Atrial Fibrillation: Therapeutic Strategies and Challenges

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

Deadline for manuscript submissions: 15 October 2024 | Viewed by 961

Special Issue Editors


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Guest Editor
Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
Interests: sleep apnea and cardiovascular disease; general clinical cardiology; cardiovascular hemodynamics; critical care cardiology; medical education

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Guest Editor
Cleveland Clinic Heart and Vascular Institute, Cleveland, OH, USA
Interests: cardiac electrophysiology; atrial fibrillation; catheter-based management of cardiac arrhythmia; cardiac device therapies; clinical research

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Guest Editor
Tulane Research Innovation for Arrhythmia Discovery (TRIAD), Tulane University School of Medicine, New Orleans, LA, USA
Interests: cardiac electrophysiology; drivers of atrial fibrillation risk; catheter-based management of cardiac arrhythmia; cardiac device therapies; clinical research

Special Issue Information

Dear Colleagues,

Atrial fibrillation is the most common rhythm disorder affecting men and women. Atrial fibrillation independently increases mortality risk, and its presence is associated with a heightened risk for stroke, a higher likelihood of the worsening of other cardiovascular conditions, and a reduced quality of life. The presence of clinical and current disease is also a unique and not uncommon issue with atrial fibrillation. Globally, both the incidence and prevalence of atrial fibrillation are increasing, making this diagnosis increasingly relevant to medical practitioners worldwide. 

Clinical trials of patients with atrial fibrillation randomized to receive a rhythm control versus rate control strategy with equivalent stroke prevention have established the paradigm that aggressive rhythm control confers no significant survival benefit; however, the past decade has seen a rapid growth in our understanding of the electrophysiology of atrial fibrillation as well as the emergence of greater options for the pharmacologic and catheter-based treatment of this arrhythmia. Not surprisingly, more contemporary reviews of the clinical management of atrial fibrillation have challenged the paradigm that early rhythm control is not superior to rate control in subjects with atrial fibrillation.

The aim of this Special Issue of the Journal of Clinical Medicine is to provide the reader with a comprehensive and up-to-date overview of atrial fibrillation, including current thinking regarding its pathogenesis, novel contributors to clinical risk, contemporary approaches to diagnosis, and state-of-the-art pharmacotherapy as well as catheter-based management. We hope to provide the reader with the most current understanding of this common rhythm disorder to equip them with the knowledge to better understand current management options to appreciate the science behind current society-based management guidelines.

In this Special Issue, we invite basic science and clinical researchers to submit high-quality original manuscripts providing current insights into the prevalence, pathophysiology, diagnosis, prevention, and treatment of atrial fibrillation. 

Dr. Michael D. Faulx
Dr. John Rickard
Dr. Eoin Donnellan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • atrial fibrillation
  • epidemiology
  • pathogenesis
  • catheter-based therapies
  • anti-arrhythmic therapy
  • stroke prevention

Published Papers (1 paper)

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Research

12 pages, 1734 KiB  
Article
Left Atrium Volume Measured with Multislice Computed Tomography as a Prognostic Predictor for Atrial Fibrillation Catheter Ablation Outcomes
by Jae-Hong Park, Dong-Hyun Yang, Ji-Hyun Kim and Yoo-Ri Kim
J. Clin. Med. 2024, 13(7), 1859; https://doi.org/10.3390/jcm13071859 - 23 Mar 2024
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Abstract
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 [...] Read more.
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. All patients underwent MSCT imaging for anatomical assessment. The endpoint of this study was documented AF recurrence after RFCA. Results: The overall procedure success rate was 77.6% (n = 118) during a mean follow-up period of 12.6 months. The LA volume was significantly larger for those who experienced AF recurrence after RFCA than for the patients without recurrent AF after the procedure (153.8 ± 29.9 mL vs. 139.2 ± 34.1 mL, p = 0.025). However, LAA volumes were nearly equivalent between the patients with and without AF recurrence after RFCA (16.2 ± 6.3 mL and 14.7 ± 6.5 mL, respectively; p = 0.235). LA volume ≥ 153.2 mL was the optimal cutoff value for estimating AF recurrence after RFCA, with 94% sensitivity and 66% specificity. LA volume remained an independent predictor of both AF recurrence and permanent AF. Conclusions: LA volume as assessed by MSCT might be helpful for identifying patients likely to achieve successful AF ablation. LA volume ≥ 153.2 mL, but not LAA volume, showed good accuracy in predicting AF recurrence after RFCA. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Therapeutic Strategies and Challenges)
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