Introduction: Although catheter ablation is a cornerstone in arrhythmia management, hospital readmissions, emergency room (ER) visits, and complications remain a significant clinical burden. Defining their frequency and predictors is essential to optimize patient follow-up and outcomes after ablation. Methods: To evaluate the rates and predictors of 90-day hospital readmissions and emergency room visits following catheter ablation, as well as procedure-related complications, among patients undergoing catheter ablation, a retrospective cohort study was conducted at King Abdulaziz Cardiac Center (Riyadh, Saudi Arabia), including adult patients undergoing catheter ablation between June 2022 and June 2024. Data were extracted from BestCare electronic medical records and analyzed using Fisher’s exact tests and logistic regression. Results: Among 176 patients, 13 (7.4%) were readmitted and 23 (13.1%) visited the ER, predominantly due to arrhythmia recurrence (61.5% and 60.9%, respectively). Recurrent events occurred in a subset of patients and were significantly more frequent among older individuals and those with a higher comorbidity burden (p< 0.01). Conclusion: Ninety-day readmissions and ER visits after catheter ablation were infrequent, mostly due to arrhythmia recurrence. Independent predictors included older age and comorbidity burden, underscoring the need for risk stratification and structured follow-up strategies to reduce preventable healthcare utilization.

Objectives: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a rapidly progressive disease that may cause permanent hearing loss. Standard primary treatments include oral corticosteroids (OCs) or intratympanic corticosteroids (ITCs). This study aimed to evaluate the effectiveness and safety of OCs versus ITCs as primary treatments for ISSNHL. Design: This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched Medline, Google Scholar, Web of Science, Embase, and Scopus, identifying 11 RCTs comprising 833 patients. Results: Both OCs and ITCs significantly improved hearing, with average pure tone audiometry (PTA) gains ranging from 12 to 40 dB. No significant between-intervention difference was observed in post-treatment PTA. Generally, combination therapy yielded the greatest improvements (>40 dB and >60% recovery). OCs caused systemic adverse effects, whereas ITCs produced mostly mild local effects. Conclusions: Both treatment routes effectively improved hearing in patients with ISSNHL, with neither demonstrating clear superiority in overall efficacy. However, combination therapy may be associated with better hearing outcomes.

Background: Subclinical systolic dysfunction due to diabetic microangiopathy and its impact on left ventricular (LV) function remains unclear. Myocardial deformation (strain) imaging can detect LV systolic dysfunction earlier than conventional ejection fraction evaluations. Thus, this study aimed to examine the relationship between uncontrolled diabetes and impaired LV global longitudinal strain (GLS) in patients with diabetes mellitus (DM) compared to non-diabetic individuals. Methods: A total of 76 asymptomatic patients with uncontrolled type 2 DM and 76 age- and gender-matched healthy controls underwent transthoracic echocardiography imaging. Patients with coronary artery disease, an LV ejection fraction <55%, atrial fibrillation, or inadequate echocardiographic quality were excluded. The presence of proliferative retinopathy, microalbuminuria, nephropathy, or peripheral neuropathy defines diabetic microvascular complications. Results: The absolute GLS% was significantly lower in the uncontrolled diabetic group (–18.4 ± 1.7) compared to controls (–22 ± 1.9, p < 0.001). Diabetic patients with complications had lower absolute GLS% values of –18.9 ± 1.7 for no complications, –17.5 ± 1.3 for one complication, and –16.8 ± 1.3 for two or more complications (p-value = 0.001). Regression analysis showed a positive association between complications and lower absolute GLS% (β = 0.41, p < 0.001). No significant difference was found in LV mass between hypertensive (155.1 ± 40.4) and non-hypertensive individuals (139.8 ± 44.3; p-value = 0.19). Conclusion: Uncontrolled diabetes and the presence of complications were associated with lower absolute GLS% values, suggesting impaired myocardial deformation. These findings highlight the importance of monitoring GLS% as a potential marker for cardiac involvement in diabetic patients.

Background: Muscle dysmorphia (MD) refers to distressing concerns about being insufficiently muscular and is increasingly reported among gym-going men. Evidence from Saudi Arabia is limited. This study estimated the proportion of gym-going men in Riyadh who screened positive for elevated MD symptomatology and examined associations with disordered eating symptoms and sociodemographic factors. Methods: A cross-sectional survey was conducted among male gym-goers in Riyadh. Elevated MD symptomatology was assessed using the Muscle Dysmorphic Disorder Inventory (MDDI), and disordered eating symptoms were screened using the Patient Health Questionnaire–Eating Disorders Module (PHQ-ED). Group differences were examined using appropriate bivariate tests. A stepwise binary logistic regression model was used to identify predictors of screening-positive status for elevated MD symptomatology (MDDI ≥ 39). Results: Of 303 participants, 49.8% screened positive for elevated MD symptomatology (MDDI ≥ 39). Screening-positive PHQ-ED status was associated with screening-positive MDDI status (Fisher’s exact test, p = 0.030). In the final stepwise multivariable model, marital status and graduate-level education were associated with screening-positive MDDI status. Body mass index (BMI) was not retained in the final stepwise model, and PHQ-ED status could not be evaluated in the multivariable model due to sparse data/complete separation (non-estimable odds ratios). Conclusions: Nearly half of the surveyed gym-going men screened positive for elevated MD symptomatology, indicating a high symptom burden in this selected sample. These findings should not be interpreted as diagnostic prevalence. Screening-based approaches in gym settings may help identify individuals who report high distress or interference and may benefit from further clinical assessment. Larger studies using probability sampling and structured diagnostic interviews are needed to estimate diagnostic prevalence and clarify associated factors.

Background/Objectives: Palpitations are among the most common reasons for cardiology referrals. Despite widespread use of ambulatory cardiac monitoring, contemporary data from the Middle East are scarce. Extended Holter monitoring provides detailed evaluation of arrhythmia burden, autonomic regulation, and symptom–rhythm correlation in routine clinical practice. Methods: We conducted a prospective observational study of consecutive patients presenting with palpitations who underwent 24–96 h ambulatory Holter monitoring at a cardiology outpatient clinic in Saudi Arabia in 2025. Demographic and clinical characteristics, comorbidities, medication use, echocardiographic parameters, heart rate variability (HRV), ventricular and supraventricular ectopy, tachyarrhythmias, and symptom diary activations were systematically evaluated. Results: Among 251 patients (mean age 41.9 ± 16.4 years; 35.5% male), Holter monitoring showed excellent recording quality (mean analyzable time 98.7 ± 9.5%). Premature ventricular contractions (PVCs) were detected in 53.4% of patients, but burden was low (median 0.0%, IQR 0–0.1%), with only 4.4% exceeding 10%. Atrial premature contractions (APCs) were common (92.0%), though usually low-burden (median burden 0.0%, IQR 0–0.1%); atrial fibrillation and supraventricular tachycardia were rare (0.8% each). Symptom diary activation occurred in 116 patients (46.2%), with 996 events; most (87.9%) correlated with sinus tachycardia, while only 8.6% correlated with PVCs and 2.6% with APCs. In the remaining 53.8% of patients, no symptom–rhythm correlation was documented during monitoring. Heart rate variability showed expected age-related changes. Conclusions: In this predominantly young cohort, Holter monitoring revealed frequent low-burden atrial and ventricular ectopy, whereas clinically significant tachyarrhythmias were uncommon. Holter monitoring up to 96 h provided a diagnostic yield in approximately 50% of patients and should be considered a first-line screening tool. Patients without diagnostic findings may require prolonged monitoring using external or implantable devices.

Persistent left superior vena cava (PLSVC) is a rare congenital anomaly that may complicate cardiac procedures when associated with a dilated coronary sinus (CS) and conduction disturbances. We report the case of a 27-year-old male with Wilson’s disease who presented with complete heart block. Echocardiography showed biatrial enlargement and severe CS dilation, while contrast-enhanced computed tomography (CT) confirmed PLSVC draining into the CS without a bridging vein. Anatomical constraints prevented cardiac resynchronization therapy, and dual-chamber pacemaker implantation proved technically challenging due to lead placement difficulties. This case highlights the importance of thorough preoperative assessment and individualized pacing strategies in patients with PLSVC, in order to anticipate anatomical challenges and optimize outcomes.