Season 3 - Ep.25: Extended interview on arrhythmias in cardiac amyloidosis

Oct 23, 2025

In this engaging discussion, cardiology specialist Stephanie Schwarting, affiliated with renowned institutions in Munich and Heidelberg, shares her expertise on arrhythmias within cardiac amyloidosis. She delves into the complexities of rate control influenced by heart rate dependence and autonomic dysfunction. The conversation covers the challenges of ablation based on disease stage and the unpredictable progression of conduction disease. Schwarting also emphasizes the importance of individualized monitoring strategies and the role of multidisciplinary teams in enhancing patient care.

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ADVICE

Be Very Cautious With Rate Control

Avoid routine use of rate‑slowing drugs in cardiac amyloidosis without careful consideration of symptoms and autonomic dysfunction.
Use beta‑blockers, calcium‑channel blockers or digoxin with great caution because they can worsen output, conduction or potentially increase fibril toxicity.

INSIGHT

Ablation Success Depends On Disease Stage

AF ablation can work well in early‑stage cardiac amyloidosis and improves survival by maintaining sinus rhythm.
Ablation success falls in advanced disease due to extensive low‑voltage areas and higher recurrence rates.

ADVICE

Monitor And Act Early On Conduction Disease

Monitor conduction disease proactively with interval ECG monitoring tailored to individual risk rather than a one‑size‑fits‑all schedule.
Consider early pacemaker implantation for patients with trifascicular block or higher‑grade conduction disease.

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Host: Susanna Price

Guest: Stephanie Schwarting

Want to watch the episode? Go to: https://esc365.escardio.org/event/2176

Want to watch the extended interview on Arrhythmias in Cardiac Amyloidosis? Go to: https://esc365.escardio.org/event/2176?resource=interview

Disclaimer:

ESC TV Today is supported by Bristol Myers Squibb and Novartis through an independent funding. The programme has not been influenced in any way by its funding partners.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

The ESC is not liable for any translated content of this video. The English language always prevails.

Declarations of interests:

Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Stephanie Schwarting has declared to have potential conflicts of interest to report: advisory board for Alnylam, Bayer, Pfizer; principal investigator in trials sponsored by Alexion, Novo Nordisk and Intellia.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.