Julian Friebel, Max Wegner, Leon Blöbaum, Philipp-Alexander Schencke, Kai Jakobs, Marianna Puccini, Emily Ghanbari, Stella Lammel, Tharusan Thevathasan, Verena Moos, Marco Witkowski, Ulf Landmesser, Ursula Rauch-Kröhnert
Patients with first-diagnosed atrial fibrillation (FDAF) exhibit major adverse cardiovascular events (MACEs) during follow-up. Preclinical models have demonstrated that thrombo-inflammation mediates adverse cardiac remodeling and atherothrombotic events. We have hypothesized that thrombin activity (FIIa) links coagulation with inflammation and cardiac fibrosis/dysfunction. Surrogate markers of the thrombo-inflammatory response in plasma have not been characterized in FDAF. In this prospective longitudinal study, patients presenting with FDAF ( n = 80), and 20 matched controls, were included...
April 8, 2024: International Journal of Molecular Sciences
Pei-Chien Tsai, Albert Min-Shan Ko, Yu-Lin Chen, Cheng-Hsun Chiu, Yung-Hsin Yeh, Feng-Chun Tsai
We aimed to identify serum exosomal microRNAs (miRNAs) associated with the transition from atrial fibrillation (AF) to sinus rhythm (SR) and investigate their potential as biomarkers for the early recurrence of AF within three months post-treatment. We collected blood samples from eight AF patients at Chang Gung Memorial Hospital in Taiwan both immediately before and within 14 days following rhythm control treatment. Exosomes were isolated from these samples, and small RNA sequencing was performed. Using DESeq2 analysis, we identified nine miRNAs (16-2-3p, 22-3p, 23a-3p, 23b-3p, 125a-5p, 328-3p, 423-5p, 504-5p, and 582-3p) associated with restoration to SR...
March 29, 2024: International Journal of Molecular Sciences
Shantanu Sarkar, Jodi Koehler, Neethu Vasudevan
BACKGROUND: Ambulatory risk stratification for worsening heart failure (HF) using diagnostics measured by insertable cardiac monitors (ICM) may depend on the left ventricular ejection fraction (LVEF). We evaluated risk stratification performance in patients with reduced versus preserved LVEF. METHODS: ICM patients with a history of HF events (HFEs) were included from the Optum® de-identified Electronic Health Record dataset merged with ICM device-collected data during 2007-2021...
April 5, 2024: Diagnostics
Sophie Gupta, Martin Lutnik, Filippo Cacioppo, Teresa Lindmayr, Nikola Schuetz, Elvis Tumnitz, Lena Friedl, Magdalena Boegl, Sebastian Schnaubelt, Hans Domanovits, Alexander Spiel, Daniel Toth, Raoul Varga, Marcus Raudner, Harald Herkner, Michael Schwameis, Jan Niederdoeckl
BACKGROUND: Computed tomography (CT) could be a suitable method for acute exclusion of left atrial appendage thrombus (LAAT) prior to cardioversion of atrial fibrillation (AF) and atrial flutter (AFL) at the emergency department. Our aim was to present our experiences with this modality in recent years. METHODS: This registry-based observational study was performed at the Department of Emergency Medicine at the Medical University of Vienna, Austria. We studied all consecutive patients with AF and AFL who underwent CT between January 2012 and January 2023 to rule out LAAT before cardioversion to sinus rhythm was attempted...
March 27, 2024: Diagnostics
Linzi Li, Alvaro Alonso, Dora Romaguera, Angel M Alonso-Gómez, Cristina Razquin, Lucas Tojal-Sierra, Miquel Fiol, Miguel Angel Martínez-González, Vinita Subramanya, Jordi Salas-Salvadó, Montserrat Fito, Estefanía Toledo
Background : Lifestyles influence atrial fibrillation (AF) risk. Determining the effect of lifestyle interventions on blood concentrations of biomarkers of AF-related pathways could help understand AF pathophysiology and contribute to AF prevention. Methods : We studied 532 participants enrolled in the PREDIMED-Plus trial, a Spanish randomized trial conducted in adults (55-75 years) with metabolic syndrome and body mass index between 27-40 kg/m2 . Eligible participants were randomized 1:1 to an intensive lifestyle intervention, emphasizing physical activity, weight loss, and adherence to an energy-reduced Mediterranean diet or to a control group...
April 7, 2024: Journal of Clinical Medicine
Sonia Alicja Nartowicz, Aleksandra Ciepłucha, Michał Waśniewski, Izabela Miechowicz, Justyna Rajewska-Tabor, Agnieszka Bartczak-Rutkowska, Maciej Lesiak, Małgorzata Pyda, Olga Trojnarska
Background : Ebstein anomaly (EA) is a rare congenital heart disease characterized by the apical displacement of the tricuspid leaflets, creating an enlarged functional right atrium. Supraventricular arrhythmias (SVA) are common, and catheter ablation remains challenging. SVA is considered a risk factor for sudden cardiac death in this population. Still, there are very few real-life data on the impact of SVA treated invasively or conservatively on a patient's prognosis. We aimed to analyze the incidence of SVA in adults with EA, evaluate the effectiveness of catheter ablation, and analyze the impact of SVA and catheter ablation on survival in this population...
April 1, 2024: Journal of Clinical Medicine
Adrian Vasile Mureșan, Elena Florea, Emil-Marian Arbănași, Réka Bartus, Eliza-Mihaela Arbănași, Alexandru Petru Ion, Bogdan Andrei Cordoș, Vasile Bogdan Halatiu, Raluca Niculescu, Adina Stoian, Claudiu Constantin Ciucanu, Eliza Russu
(1) Background : Arteriovenous fistula (AVF) is the preferred type of vascular access for dialysis in patients with end-stage kidney disease (ESKD). However, the primary patency of AVF at one year is under 70% due to several risk factors and comorbidities. Leukocyte glucose index (LGI), a new biomarker based on blood leukocytes and glucose values, has been found to be associated with poor outcomes in cardiovascular disease. The aim of this study is to analyze the impact of LGI on the long-term primary patency of AVF following dialysis initiation...
April 1, 2024: Journal of Clinical Medicine
Daniela Poli, Emilia Antonucci, Walter Ageno, Martina Berteotti, Anna Falanga, Vittorio Pengo, Paolo Chiarugi, Benilde Cosmi, Carmelo Paparo, Antonio Chistolini, Antonio Insana, Domenico Lione, Giuseppe Malcangi, Giuliana Martini, Lucilla Masciocco, Simona Pedrini, Eugenio Bucherini, Daniele Pastori, Pasquale Pignatelli, Andrea Toma, Sophie Testa, Gualtiero Palareti, Start Af Study Group
Background: Direct oral anticoagulants (DOACs) are recommended for stroke prevention in non-valvular atrial fibrillation (NVAF) patients. We aimed to describe the prevalence of inappropriate DOACs dose prescription in the START2-AF Registry, the outcomes according to the appropriateness of the dosage, and the factors associated with inappropriate dose prescription. Methods: Patients' demographics and clinical data were prospectively collected as electronic files in an anonymous form on the website of the START2-Registry; DOACs dosage was determined to be appropriate when prescribed according to the European Heart Rhythm Association Guidelines...
March 29, 2024: Journal of Clinical Medicine
Márton Boga, Gábor Orbán, Péter Perge, Zoltán Salló, Edit Tanai, Arnold Béla Ferencz, Patrik Tóth, Ferenc Komlósi, István Osztheimer, Klaudia Vivien Nagy, Béla Merkely, László Gellér, Nándor Szegedi
Background: Atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) is predominantly attributed to pulmonary vein reconnection (PVR). Predictors of AF recurrence have been widely studied; however, data are scarce on procedural parameters that predict chronic PVR. We aimed to study PVR rates and predictors of PVR. Methods: We retrospectively included 100 patients who underwent repeated ablation due to AF recurrence after initial PVI with the CARTO system. PVR was determined during the repeated procedure by electrophysiological evaluation, and initial procedural characteristics predicting PVR were studied, including adherence to the CLOSE protocol, use of high power, first-pass isolation (FPI), and baseline generator impedance (BGI)...
March 28, 2024: Journal of Clinical Medicine
Jeroen Bijnens, Sander Trenson, Gabor Voros, Pieter Martens, Sebastian Ingelaere, Pascal Betschart, Jens-Uwe Voigt, Matthias Dupont, Alexander Breitenstein, Jan Steffel, Rik Willems, Frank Ruschitzka, Wilfried Mullens, Stephan Winnik, Bert Vandenberk
Background: Cardiac resynchronization therapy (CRT) has evolved into an established therapy for patients with chronic heart failure and a wide QRS complex. Data on long-term outcomes over time are scarce and the criteria for implantation remain a subject of investigation. Methods: An international, multicenter, retrospective registry includes 2275 patients who received CRT between 30 November 2000 and 31 December 2019, with a mean follow-up of 3.6 ± 2.7 years. Four time periods were defined, based on landmark trials and guidelines...
March 25, 2024: Journal of Clinical Medicine
Mateusz Polak, Joanna Wieczorek, Malwina Botor, Aleksandra Auguścik-Duma, Andrzej Hoffmann, Anna Wnuk-Wojnar, Katarzyna Gawron, Katarzyna Mizia-Stec
Background: MicroRNA (miRNA) have the potential to be non-invasive and attractive biomarkers for a vast number of diseases and clinical conditions; however, a reliable analysis of miRNA expression in blood samples meets a number of methodological challenges. In this report, we presented and discussed, specifically, the principles and limitations of miRNA purification and analysis in blood plasma samples collected from the left atrium during an ablation procedure on patients with atrial fibrillation (AF). Materials and Methods: Consecutive patients hospitalized in the First Department of Cardiology for pulmonary vein ablation were included in this study (11 with diagnosed paroxysmal AF, 14 with persistent AF, and 5 without AF hospitalized for left-sided WPW ablation-control group)...
March 25, 2024: Journal of Clinical Medicine
Jerremy Weerts, Anne G Raafs, Birgit Sandhoefner, Frank C T van der Heide, Sanne G J Mourmans, Nicolas Wolff, Robert P Finger, Peyman Falahat, Maximilian W M Wintergerst, Vanessa P M van Empel, Stephane R B Heymans
Background: Systemic microvascular regression and dysfunction are considered important underlying mechanisms in heart failure with preserved ejection fraction (HFpEF), but retinal changes are unknown. Methods: This prospective study aimed to investigate whether retinal microvascular and structural parameters assessed using optical coherence tomography angiography (OCT-A) differ between patients with HFpEF and control individuals (i.e., capillary vessel density, thickness of retina layers). We also aimed to assess the associations of retinal parameters with clinical and echocardiographic parameters in HFpEF...
March 25, 2024: Journal of Clinical Medicine
Suneesh Anand, Edmond M Cronin
Arrhythmias frequently complicate the course of advanced pulmonary hypertension, often leading to hemodynamic compromise, functional impairment, and mortality. Given the importance of right atrial function in this physiology, the restoration and maintenance of sinus rhythm are of critical importance. In this review, we outline the pathophysiology of arrhythmias and their impact on right heart performance; describe considerations for antiarrhythmic drug selection, anesthetic and periprocedural management; and discuss the results of catheter ablation techniques in this complex and challenging patient population...
March 24, 2024: Journal of Clinical Medicine
Jae-Hong Park, Dong-Hyun Yang, Ji-Hyun Kim, Yoo-Ri Kim
Background: Current guidelines consider atrial fibrillation (AF) type as the prognostic factor for a recommendation of catheter ablation. We aimed to determine whether LA and LA appendage (LAA) volumes measured using multislice computed tomography (MSCT) were related to long-term outcomes in AF following radiofrequency catheter ablation (RFCA). Methods: We evaluated 152 consecutive patients with drug-refractory AF (median age, 55.8 ± 9.6 years), including 110 male patients, who underwent RFCA in a single center...
March 23, 2024: Journal of Clinical Medicine
Łukasz Zarębski, Piotr Futyma, Yashvi Sethia, Marian Futyma, Piotr Kułakowski
In patients with atrial fibrillation (AF) recurrences after pulmonary vein isolation (PVI), concomitant treatment using anti arrhythmic drugs (AADs) can lead to clinical success. However, patients with atrioventricular (AV) block may not be good candidates for concomitant AAD therapy due to the risk of further worsening of conduction abnormalities. Cardioneuroablation (CNA), as an adjunct to PVI, may offer a solution to this problem. We present a case of a 74-year-old male with paroxysmal AF and first degree AV block in whom CNA following PVI led to PR normalization...
March 27, 2024: Healthcare (Basel, Switzerland)
Zhuoya Zhang, Jiale Zhang, Haoyang Jiao, Wei Tian, Xu Zhai
BACKGROUND AND AIM: Previous observational investigations have indicated a potential association between relative dietary macronutrient intakes and atrial fibrillation and flutter (AF) risk. In this study, we employed Mendelian Randomization (MR) to evaluate the presence of causality and to elucidate the specific causal relationship. METHODS: We employed six, five, and three single nucleotide polymorphisms (SNPs) as instrumental variables for relative carbohydrate, protein, and fat intake, identified from a genome-wide association study that included 268,922 individuals of European descent...
April 12, 2024: European Journal of Medical Research
Elisa Perez-Bernat, M ª Angeles Viñas, Manel Vera, Miguel González-Rico, Marco Montomoli, Elena Astudillo-Cortés, Juan Carlos Quevedo-Reina, Isabel García-Méndez, Adoración Martinez-Losa, Ines Rama-Arias, María Maldonado-Martín, M ª Antonia Munar, Agustín Ortega Cerrato, Sandra Beltrán-Catalán, Gloria Del Peso, Aleix Cases, Jose Luis Górriz
Atrial fibrillation is the most frequent chronic arrhythmia in patients with chronic kidney disease. Oral anticoagulation with vitamin K antagonists and now direct oral anticoagulants have been and are the fundamental pillars for the prevention of thromboembolic events. However, there are no randomized clinical trials on the risk-benefit profile of oral anticoagulation in patients with chronic kidney disease stage 5 on peritoneal dialysis and there is little evidence in the literature in this population. The objective of our study was to know the prevalence, treatment and professionals involved in the management of atrial fibrillation in peritoneal dialysis patients...
April 11, 2024: Nefrología
Stylianos Tzeis, Edward P Gerstenfeld, Jonathan Kalman, Eduardo Saad, Alireza Sepehri Shamloo, Jason G Andrade, Chirag R Barbhaiya, Tina Baykaner, Serge Boveda, Hugh Calkins, Ngai-Yin Chan, Minglong Chen, Shih-Ann Chen, Nikolaos Dagres, Ralph J Damiano, Tom De Potter, Isabel Deisenhofer, Nicolas Derval, Luigi Di Biase, Mattias Duytschaever, Katia Dyrda, Gerhard Hindricks, Meleze Hocini, Young-Hoon Kim, Mark la Meir, Jose Luis Merino, Gregory F Michaud, Andrea Natale, Isabelle Nault, Santiago Nava, Takashi Nitta, Mark O'Neill, Hui-Nam Pak, Jonathan P Piccini, Helmut Pürerfellner, Tobias Reichlin, Luis Carlos Saenz, Prashanthan Sanders, Richard Schilling, Boris Schmidt, Gregory E Supple, Kevin L Thomas, Claudio Tondo, Atul Verma, Elaine Y Wan
In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017...
April 13, 2024: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Felix K Wegner, Lars Eckardt
Availability of devices capable of continuous rhythm monitoring such as smartwatches, implantable loop recorders, or pacemakers/defibrillators is continuously increasing. Importantly, device detected "subclinical" atrial fibrillation seems to convey a significantly lower risk of thromboembolism than "clinical" atrial fibrillation verified by a conventional ECG recording. While current guidelines indicate a possible role of oral anticoagulation in selected high-risk patients with subclinical AF, recent trials show an ambiguous risk/benefit relationship of anticoagulation in this setting...
April 9, 2024: Trends in Cardiovascular Medicine
Denis Qeska, Feng Qiu, Ragavie Manoragavan, Harindra C Wijeysundera, Christopher C Cheung
BACKGROUND: Rhythm control is a cornerstone of atrial fibrillation (AF) management. Shorter time between diagnosis of AF and receipt of catheter ablation is associated with greater rates of therapy success. Prior work considered diagnosis-to-ablation time as a binary or categorical variable and did not consider the unique risk profile of patients once a referral for ablation is made. OBJECTIVES: Comprehensively assess the impact of diagnosis-to-ablation and referral-to-ablation time on post-procedural outcomes at a population level...
April 10, 2024: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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