Heart failure (HF) is an increasing cause of cardiovascular morbidity and mortality. However, the lay public awareness about HF is shown to be inferior to the knowledge of myocardial infarction or stroke. The vast majority of HF patients lack basic comprehension of HF and self-care, which translates into suboptimal treatment outcomes. Therefore this study aimed to establish the present level of knowledge about HF of the lay public and to evaluate the effects of a single public lecture for the consideration of implementing further steps to raise public awareness. Design and methods: We performed a cross sectional survey study using an anonymous questionnaire designed by the German Competence Network Heart Failure (CNHF). Respondents were selected randomly and fulfilled the questionnaire free-willingly prior to and after a standardized lecture on HF. The CNHF questionnaire consisted of two sets of questions focusing on individual characteristics of the respondent and HF-related knowledge. The gathered data were verified by a standardized procedure in Wurzburg, Germany. Results: Among 1025 respondents 60% were females: 15% of the participants had occupational experience in the medical field. The majority (79%) of the study population had heard about HF previously. Typical complaints and symptoms of HF were correctly identified as ‘shortness of breath’ by 69%, ‘swelling of feet’ by 56%, ‘fatigue’ by 56%, and ‘weakness’ by 54% survey participants. The lecture resulted in 22% (from 26% to 48%) increase of correct identification of the combination all three HF symptoms (shortness of breath, swelling of feet and tiredness). The lecture significantly increased the proportion of correct answers for most of the questions. Particularly notable gains were observed in respondents without prior medical experience. Conclusion: The study population’s initial awareness of HF was insufficient. Standardized lecture improved the short-term knowledge about HF symptoms and nature of the disease. Regular educational activities increasing the HF awareness of general population and HF patients can increase the overall HF treatment success.

SummaryTetralogy of Fallot (TOF) is the most common cause of cyanotic congenital heart defect. Over the last century, the life expectancy of TOF patients has significantly improved. This, however, has brought new challenges both to patients and their health-care providers, the main of them being late arrhythmia. Ironically, late arrhythmia is predominantly generated due to the fibrotic scars caused by the life-saving surgical repair. Once the first two mainly arrhythmia-free decades after the repair pass, the risk of developing late arrhythmia and, therefore, SCD becomes substantial. Consequently, young adults with repaired Tetralogy of Fallot (rTOF) require careful outpatient monitoring.There have been many attempts to predict the risk of life-threatening arrhythmia in rTOF patients. This has led to the defining of various risk factors, ranging from the widely used QRS prolongation to novel predictors, derived from cardiac magnetic resonance (CMR) based anatomical findings (left ventricular dyssynchrony indexes, right ventricular output tract akinetic length, right ventricular mass-to-volume ratio). The latter predictors have recently established CMR as a tool of high significance in evaluation of rTOF patients.Although the role of Holter monitoring findings in rTOF patient-assessment remains unclear, it may be useful in those who are 25 years and older. Implantable cardioverter-defibrillator (ICD) implantation is the first-line treatment for secondary prevention of sudden cardiac death (SCD). rTOF patients suffer from the highest rate of inappropriate and the lowest rate of appropriate ICD shocks, when compared to other congenital heart diseases. As a consequence, ICD implantation for primary SCD prevention should be carefully weighed. Catheter-based ablation therapy leads to high rate of initial success when abolishing monomorphic ventricular tachycardia and intra-atrial reentrant tachycardia, however recurrence rates remain high. Seminars in Cardiovascular Medicine