The Input and Impact of Practicing Cardiologists in ESC Guideline Commissions 

Practicing clinical cardiology in a university clinic means treating patients usually admitted to the hospital for special diagnostic and therapeutic procedures with a diagnosis already been made in the referring institution. Moreover it means that these patients gave their informed consent for further diagnostic and treatment procedures. As a consequence university clinicians develop this very specific and typical university-clinic-“point-of-view“. But reality of a practicing cardiologist is different, which may possibly be demonstrated by means of the two following situations:

1. Still as a practicing university cardiologist, I have never expected, that probably the majority of patients with symptomatic aortic stenosis will remain at home rejecting the life-saving aortic valve surgery or upcoming interventional therapies.
2. It is not easy to explain to a university-neurologist (who certainly can differentiate between a grand-mal and a low-output seizure) that the majority of patients after a rhythmogenic syncope including a low-output seizure will be admitted to the clinic of Neurology for further diagnostics, and the necessary cardiological diagnostic procedures will probably take place not earlier than after ruling out the necessary neurological disorders.

While changing from a practicing university cardiologist (and researcher) to practicing cardiologist, my clinical point-of-view changed exactly in this way. ESC-guidelines need this specific “point-of-view” and it makes a lot of sense that cardiologists from the Council for Cardiology Practice participate in ESC Guideline commissions.