Cardiology has traditionally been a high-tech subspecialty, and in no field is this more true than interventional cardiac electrophysiology. Following the advent of computer-assisted recording systems and electroanatomic mapping, impressive technological innovations are emerging. Fusion of intracardiac ultrasound, or cardiac CT, and cardiovascular magnetic resonance (CMR)-derived imaging to electroanatomic mapping is used to improve intraprocedural guidance for ablation. Myocardial scar border zones can be visualised using late gadolinium enhancement (LGE) techniques, and, more importantly, smaller and more tightly-spaced electrodes. New materials for electrodes and other equipment have allowed the concept of the radiation-free electrophysiology laboratory with the use of CMR, and the vision of a fully radiation-free, magnetic laboratory is no longer science fiction. Mathematical modelling using fast Fourier and Gaussian models has been employed in the investigation of arrhythmia circuits. Histochemistry techniques such as connexin genotyping as well as the revolution in genetics have expanded our understanding of both the mechanism and clinical significance of specific tachycardias. Last, but not least, the emerging field of nanotechnology is being applied to electrophysiology both for characterisation and therapy of arrhythmia substrates.
On 20 July 1969, mission commander Neil Armstrong and pilot Buzz Aldrin landed the lunar module Eagle on the moon. The total computer memory on board Apollo 11 was 32 kilobytes. It was the year Damato published his seminal study on His bundle recordings. Now I am writing this editorial on my personal computer with a storage memory of 512 gigabytes, and giants in the field, such as Mark Josephson, have bestowed upon us a totally new world of cardiac arrhythmias. We live in an era of revolutionary technological innovations and the future of arrhythmia treatment is more promising than ever. In Arrhythmia & Electrophysiology Review we are more than excited to see an increasing number of papers reviewing innovative applications in cardiac electrophysiology. We shall do our best to keep pace by disseminating this knowledge in as succinct, focused and reader-friendly a manner as possible.
Editor-in-Chief, Arrhythmia & Electrophysiology Review
Athens Euroclinic, Athens, Greece