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Current Research in Diagnosis and Management of Atrial Fibrillation
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Current Research in Diagnosis and Management of Atrial Fibrillation

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 3503

Special Issue Editor

Prof. Dr. Boyoung Joung

E-Mail Website
Guest Editor
Cardiology, Department of Internal Medicine, Yonsei University, Seoul 03722, Republic of Korea
Interests: atrial fibrillation; big data; ventricular tachycardia; bradycardia; optical mapping

Special Issue Information

Dear Colleagues,

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. AF increases the risk of mortality and morbidity resulting from stroke and congestive heart failure, and leads to an impaired quality of life, explaining its enormous socioeconomic and healthcare implications. Existing and emerging mobile technologies have been used to successfully identify AF in a variety of clinical and community settings, and these technologies offer great promise for revolutionizing AF detection and screening. Clinical evidence is mounting in support of the early application of rhythm-control therapies in patients with AF that has not become longstanding. As a result of technological advancements, transcatheter ablation has become the most effective currently available control strategy for arrhythmia. Single-shot pulmonary vein isolation modalities, mostly in the form of cryoballoons, are increasingly being used across the globe. Cryoablation is at least equal to conventional radiofrequency ablation, and can prevent the progression of AF. Furthermore, other forms of balloon technology, including laser or radiofrequency, have been proven to effectively isolate pulmonary veins. The most promising new technology is pulsed field ablation. This approach could be proved as a uniquely safe modality for AF ablation, limiting collateral tissue damage, because cardiomyocytes present the lowest threshold to pulsed electric fields. Cardiac imaging has substantially improved the efficacy and safety of atrial fibrillation ablation. The aim of this Special Issue is to provide new insights into the diagnosis and management of AF, with particular emphasis on AF screening, early diagnosis, ablation, and stroke prophylaxis.

Prof. Dr. Boyoung Joung
Guest Editor

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
  • early diagnosis
  • wearable device
  • screening
  • stroke
  • rate control
  • rhythm control
  • ablation
  • pulsed field ablation
  • cryoballoon
  • balloon catheter

Published Papers (3 papers)

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Research

12 pages, 269 KiB  
Article
Safety and Efficacy of Uninterrupted Oral Anticoagulation in Patients Undergoing Catheter Ablation for Atrial Fibrillation with Different Techniques
by Marco Schiavone, Alessio Gasperetti, Annalisa Filtz, Gaia Vantaggiato, Cecilia Gobbi, Claudio Tondo and Giovanni Battista Forleo
J. Clin. Med. 2023, 12(20), 6533; https://doi.org/10.3390/jcm12206533 - 15 Oct 2023
Viewed by 936
Abstract
Background. The safety and efficacy of an uninterrupted direct anticoagulation (DOAC) strategy during catheter ablation (CA) for atrial fibrillation (AF) has not been fully investigated with different ablation techniques. Methods. We evaluated consecutive AF patients undergoing catheter ablation with three different techniques. All [...] Read more.
Background. The safety and efficacy of an uninterrupted direct anticoagulation (DOAC) strategy during catheter ablation (CA) for atrial fibrillation (AF) has not been fully investigated with different ablation techniques. Methods. We evaluated consecutive AF patients undergoing catheter ablation with three different techniques. All patients were managed with an uninterrupted DOAC strategy. The primary endpoint was the rate of periprocedural thromboembolic and bleeding events. The secondary endpoints of the study were the rate of MACE and bleeding events at one-year follow-up. Results. In total, 162 patients were enrolled. Overall, 53 were female and the median age was 60 [55.5–69.5] years. The median CHA2DS2-VASc and HAS-BLED scores were 2 [1–4] and 2 [1–2], respectively. In total, 16 patients had a past stroke or TIA while 11 had a predisposition or a history of bleeding. The CA procedure was performed with different techniques: RF 43%, cryoballoon 37%, or laser–balloon 20%. Overall, 35.8% were on rivaroxaban, 20.4% were on edoxaban, 6.8% were on apixaban, and 3.7% were on dabigatran. All other patients were all naïve to DOACs; the first anticoagulant dose was given before the ablation procedure. As for periprocedural complications, we found three groin hematomas not requiring interventions, one ischemic stroke, and one systemic air embolism (the last two likely due to several catheter changes through the transeptal sheath). Five patients reached the secondary endpoints: one patient for a myocardial infarction while four patients experienced minor bleeding during 1-year follow-up. Conclusions. Our results corroborate the safety and the efficacy of uninterrupted DOAC strategy in patients undergoing CA for AF, regardless of the ablation technique. Full article
(This article belongs to the Special Issue Current Research in Diagnosis and Management of Atrial Fibrillation)
8 pages, 247 KiB  
Article
Prevalence and Factors Associated with Atrial Fibrillation in Patients with Transient Ischemic Attack or Ischemic Stroke in Northern Vietnam
by Phan Dinh Phong, Bui Nguyen Tung, Pham Manh Hung, Nguyen Ngoc Quang, Nguyen Thi Thu Hoai, Nguyen Viet Dung, Thanh N. Nguyen, Dao Viet Phuong and Mai Duy Ton
J. Clin. Med. 2023, 12(17), 5516; https://doi.org/10.3390/jcm12175516 - 25 Aug 2023
Viewed by 989
Abstract
Background: The prevalence and risk factors of atrial fibrillation (AF) in patients with transient ischemic attack (TIA) or ischemic stroke in Northern Vietnam are not well understood. This study aimed to estimate the prevalence and identify factors associated with AF in this population. [...] Read more.
Background: The prevalence and risk factors of atrial fibrillation (AF) in patients with transient ischemic attack (TIA) or ischemic stroke in Northern Vietnam are not well understood. This study aimed to estimate the prevalence and identify factors associated with AF in this population. Methods: A cross-sectional study was conducted on 2038 consecutive patients with TIA or ischemic stroke admitted to Bach Mai Hospital. AF was diagnosed using an electrocardiogram or Holter monitor. Logistic regression analyses were performed to determine the association between AF and risk factors. Results: Among the patients, 18.1% (95% CI: 16.46 to 19.85) had AF. Older age, renal dysfunction, valvular heart disease (VHD), and low ejection fraction were significantly associated with AF. Advanced age (per 10 years) (adjusted OR, aOR 1.39; 95% CI, 1.23 to 1.57), estimated glomerular filtration ratio decrease (per 10 mL/min/1.73 m2) (aOR 1.12; 95% CI, 1.06 to 1.17), VHD (aOR 9.59; 95% CI, 7.10 to 12.95), and low ejection fraction (<50%) (aOR 2.61; 95% CI, 1.62 to 4.21) had notable odds ratios for AF. Conclusions: Atrial fibrillation is prevalent among patients with TIA or ischemic stroke in Northern Vietnam, surpassing rates in other Southeast Asian countries. Age, renal dysfunction, VHD, and low ejection fraction were significant risk factors for AF in this population. Full article
(This article belongs to the Special Issue Current Research in Diagnosis and Management of Atrial Fibrillation)
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13 pages, 909 KiB  
Article
Rhythm Control and Cardiovascular or Cerebrovascular Outcomes in Patients with Atrial Fibrillation: A Study of the CODE-AF Registry
by Ho-Gi Chung, Junbeom Park, Jin-Kyu Park, Ki-Woon Kang, Jaemin Shim, Jin-Bae Kim, Jun Kim, Eue-Keun Choi, Hyung Wook Park, Young Soo Lee and Boyoung Joung
J. Clin. Med. 2023, 12(14), 4579; https://doi.org/10.3390/jcm12144579 - 10 Jul 2023
Viewed by 1213
Abstract
Background: It is not clear whether the data regarding rhythm control during atrial fibrillation (AF) contained in AF registries is prognostically significant. Thus, this study investigated the relationship between rhythm control and cardiovascular outcomes in patients in contemporary AF registries. Methods: This study [...] Read more.
Background: It is not clear whether the data regarding rhythm control during atrial fibrillation (AF) contained in AF registries is prognostically significant. Thus, this study investigated the relationship between rhythm control and cardiovascular outcomes in patients in contemporary AF registries. Methods: This study was conducted using data from 6670 patients with AF receiving oral anticoagulation in the CODE-AF registry. We used propensity overlap weighting to account for differences in baseline characteristics between the rhythm control and rate control groups. The primary outcome was a composite of the rate of death due to cardiovascular causes, stroke, acute coronary syndrome, and heart failure. The secondary outcomes were individual components of the primary outcome. Results: In the CODE-AF registry, 5407 (81.1%) patients were enrolled three months after AF diagnosis. During a median follow-up period of 973 days (interquartile range: 755–1089 days), a primary outcome event occurred in 72 patients in the rhythm control group (1.4 events per 100 person-years) and in 211 patients in the rate control group (1.8 events per 100 person-years). However, after overlap weighting, the incidence rates were 1.4 and 1.5 events per 100 person-years, respectively. No significant difference was found in either the primary outcome (weighted HR: 0.87; 95% CI: 0.66–1.17; p = 0.363) or secondary outcomes between the rhythm control and rate control groups. Conclusion: In a prospective AF registry in which most of the population was enrolled at least three months after AF diagnosis, no difference in the risk of cardiovascular or cerebrovascular outcomes was found between the rhythm control and rate control groups, suggesting the early rhythm control should be considered to improve the outcome of patients. Full article
(This article belongs to the Special Issue Current Research in Diagnosis and Management of Atrial Fibrillation)
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