Addressing the Atrial Fibrillation Epidemic: New Insights and Approaches to Prevention and Therapy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 June 2024 | Viewed by 1106

Special Issue Editors


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Guest Editor
Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, Von-Guttenberg-Straße 11, 97616 Bad Neustadt an der Saale, Germany
Interests: electrophysiology; atrial fibrillation; ventricular tachycardia; ablation

E-Mail Website
Guest Editor
Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, Von-Guttenberg-Straße 11, 97616 Bad Neustadt an der Saale, Germany
Interests: atrial fibrillation; zero fluoroscopy; ablation; ventricular tachycardia

Special Issue Information

Dear Colleagues,

Atrial fibrillation (AF) is the most common arrhythmia wordwide and its prevalence is dramatically increasing. Despite technological advantages and upcoming new ablation strategies, ablation rates are still suboptimal. Several non-invasive measures and prevention are required to increase AF therapy success.

The aim of this Special Issue is to provide a comprehensive summery of possible approaches for arrhythmia prevention and non-invasive (pharmalogical)/interventional techniques for AF therapies. Colleagues and researchers working in the field of prevention and clinical electrophysiology are welcome to submit original articles or reviews to this Special Issue. 

Dr. Julian Müller
Dr. Heiko Lehrmann
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • cardiac arrhytmias
  • catheter ablation
  • new technologies
  • prevention
  • atrial fibrillation

Published Papers (1 paper)

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Research

14 pages, 2015 KiB  
Article
Recurrent Atrial Fibrillation Ablation after Initial Successful Pulmonary Vein Isolation
by Julian Müller, Karin Nentwich, Artur Berkovitz, Kai Sonne, Olena Kozlova, Sebastian Barth, Alexandru Deacanu, Christian Waechter, Philipp Halbfass, Heiko Lehrmann and Thomas Deneke
J. Clin. Med. 2023, 12(22), 7177; https://doi.org/10.3390/jcm12227177 - 19 Nov 2023
Viewed by 879
Abstract
Background: Pulmonary vein isolation (PVI) is an effective treatment option for patients with symptomatic atrial fibrillation (AF). However, the electrical recovery of pulmonary veins (PVs) is the main trigger for AF recurrences. This study investigates the characteristics of patients admitted for redo AF [...] Read more.
Background: Pulmonary vein isolation (PVI) is an effective treatment option for patients with symptomatic atrial fibrillation (AF). However, the electrical recovery of pulmonary veins (PVs) is the main trigger for AF recurrences. This study investigates the characteristics of patients admitted for redo AF ablation, the PV reconnection rates depending on previous ablation modalities and the impact of different ablation strategies for redo procedures. Methods: Consecutive patients undergoing first redo AF ablation were included. Patients were grouped according to the electrical recovery of at least one PV. The impacts of the technique for first AF ablation on PV reconnection rates and patients with and without PV reconnection were compared. Different ablation strategies for redo procedures were compared and its recurrence rates after a mean follow-up of 25 ± 20 months were investigated. Results: A total of 389 patients (68 ± 10 years; 57% male; 39% paroxysmal AF) underwent a first redo. The median time between the first and redo procedure was 40 ± 39 months. Radiofrequency was used in 278 patients, cryoballoon was used in 85 patients and surgical AF ablation was performed on 26 patients. In total, 325 patients (84%) had at least one PV reconnected, and the mean number of reconnected PVs was 2.0 ± 1.3, with significant differences between ablation approaches (p for all = 0.002); this was mainly due to differences in the left inferior PV and right superior PV reconnections. The presence of PV reconnection during redo was not associated with better long-term success compared to completely isolated PVs (67% vs. 67%; log-rank p = 0.997). Overall, the different ablation strategies for redos were comparable regarding AF recurrences during follow-up (p = 0.079), with the ablation approach having no impact in the case of left atrial low voltage or without. Conclusions: PV reconnections after initial successful PVI are common among all techniques of AF ablation. Long-term rhythm control off antiarrhythmic drugs was possible in 2/3 of all patients after the redo procedure; however, different ablation strategies with extra-PV trigger ablation did not improve long-term success. Patients with recurrent AF after PVI constitute a challenging group of patients. Full article
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