%, p = 0.031) of ischemic stroke and a 1.73-fold increased risk (73%, p = 0.005) of hemorrhagic stroke compared to those in the lowest variability group, revealing that higher SBP variability is strongly associated with an increased risk of both ischemic and hemorrhagic strokes, with the relationship being particularly pronounced for hemorrhagic stroke. Patients exhibiting greater fluctuations in SBP experienced significantly earlier stroke events and reduced stroke-free survival. Moreover, mortality rates were notably higher among individuals with very high SBP variability, indicating its profound impact on long-term outcomes. Conclusions: Visit-to-visit SBP variability is a significant and independent predictor of both ischemic and hemorrhagic stroke, emphasizing the clinical importance of monitoring and managing blood pressure stability. Further research should explore interventions to mitigate SBP variability and its impact on cerebrovascular outcomes.

Background and Objectives: Heart failure (HF) among patients with type 2 diabetes (T2DM) is linked to significant morbidity and mortality, despite the increased availability of new drug therapy. This study aims to investigate subclinical changes in patients with HF stage A (at risk for HF) and B (Pre-HF) and T2DM treated with oral semaglutide. Materials and Methods: In a prospective, observational, single-center study, 50 T2DM patients were assessed at baseline and one-year follow-up for changes in spectral Doppler, tissue Doppler, and speckle-tracking (2DST) and metabolic parameters. Results: Correlation and regression analyses identified predictors of Δ GLS. In correlation analysis, Δ GLS showed a negative correlation with Δ VAI (rho = −0.3, p = 0.02), Δ LAP (rho = −0.3, p = 0.04), Δ FPG (rho = −0.3, p = 0.009), Δ TG (rho = −0.4, p = 0.004), and Δ TyG (rho = −0.3, p = 0.02). In linear stepwise regression analysis, the most accurate model, with a p-value < 0.001, was M₃, explaining 70% of the variance in Δ GLS (adjusted R² = 0.7); this model included Δ FPG (beta −0.4, p = 0.001), Δ CRR (beta −1.3, p < 0.001), and Δ LDLc (beta 0.6, p = 0.01). Conclusions: These findings show that improved subclinical left ventricular systolic dysfunction is associated with improved glycemic control, visceral adiposity, and reduced insulin resistance, respectively, with improved lipid profiling.

Background/Objectives: Cardiac resynchronization therapy (CRT) with fusion pacing (“LV only”), also known as fusion-CRT (f-CRT), represents a feasible alternative to cardiac resynchronization therapy (CRT) with biventricular pacing (BiVP), not only in cases of BiVP failure, but also as a primary therapy option due to its potential benefits over traditional CRT. Fusion pacing may be particularly beneficial in selected patients and understanding the structural and functional differences between responders could guide future optimization strategies. This study provides a descriptive comparison between super-responders (SRs) and non-super-responders (NSRs) undergoing fusion-CRT. Methods: Patients with RA/LV-only pacing systems or biventricular CRT systems operating predominantly in LV-only pacing mode due to intrinsic RV conduction were included. A follow-up protocol was conducted for all patients at 6 months and then annually. Data from the most recent follow-up were used for statistical analysis. Super-responders (SRs) were those with substantial reverse remodeling, quantified by a ≥30% reduction in LVESV and a stable LVEF of ≥45% at follow-up. Although SRs were defined based on these reverse remodeling criteria, separate analyses of additional echocardiographic parameters (e.g., left atrial dimensions) were performed to independently assess the broader impact of fusion-CRT on cardiac structure and function. Results: Among 71 patients, 55 were non-super-responders (NSRs) and 16 were super-responders (SRs), with a mean follow-up of 43.2 months. SRs were predominantly female and had smaller left ventricular (LV) dimensions: LVEDd (6.30 cm vs. 6.80 cm, p = 0.02), LVEDV (185 mL vs. 240 mL, p = 0.03), LVESV (132.5 mL vs. 175 mL, p = 0.03), and a higher LVEF (p = 0.03). The follow-up LVEF was positively correlated with changes in LVESV (ρ = 0.557, p < 0.001), but not with NYHA class changes (ρ = 0.184, p = 0.125). Larger baseline LV and left atrial (LA) volumes were associated with a reduced follow-up LVEF (LVESV: ρ = −0.426, p < 0.001; LVEDV: ρ = −0.394, p < 0.001; LAv: ρ = −0.374, p = 0.001). Both groups showed improvement in the NYHA class (p < 0.001, p = 0.007). MR improved significantly in SRs (p = 0.02) and worsened slightly in NSRs (p = 0.13), while TR worsened significantly in the NSRs group (p = 0.03). Conclusions: Our findings highlight key differences in clinical and echocardiographic parameters between SRs and NSRs following fusion-CRT. These observations may contribute to a better understanding of response patterns and inform future prospective studies aiming to optimize patient selection and timing of therapy.

Background and Objectives: Cardiac arrhythmias during the SARS-CoV-2 infection may occur due to the direct impact of the virus on the respiratory and cardiovascular systems, as well as through the broader effects of systemic inflammation, or a combination of both. Additional mechanisms include the proarrhythmic effects of COVID-19 pharmacotherapies, drug–drug interactions, and associated autonomic dysfunction. To improve future risk stratification and clinical management, it is essential to accurately assess the risk of arrhythmia in the context of severe infections, in order to develop diagnostic and therapeutic algorithms that support the fastest and safest possible interventions. Materials and Methods: This retrospective observational study included 151 patients diagnosed with COVID-19, who were hospitalized at the Cardiology Clinic of the Timisoara County Emergency Hospital between 2020 and 2022. Results: The most common arrhythmia observed was atrial fibrillation. Elevated inflammatory markers were associated with a higher risk of arrhythmias and increased mortality. Conclusions: The onset of sepsis, as indicated by the laboratory markers, was associated with increased incidence of arrhythmias and unfavorable outcome of the disease.

The coronavirus pandemic has significantly impacted a substantial part of the global population, and the cardiovascular repercussions of COVID-19 infection have been unveiled for the first time. While the arrhythmogenic effects of the severe inflammatory syndrome associated with the infection are well-established, another critical cause of arrhythmias, particularly ventricular arrhythmias such as ventricular tachycardia, torsades de pointes, or ventricular fibrillation, which can result in cardiac arrest, is the pharmacological treatment employed to manage the disease in hospitalized patients. Among all arrhythmogenic mechanisms, the QT interval prolongation is the most alarming. This review aims to provide a more in-depth exploration of these effects and the potential mechanisms underlying their occurrence.