Journal of Atrial Fibrillation

Atrial fibrillation (AF) has a heterogeneous clinical presentation. It can occur: (a) in the presence or absence of detectable heart disease, and, (b) with or without relatedsymptoms. Its prognosis in terms of thromboembolismand mortality is most benign when applied to young individuals (aged less than 60 years) without clinical orechocardiographic evidence of cardiopulmonary disease [termed "lone AF"]. However, by virtue of aging or because of the development of concomitant cardiovascular disorders, patientsmove out of the lone AF category over time, accompanied by increased risks for thromboembolism and mortality...

A patient underwent the LARIAT left atrial appendage (LAA) ligation procedurewith persistent atrial fibrillation history. The procedure was done successfully. A transthoracic echocardiography did not show pericardial effusion. The patient was examined under fluoroscopy where the tip of the drain was not in the pericardial space and contrast injection pericardial drain confirmed its location in the inferior vena cava.

Objective: To examine the incidence of atrial fibrillation (AF) newly developed after cardiovascular surgery in Vietnam, its associated risk factors, and postoperative complications. We also sought to evaluate the feasibility of a novel screening strategy for post-operative AF (POAF) using the combination of two portable devices. Methods: Single-centre, prospective cohort study at the Cardiovascular Centre, E Hospital, Hanoi, Vietnam. All patients aged≥18 years, undergoing cardiovascular surgery and in sinus rhythm preoperatively were eligible...

BACKGROUND: Sodium glucose cotransporter 2 (SGLT2) inhibitors have been associated with various cardiovascular benefits. There is limited data examining the effect of these medications on atrial fibrillation (AF) associated clinical outcomes. We compared ischemic stroke, acute coronary syndrome (ACS), cardioversion, and all-cause mortality outcomes in AF patients on SGLT2 inhibitors to propensity matched controls. MATERIALS AND METHODS: We conducted a retrospective study with a global medical research network database...

Patients undergoing catheter ablation for atrial fibrillation (AF) are routinely admitted for observation overnight in the hospital. With the rising incidence of AF among the population, increased volumes of procedures are placing increased demands on hospital resources. The purpose of this study was to evaluate the efficacy and safety of same day discharge in patients undergoing ablation for AF when compared to patients admitted for overnight observation. We performed a retrospective analysis using a multicenter cohort among patients who were discharged home after elective pulmonary vein isolation (PVI) ablation for AF...

The relationship between Metabolic syndrome and Atrial Fibrillation is confirmed by many studies. The components of Metabolic syndrome cause remodeling of the atrial. Metabolic syndrome and metabolic derangements of the syndrome could be the cause of the pathogenesis of AF. This review article discusses the major biomarkers of Metabolic syndrome and their role in the pathogenesis of AF. The biomarkers are adiponectin, leptin, Leptin/ Adiponectin ratio, TNF-α, Interleukin-6, Interleukin-10, PTX3, ghrelin, uric acid, and OxLDL...

Background: Some patients fail to respond to persistent atrial fibrillation (PeAF) catheter ablation in spite of multiple procedures and ablation strategies, including low voltage area (LVA)-guided, linear, and complex fractionated atrial electrogram (CFAE)-guided ablation procedures. We hypothesized that LVA extent could predict non-responseto Pe AF catheter ablation in spite of multiple procedures. Methods: This study included 510 patients undergoing initial ablation procedures for PeAF...

Background: Large prospective trials attribute minimal thromboembolic risk for cardioversion of atrial fibrillation (AF) when duration of symptoms is shorter than 48 hours. Our goal is to compare the prevalence of left atrial appendage (LAA) thrombus as demonstrated by a Trans esophageal echocardiography (TEE) exam between patients presenting with less or more than 48 hours of AF symptoms. Methods: Observational cohort study including consecutive patients hospitalized with primary diagnosis of new onset AF, not previously treated with oral anticoagulation...

Objective: To evaluate the feasibility, safety, and clinical efficacy of non-fluoroscopic radiofrequency catheter ablation of atrial fibrillation (AF) in comparison to traditional fluoroscopy-guided ablation in a local Canadian community cohort. Methods: We retrospectively studied consecutive patients with paroxysmal and persistent AF undergoing pulmonary vein isolation (PVI) guided by intracardiac echocardiography (ICE) and Carto system (CartoSound module). ICE-guided PVI without fluoroscopy (Zero-fluoro group) was performed in 116 patients, and conventional fluoroscopy-guided PVI (Traditional group) was performed in 131 patients...

Background: The efficacy of posterior wall isolation (PWI) on top of pulmonary vein isolation (PVI) in patients affected by persistent atrial fibrillation (AF) is still controversial and little is known about the impact of contact-force (CF) technology. Objective: In this retrospective study, we present our experience with PWI using CF sensing catheters and its efficacy and safety as an adjunctive ablation strategy on top of PVI for management of patients with persistent and longstanding persistent AF...

BACKGROUND: Corona virus disease 2019 (COVID-19) contributes to cardiovascular complications including arrhythmias due to high inflammatory surge. Nevertheless, the common types of arrhythmia amongst severe COVID-19 is not well described. New onset atrial fibrillation(NOAF) is frequentlyseen in critically ill patients and therefore we aim to assess the incidence of NOAF in severe COVID -19and its association with prognosis. METHODS: This is a retrospective multicentre study including 109 consecutive patients admitted to intensive care units (ICU) with confirmed COVID-19 pneumonia and definitive outcome (death or discharge)...

AIM: Catheter ablation in patients with atrial fibrillation (AF)/atrial flutter carries a risk of thromboembolism and major bleeding. In light of recent prospective trial data on the safety and efficacy of uninterrupted edoxaban in patients undergoing AF/flutter ablation, real-world Data was aimed for validation. METHODS: A total of 228 patients who underwent AF/atrial flutter ablation over 14 months at our centre were retrospectively analyzed. All patients received uninterrupted oral anticoagulation for at least 4 weeks prior to ablation and 3 months post-ablation...

Introduction: Catheter ablation (CA) for atrial fibrillation (AF) can be associated with limited efficacy. Due to its autonomic innervation, the vein of Marshall (VOM) is an attractive target during AF ablation. In this meta-analysis, we aimed to evaluate the efficacy and safety of adjunctive ethanol infusion of VOM (VOM-EI) in AF ablation. Methods: We performed a comprehensive literature search for studies that evaluated the efficacy and safety of VOM-EI in AF ablation compared to AF catheter ablation alone...

Introduction: Implantable cardioverter-defibrillator (ICD) in patients with heart failure with reduced ejection fraction reduces mortality secondary to malignant arrhythmias. Whether end-stage heart failure (HF) with continuous-flow left ventricular assist device (cf-LVAD) derive similar benefits remains controversial. Methods: We performed a systematic literature review and meta-analysis of all published studies that examined the association between active ICDs and survival in advanced HF patients with cfLVAD...

Purpose: Incident atrial fibrillation (AF) is common after cavotricuspid isthmus (CTI) dependent atrial flutter (AFL) ablation. Risk factors for the development of AF post ablation are not well understood. The purpose of this study was to identify patients undergoing CTI ablation for AFL most likely to develop AF. Methods: Retrospective chart review identified 114 consecutive patients without a history of AF or prior cardiac surgery who underwent typical CTI dependent AFL ablation between December 2013 to November 2018, who also had a complete preoperative transthoracic echocardiogram, and at least 1 year of follow-up at our medical center...

We submit an unusual presentation of spontaneous atrial fibrillation in a young fit active-duty U.S. military African-American male without evidence of structural heart disease. His atrial fibrillation was refractory to several ablation treatments over the course of 3 years. Subsequently he was diagnosed with extracardiac sarcoidosis and fluorodeoxyglucose-positron emission tomography (FDG-PET) scan identified bi-atrial hypermetabolic lesions, concerning for cardiac sarcoidosis. Given the low incidence of atrial fibrillation in patients < 45 years-of-age, this case report aims to underscore consideration of cardiac sarcoidosis as a subclinical contributor towards developing atrial fibrillation in the appropriate patient population...

No abstract text is available yet for this article.

Left atrial appendage (LAA) exclusion is the cornerstone of stroke prevention in surgical treatment of atrial fibrillation (AF). Still, little is known about the direct hemodynamic consequences of LAA closure. In the current pilot study, where we aimed to evaluate these consequences in patients undergoing hybrid AF ablation with LAA exclusion by an atrial clip, seven patients were included. Hemodynamic and intracardiac pressure measurements such as systemic, pulmonary artery (PA), central venous and LA pressure, cardiac output and indexed left ventricular stroke volume (LVSVi) were measured directly before (T0) and after (T1), and 10 minutes after (T2) LAA closure...

BACKGROUND: The utility of ultra-high definition mapping (UHDM) for ablation of premature ventricular contractions (PVC) remains undetermined. The aim of this study was to investigate UHDM for PVC ablation, and additionally to compare to conventional technique. METHODS: Twenty patients investigated using UHDM were prospectively included and analyzed. Electrophysiological caracteristics and results were compared to 40 patients ablated using fluoroscopy only. RESULTS: 2541±2033 EGMs and 331±240 PVC beats were recorded for each patient...

BACKGROUND: The novel Polarx™ cryoablation system is currently being studied for atrial fibrillation (AF) ablation. To the best of our knowledge, no study comparing the novel cryoablation system with the standard Arctic Front™ cryoballoon is available in today's literature. This study aims to compare Polarx™ and Arctic Front™ cryoballoon in terms of safety and efficacy. METHODS: From a total cohort of 202 patients who underwent pulmonary vein (PV) isolation for paroxysmal AF through cryoablation, a population of 30 patients who used Polarx™ were compared with 30 propensity-score matched patients who used Arctic Front™...