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Medicina
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Evolving Concepts in Clinical Cardiology
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Evolving Concepts in Clinical Cardiology

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (28 February 2026) | Viewed by 5919

Special Issue Editors

Dr. Riccardo Proietti

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Guest Editor
Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
Interests: arrhythmias; atrial fibrillation; pacemakers; cardiac electrophysiology; catheter ablation; clinical electrophysiology; interventional electrophysiology
Special Issues, Collections and Topics in MDPI journals
Dr. Andrea Silvio Giordani

E-Mail
Guest Editor Assistant
Cardiology, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
Interests: myocarditis; inflammatory cardiomyopathy; pericarditis; immunosuppressive therapy; cardioimmunology

Special Issue Information

Dear Colleagues,

Clinical cardiology is a field in rapid evolution, thanks to continuous advancements in the molecular and clinical understanding of cardiovascular diseases, molecular and clinical diagnostic techniques, and innovative therapeutic options in terms of innovative devices and medical therapies. In recent years, cardiology has witnessed a profound transformation in the approach to patient care, shifting from supportive interventions to progressively personalised strategies.

This Special Issue, titled “Evolving Concepts in Clinical Cardiology”, is aimed at providing an exhaustive overview of the most recent innovations and paradigm shifts in clinical cardiology.

Our goal is to offer professionals in the field an in-depth analysis of the emerging trends, new technologies, and evidence-based practices that are redefining clinical cardiology. Secondly, we aim to prompt future research by identifying the fields and cardiology subspecialties where further studies and advances are needed.

This Special Issue will cover a broad spectrum of topics including, but not limited to, the following:

  • Advances in precision medicine in cardiac diseases;
  • Future perspectives in cardiac imaging and other non-invasive diagnostic techniques;
  • Innovative therapies, either pharmacological or interventional;
  • Evolving challenges in the management of cardiovascular comorbidities.

Dr. Riccardo Proietti
Guest Editor

Dr. Andrea Silvio Giordani
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • clinical cardiology
  • cardiovascular diseases
  • molecular diagnostics
  • personalized strategies
  • precision medicine
  • cardiac imaging
  • interventional cardiology
  • cardiovascular comorbidities

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Review

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11 pages, 557 KB  
Review
Reappraising Use of Flecainide for Atrial Fibrillation and Ventricular Arrhythmias in Structural Heart Disease Patients
by Dimitrios Tsiachris, Sotirios C. Kotoulas, Ioannis Doundoulakis, Christos-Konstantinos Antoniou, Michail Botis, Konstantinos Pamporis, Nikolaos Argyriou, Aikaterini-Eleftheria Karanikola, Panagiotis Tsioufis, Athanasios Kordalis and Konstantinos Tsioufis
Medicina 2025, 61(10), 1845; https://doi.org/10.3390/medicina61101845 - 15 Oct 2025
Cited by 3 | Viewed by 4982
Abstract
Background: Flecainide, a class Ic antiarrhythmic agent, has long been contraindicated in structural heart disease (SHD) due to findings of the Cardiac Arrhythmia Suppression Trial (CAST). However, its proven efficacy in patients without structural abnormalities and emerging safety data in selected SHD [...] Read more.
Background: Flecainide, a class Ic antiarrhythmic agent, has long been contraindicated in structural heart disease (SHD) due to findings of the Cardiac Arrhythmia Suppression Trial (CAST). However, its proven efficacy in patients without structural abnormalities and emerging safety data in selected SHD populations have prompted reconsideration of its role. Aim: This mini review evaluates recent evidence on the safety and efficacy of flecainide in atrial fibrillation (AF) and premature ventricular contractions (PVCs), particularly in patients with stable coronary artery disease (CAD), and arrhythmogenic right ventricular cardiomyopathy (ARVC). Results: Modern imaging and improved risk stratification allow for more precise identification of patients who may safely receive flecainide, even in the presence of specific structural abnormalities. Observational studies have reported no mortality or ventricular arrhythmias incidence increase in stable CAD or ARVC when flecainide is administered under stringent criteria. While current guidelines remain cautious, clinical practice is beginning to reflect a more individualized approach. Conclusions: Flecainide use in selected SHD patients appears both feasible and safe when guided by comprehensive imaging and clinical judgment. The need for prospective randomized trials to confirm these findings and potentially inform future guideline updates is urgent and of utmost importance in the field of antiarrhythmic therapies. Full article
(This article belongs to the Special Issue Evolving Concepts in Clinical Cardiology)
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Other

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17 pages, 626 KB  
Systematic Review
Expanding the Therapeutic Landscape of Pericarditis: A Systematic Review of the Use of Conventional Immunosuppressants
by Andrea Silvio Giordani, Caterina Menghi, Antonella Risoli, Anna Baritussio, Federico Scognamiglio, Matteo Castegnaro, Elena Pontara, Maria Grazia Cattini, Elisa Bison, Celeste Ambra Murace, Elena Verrecchia, Marco Giuseppe Del Buono, Francesco Landi, Ludovico Luca Sicignano and Alida Linda Patrizia Caforio
Medicina 2026, 62(5), 887; https://doi.org/10.3390/medicina62050887 - 5 May 2026
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Abstract
Background and Objectives: While interleukin-1 inhibitors represent the standard of care for refractory idiopathic recurrent acute pericarditis, current guidelines also endorse conventional immunosuppressive (IS) agents as potential alternatives. The use of conventional IS agents is particularly relevant in specific clinical scenarios, such [...] Read more.
Background and Objectives: While interleukin-1 inhibitors represent the standard of care for refractory idiopathic recurrent acute pericarditis, current guidelines also endorse conventional immunosuppressive (IS) agents as potential alternatives. The use of conventional IS agents is particularly relevant in specific clinical scenarios, such as systemic immune-mediated disease (SID)-associated pericarditis. However, existing evidence regarding their efficacy and safety for pericarditis treatment remains fragmented, deriving exclusively from case reports, case series, and small monocentric observational studies. Our aims are: To characterize the clinical and diagnostic profiles of patients with pericarditis treated with conventional IS agents and to evaluate the therapeutic efficacy and safety of such agents. Materials and Methods: A systematic review was conducted in accordance with PRISMA guidelines. Major electronic databases were searched from January 1970 to March 2026 for case reports, case series, and observational studies detailing the use of conventional IS therapies for pericarditis. Clinical and therapeutic data, including specific IS indications and dosing regimens, were systematically extracted. Results: The final analysis included 39 reports comprising 75 patients (60% female; median age 36.0 years). The underlying pericarditis aetiology was predominantly SID-related (53%, n = 40) or idiopathic/presumed viral recurrent disease (40%, n = 30). The most frequently prescribed first-line IS agents were azathioprine (44%) and methotrexate (25%). Across published reports, IS therapy was described as achieving pericarditis clinical resolution in all cases and facilitated corticosteroid withdrawal in 72% of patients. Overall, pericarditis recurrence while on IS therapy occurred in only 10% of the cohort. Adverse events requiring IS withdrawal were rare (n = 2, 3%). Conclusions: Conventional IS agents appear effective and generally well tolerated in the published literature on SID-associated and isolated recurrent pericarditis. These findings reinforce the clinical utility of conventional IS therapies as a viable, steroid-sparing strategy when targeted biologic therapies lack sufficient investigation. Full article
(This article belongs to the Special Issue Evolving Concepts in Clinical Cardiology)
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