• CARDIAC PROCEDURES AND THERAPY

Cardiology has embraced the concept of evidence-based medicine with professional societies publishing clinical guidelines that have transformed cardiovascular care over the past 30 years. However, our current approach to guideline development in no longer viable—we need a process that responds more rapidly to new evidence, is free from bias, includes patients in the process, is based on rigorous review of the evidence by experts in research methodology, and is disseminated to clinicians and patients via intuitive and accessible multi-layered digital formats. As discussed in an editorial in this issue of Heart (see page 3), the BMJ has partnered with the MAGIC project to produce the first BMJ RapidRecs, addressing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis in patients at lower surgical risk.1–4 I hope many of you will take the time to look at this new approach and provide your feedback and thoughts (figure 1).

Appropriate treatment with oral anticoagulation reduces the risk of stroke in patients with atrial fibrillation (AF). However, AF often is not diagnosed until after a stoke has occurred because many patients are asymptomatic and the arrhythmia may be intermittent. Given the …