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We were delighted to accept the invitation of Drs Thakur and Natale to guest edit this issue of Cardiac Electrophysiology Clinics entitled "Difficult Decisions in Clinical Electrophysiology—A Case-Based Approach." In this issue, we gather the opinions of some of our favorite consultants on the thorniest issues faced by practicing electrophysiologists. The topics were suggested by our contributors and represent their "best thinking" on clinical challenges they have personally confronted in their practices. None of the problems discussed in this issue have a "guideline answer." Rather, each article points to an area of ongoing uncertainty for which no clinical trial has been completed or, in many instances, contemplated. In such circumstances, "expert opinion" is invaluable, and when a discussion is closely tied to a clinical case, as it is in each article presented here, it can be very enlightening.
