Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
Atrial Fibrillation: Clinical Updates and Perspectives
share announcement

Atrial Fibrillation: Clinical Updates and Perspectives

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

Deadline for manuscript submissions: closed (15 August 2023) | Viewed by 6659

Special Issue Editors

Dr. Michele Magnocavallo

E-Mail
Guest Editor
Cardiology Division, Arrhythmology Unit, S. Giovanni Calibita Hospital, Isola Tiberina, 00186 Rome, Italy
Interests: atrial fibrillation; catheter ablation; PFA; paroxysmal atrial fibrillation; persistent atrial fibrillation; stroke prevention; left atrial appendage occlusion; cryoablation; one-shot ablation; neuromodulation
Special Issues, Collections and Topics in MDPI journals
Dr. Stefano Bianchi

E-Mail
Guest Editor
Arrhythmology Unit, Fatebenefratelli Isola Tiberina–Gemelli Isola, 00186 Rome, Italy
Interests: atrial fibrillation; catheter ablation; PFA; paroxysmal atrial fibrillation; persistent atrial fibrillation; stroke prevention; left atrial appendage occlusion; cryoablation; one-shot ablation; neuromodulation
Special Issues, Collections and Topics in MDPI journals
Dr. Filippo Maria Cauti

E-Mail Website
Guest Editor
Cardiology Division, Arrhythmology Unit, S. Giovanni Calibita Hospital, Isola Tiberina, 00186 Rome, Italy
Interests: atrial fibrillation; catheter ablation; PFA; paroxysmal atrial fibrillation; persistent atrial fibrillation; stroke prevention; left atrial appendage occlusion; cryoablation; one-shot ablation; neuromodulation
Dr. Pietro Rossi

E-Mail
Guest Editor
Arrhythmology Unit, Fatebenefratelli Isola Tiberina–Gemelli Isola, 00186 Rome, Italy
Interests: atrial fibrillation; catheter ablation; PFA; paroxysmal atrial fibrillation; persistent atrial fibrillation; stroke prevention; left atrial appendage occlusion; cryoablation; one-shot ablation; neuromodulation
Special Issues, Collections and Topics in MDPI journals
Dr. Domenico G. Della Rocca

E-Mail Website
Guest Editor
Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, 1090 Brussels, Belgium
Interests: atrial fibrillation; catheter ablation; PFA; paroxysmal atrial fibrillation; persistent atrial fibrillation; stroke prevention; left atrial appendage occlusion; cryoablation; one-shot ablation; neuromodulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Atrial fibrillation is the most common sustained arrhythmia in adults, with an estimated prevalence ranging between 2% and 4%. Atrial fibrillation is responsible for 20%–30% of all ischemic strokes and significantly increases the risk of heart failure as well as dementia. Moreover, this arrhythmia has a significant impact on quality of life and functional status.

Atrial fibrillation poses a considerable burden for healthcare systems, requiring a multidisciplinary approach for early detection, effective pharmacological and/or interventional treatments, and complication prevention.

In recent years, multiple efforts have been devoted to obtaining an effective rhythm control strategy and stroke prophylaxis. Transcatheter ablation has become the most effective arrhythmia control strategy currently available. Specifically, the adoption of novel nonthermal energy sources for cardiac tissue ablation has substantially improved the safety and efficacy of this approach. Similarly, new devices with which to exclude the left atrial appendage from systemic circulation have proven noninferior in preventing thromboembolic events compared to oral anticoagulation in high-risk patients. Researchers in this field are encouraged to submit an original research or review article to this Special Issue that can provide useful insights into the clinical updates and perspectives directed to the management of atrial fibrillation, with a particular emphasis on catheter ablation and stroke prophylaxis.

Dr. Michele Magnocavallo
Dr. Stefano Bianchi
Dr. Filippo Maria Cauti
Dr. Pietro Rossi 
Dr. Domenico G. Della Rocca
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
  • catheter ablation
  • PFA
  • paroxysmal atrial fibrillation
  • persistent atrial fibrillation
  • stroke prevention
  • left atrial appendage occlusion
  • cryoablation
  • one-shot ablation
  • neuromodulation

Related Special Issue

Published Papers (5 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

12 pages, 1385 KiB  
Article
Reduced-Dose Rivaroxaban Is Associated with Lower All-Cause Mortality in Older Patients with Nonvalvular Atrial Fibrillation
by Wei-Ru Chiou, Min-I Su, Ying-Hsiang Lee, Po-Lin Lin and Cheng-Wei Liu
J. Clin. Med. 2023, 12(20), 6686; https://doi.org/10.3390/jcm12206686 - 23 Oct 2023
Cited by 1 | Viewed by 1519
Abstract
Background: Reduced-dose rivaroxaban (10 mg) was used in the J-ROCKET AF trial, demonstrating safety in the Asian population. It remains unclear whether treatment with reduced-dose versus full-dose rivaroxaban (20 mg/15 mg) is associated with all-cause mortality in older patients with nonvalvular atrial fibrillation. [...] Read more.
Background: Reduced-dose rivaroxaban (10 mg) was used in the J-ROCKET AF trial, demonstrating safety in the Asian population. It remains unclear whether treatment with reduced-dose versus full-dose rivaroxaban (20 mg/15 mg) is associated with all-cause mortality in older patients with nonvalvular atrial fibrillation. Proposed: To evaluate the effects of reduced-dose rivaroxaban on all-cause mortality in patients over 85. Methods: We retrospectively enrolled medical records representing the period from October 2012 to November 2016. The 2 × 2 factorial design incorporated age (≥85 vs. <85) and rivaroxaban use (reduced vs. full dose). The primary study outcomes were all-cause and cardiac-related mortality. Results: The study enrolled 2386 patients with a mean age of 76.6 ± 10.4 years; 51.8% were male. In the ≥85 group (n = 593), the reduced-dose subgroup had lower all-cause (5.3% vs. 10.6%, p = 0.02) and cardiac-related mortality (1.9% vs. 5.1%, p = 0.04), whereas the younger patients receiving reduced-dose rivaroxaban had higher all-cause mortality (3.7% vs. 1.8%, p = 0.01) but no difference in cardiac-related mortality (1.2% vs. 0.7%, p = 0.33). The rate of hospitalization for heart failure was significantly lower in the elderly group with reduced-dose rivaroxaban (7.2% vs. 15.7%, p < 0.01) but not in the younger group. After adjusting for confounders in the older group, treatment with reduced-dose rivaroxaban was associated with lower risk of all-cause mortality (adjusted HR (aHR): 0.40, 95% CI: 0.21–0.74, p < 0.01) and hospitalization for heart failure (aHR: 0.54, 95% CI: 0.29–0.99, p = 0.05). No associations were found between rivaroxaban dose and cardiac-related mortality in either group, nor between younger age and any outcome. Conclusions: Reduced-dose rivaroxaban was associated with lower risks of all-cause mortality and hospitalization for heart failure in older patients with nonvalvular atrial fibrillation. Future studies can investigate the effect of reduced-dose rivaroxaban on prognoses in elderly individuals ≥85 years in the west. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Updates and Perspectives)
►▼ Show Figures

Graphical abstract

10 pages, 497 KiB  
Article
Inflammatory Markers as Predictors of Atrial Fibrillation Recurrence: Exploring the C-Reactive Protein to Albumin Ratio in Cryoablation Patients
by Eyup Ozkan, Deniz Elcik, Suleyman Barutcu, Saban Kelesoglu, Murat Erdem Alp, Ramazan Ozan, Gazi Capar, Omer Turkmen, Goksel Cinier, Veli Polat, Mehmet Tugrul Inanc, Alper Kepez and Taylan Akgun
J. Clin. Med. 2023, 12(19), 6313; https://doi.org/10.3390/jcm12196313 - 30 Sep 2023
Cited by 1 | Viewed by 904
Abstract
BACKGROUND: Atrial fibrillation (AF) is a common cardiac rhythm disorder associated with hemodynamic disruptions and thromboembolic events. While antiarrhythmic drugs are often recommended as the initial treatment, catheter ablation has emerged as a viable alternative. However, the recurrence of AF following ablation remains [...] Read more.
BACKGROUND: Atrial fibrillation (AF) is a common cardiac rhythm disorder associated with hemodynamic disruptions and thromboembolic events. While antiarrhythmic drugs are often recommended as the initial treatment, catheter ablation has emerged as a viable alternative. However, the recurrence of AF following ablation remains a challenge, and there is growing interest in exploring inflammatory markers as predictors of recurrence. METHODS: This retrospective, cross-sectional analysis included 249 patients who underwent cryoablation for paroxysmal AF. The relationship between the ‘C-reactive protein (CRP) to albumin ratio (CAR)’ and AF recurrence was examined. RESULTS: Two hundred and forty-nine patients with paroxysmal non-valvular atrial fibrillation were included. They were divided into two groups: those without recurrence (Group 1) and those with recurrence (Group 2). Significant differences were observed in age (57.2 ± 9.9 vs. 62.5 ± 8.4, p = 0.001) and left atrial size (4.0 ± 0.5 vs. 4.2 ± 0.7, p = 0.001) between the two groups. In blood parameters, significant differences were found in CRP (5.2 ± 1.3 vs. 9.4 ± 2.8, p < 0.001) and neutrophil counts (5.1 ± 2.2 vs. 6.7 ± 3.6, p = 0.001). In univariate regression analysis, age (OR: 1.058, CI: 1.024–1.093, p = 0.001), WBC count (OR: 1.201, CI: 1.092–1.322, p < 0.001), neutrophil count (OR: 1.239, CI: 1.114–1.378, p = 0.001), CAR (OR: 1.409, CI: 1.183–1.678, p < 0.001), and left atrial diameter (OR: 0.968, CI: 0.948–0.989, p = 0.002) showed significant associations with AF recurrence. CONCLUSIONS: Inflammation plays a crucial role in the initiation and progression of AF. This study demonstrated that along with age, the CAR can serve as an independent predictor of AF recurrence following cryoablation. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

15 pages, 635 KiB  
Article
Therapeutic Drug Monitoring of Direct Oral Anticoagulants in Patients with Extremely Low and High Body Weight—Pilot Study
by Łukasz Wołowiec, Mateusz Kusiak, Jacek Budzyński, Anna Wołowiec, Albert Jaśniak, Michał Wiciński, Agnieszka Pedrycz-Wieczorska, Daniel Rogowicz and Grzegorz Grześk
J. Clin. Med. 2023, 12(15), 4969; https://doi.org/10.3390/jcm12154969 - 28 Jul 2023
Cited by 2 | Viewed by 1387
Abstract
Phase III clinical trials for individual direct oral anticoagulants (DOACs) contained a limited representation of subjects with abnormal body weight, which were mostly limited to a BMI > 40 kg/m2, or body weight > 120 kg for obese subjects, and <50 [...] Read more.
Phase III clinical trials for individual direct oral anticoagulants (DOACs) contained a limited representation of subjects with abnormal body weight, which were mostly limited to a BMI > 40 kg/m2, or body weight > 120 kg for obese subjects, and <50 kg for underweight subjects. Although low or high body weight is not a contraindication to DOACs therapy, it can significantly affect the safety and effectiveness of treatment. Due to the limited amount of clinical data on the use of DOACs in extremely abnormal weight ranges, optimal pharmacotherapy in this group of patients is a matter of controversy. The objective of this study was to evaluate the pharmacokinetics of DOAC properties in patients with abnormal body weight beyond the established cut-off points in the phase III studies for rivaroxaban, apixaban, and dabigatran. In total, 38 patients took DOACs for at least 12 months for non-valvular atrial fibrillation in 2019–2021. Blood samples were collected before the planned intake of the drug and 4 h after its administration. The determined concentrations of DOACs were statistically analyzed in relation to body weight, age, and eGFR (estimated Glomerular Filtration Rate). Among subjects taking apixaban, rivaroxaban, and dabigatran, the smallest representation of patients who achieved therapeutic concentrations were those treated with dabigatran. The population of people with abnormal body weight is a potential risk group of patients, in which some of them do not reach the therapeutic range of DOACs. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Updates and Perspectives)
►▼ Show Figures

Figure 1

10 pages, 938 KiB  
Article
Value of Left Atrial Strain in Predicting Recurrence after Atrial Fibrillation Ablation
by Marek Kiliszek, Beata Uziębło-Życzkowska, Krystian Krzyżanowski, Agnieszka Jurek, Robert Wierzbowski, Magdalena Smalc-Stasiak and Paweł Krzesiński
J. Clin. Med. 2023, 12(12), 4034; https://doi.org/10.3390/jcm12124034 - 13 Jun 2023
Cited by 4 | Viewed by 995
Abstract
This study tested the relationship between left atrial (LA) function parameters and the results of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Consecutive patients undergoing PVI for the first time between 2019 and 2021 were included. Patients underwent radiofrequency ablation [...] Read more.
This study tested the relationship between left atrial (LA) function parameters and the results of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Consecutive patients undergoing PVI for the first time between 2019 and 2021 were included. Patients underwent radiofrequency ablation using contact force catheters and an electroanatomical system. Follow-up consisted of ambulatory visits/televisits and 7-day Holter monitoring (at 6 and 12 months after ablation). On the day of ablation, all patients underwent transesophageal and transthoracic echocardiography with LA strain analysis. The primary endpoint was atrial tachyarrhythmia recurrence during the follow-up period. Of 221 patients, 22 did not meet the echocardiographic quality criteria, leaving 199 patients. The median follow-up period was 12 months, and 12 patients were lost to follow-up. Recurrences were observed in 67 patients (35.8%) after a mean of 1.06 procedures per patient. The patients were divided into a sinus rhythm (SR, n = 109) group and an AF (n = 90) group based on their cardiac rhythm at the time of echocardiography. In the SR group, univariable analysis showed that LA reservoir strain, LA appendage emptying velocity (LAAV), and LA volume index predicted AF recurrence, with only LAAV being significant in the multivariable analysis. In AF patients, univariable analysis revealed no LA strain parameters predicting AF recurrence. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Updates and Perspectives)
►▼ Show Figures

Graphical abstract

10 pages, 3082 KiB  
Article
Provocation and Localization of Arrhythmogenic Triggers from Persistent Left Superior Vena Cava in Patients with Atrial Fibrillation
by Kentaro Minami, Kohki Nakamura, Eiko Maeno, Keitaro Iida, Ikuta Saito, Taiki Masuyama, Yoshiyuki Kitagawa, Toshiaki Nakajima, Yosuke Nakatani, Shigeto Naito, Shigeru Toyoda, Milan Chovanec, Jan Petrů, Jan Škoda, Koji Kumagai and Petr Neužil
J. Clin. Med. 2023, 12(5), 1783; https://doi.org/10.3390/jcm12051783 - 23 Feb 2023
Cited by 1 | Viewed by 1244
Abstract
Background: Although pulmonary vein isolation (PVI) is an established procedure for atrial fibrillation (AF), non-PV foci play a crucial role in AF recurrence. Persistent left superior vena cava (PLSVC) has been reported as critical non-PV foci. However, the effectiveness of provocation of AF [...] Read more.
Background: Although pulmonary vein isolation (PVI) is an established procedure for atrial fibrillation (AF), non-PV foci play a crucial role in AF recurrence. Persistent left superior vena cava (PLSVC) has been reported as critical non-PV foci. However, the effectiveness of provocation of AF triggers from PLSVC remains unclear. This study was designed to validate the usefulness of provoking AF triggers from PLSVC. Methods: This multicenter retrospective study included 37 patients with AF and PLSVC. To provoke triggers, AF was cardioverted, and re-initiation of AF was monitored under high-dose isoproterenol infusion. The patients were divided into two groups: those whose PLSVC had arrhythmogenic triggers initiating AF (Group A) and those whose PLSVC did not have triggers (Group B). Group A underwent isolation of PLSVC after PVI. Group B received PVI only. Results: Group A had 14 patients, whereas Group B had 23 patients. After a 3-year follow-up, no difference in the success rate for maintaining sinus rhythm was observed between the two groups. Group A was significantly younger and had lower CHADS2-VASc scores than Group B. Conclusions: The provocation of arrhythmogenic triggers from PLSVC was effective for the ablation strategy. PLSVC electrical isolation would not be necessary if arrhythmogenic triggers are not provoked. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Updates and Perspectives)
►▼ Show Figures

Graphical abstract

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-5
Back to TopTop