Tag: Atrial fibrillation

Catheter Ablation as the First-Line Therapy for Atrial Fibrillation: Update on Evidence and Clinical Implications

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Therapy for atrial fibrillation has markedly evolved over the past two decades. Advancements in technology and growing therapeutic options have led to reexamination of the current evidence. New guidelines have also been updated and published across continents. This reappraisal of the contemporary data assesses the overall treatment strategies for patients with atrial fibrillation and examines how atrial fibrillation ablation ranks among the hierarchy of therapeutic modalities. The role of catheter ablation as a first-line therapy in selected patients with atrial fibrillation is emphasized, and a selective discussion of catheter ablation in patients with heart failure is included.

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Roles of Major Chemokines in the Pathophysiology of Atrial Fibrillation

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Chemokines are a subclass of cytokines, a large family of small secreted proteins that communicate via G protein-coupled heptahelical chemokine receptors on the cell surface. Atrial fibrillation (AF) is the most prevalent clinically relevant cardiac rhythm condition.Patients with persistent AF have higher levels of C-X-C motif chemokine ligand 8 (CXCL8) than those with paroxysmal AF, thus suggesting a link between long-lasting AF and a low-grade inflammatory response. A newly identified function of C-X-C motif chemokine receptor 2 (CXCR2) is promoting monocyte infiltration of the atria, thus accelerating atrial remodeling and AF after hypertension.

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Atrial Fibrillation and Adipokines: A Pathophysiological Perspective

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Atrial fibrillation (AF) is a prevalent cardiac arrhythmia characterized by irregular and frequently rapid electrical activity in the atria. Adipokines are bioactive molecules that are secreted by adipose tissue, and exert diverse effects on health and disease.

Obesity is a complex condition influenced by multiple interconnected factors, and the specific mechanisms linking obesity to AF may vary among individuals. Obesity contributes to the development of atrial arrhythmia. Moreover, obesity plays major roles in the pathophysiology of AF and its associated complications by inducing systemic changes, including altered hemodynamics, heightened sympathetic tone, and a persistent low-grade inflammatory state.

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Medical Economic Consequences, Predictors, and Outcomes of Immediate Atrial Fibrillation Recurrence after Radiofrequency Ablation

Atrial Fibrillation Recurrence

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Immediate recurrence (Im-Recurr), a type of atrial fibrillation (AF) recurrence occurring during the blanking period after radiofrequency catheter ablation (RFCA), has received little attention. Therefore, this study was aimed at exploring the clinical significance of Im-Recurr in patients with AF after RFCA.

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Rheumatoid Arthritis and Risk of Atrial Fibrillation: Results from Pooled Cohort Studies and Mendelian Randomization Analysis

Announcing a new article publication for Cardiovascular Innovations and Applications journal. Observational research has indicated that individuals diagnosed with rheumatoid arthritis (RA) have an elevated likelihood of developing atrial fibrillation (AF). The authors of this article performed meta-analysis and Mendelian randomization (MR) analysis to explore the correlation and potential causal relationship between RA and AF. PubMed, Embase, and Web of Science were searched for cohort studies comparing AF risk among participants with and without RA. Quantitative synthesis of the adjusted risk ratio (RR) or hazard ratio was performed with the random-effects model. RA and AF were studied with two-sample MR analysis with the random-effects inverse variance weighted method. Patients with RA had a higher risk of AF than participants without RA [RR = 1.32, 95% confidence interval (CI): 1.23–1.43, P < 0.0001]. Genetically predicted RA was not associated with a significantly elevated risk of AF (odds ratio = 1.009, 95% CI: 0.986–1.032, P = 0.449). After adjustment for confounding factors in multifactorial MR, RA and AF still showed no correlation. Sensitivity analyses yielded similar results, thus indicating the robustness of the causal association. Overall, RA was associated with elevated risk of AF in this meta-analysis. However, genetically predicted RA may not be causal.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2024.0006

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Qiyuan Song, Luxiang Shang and Yujiao Zhang et al. Rheumatoid Arthritis and Risk of Atrial Fibrillation: Results from Pooled Cohort Studies and Mendelian Randomization Analysis. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2024.0006

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Incremental Metabolic Benefits from Cryoablation for Paroxysmal Atrial Fibrillation: Insights from Metabolomic Profiling

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Cryoablation (CRYO) is a novel catheter ablation technique for atrial fibrillation (AF). However, uncertainty persists regarding the role of metabolic modifications associated with CRYO. This study was aimed at exploring whether CRYO influences the metabolic signature – a possibility not previously investigated.

Paired serum samples from patients with AF (n = 10) were collected before and 24 h after CRYO. Untargeted metabolomic analysis was conducted with LC-MS. Univariate and multivariate analyses were applied to identify differential metabolites between samples. Pathway enrichment and Pearson correlation analyses were performed to reveal the perturbed metabolic pathways and potential interactions.

Levels of 19 metabolites showed significant changes between baseline and 24 h after CRYO. Pathway analysis revealed that the perturbed metabolites were enriched in unsaturated fatty acid biosynthesis, retrograde endocannabinoid signaling, and neuroactive ligand-receptor interactions. Pearson correlation analysis indicated strong correlations among differential metabolites, biochemical markers, and clinical indicators.

CRYO induces systemic changes in the serum metabolome in patients with paroxysmal AF and provides potential metabolic benefits. These findings might enable enhanced understanding of the pathophysiology and metabolic mechanisms involved in catheter ablation.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0079

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Mengjie Xie, Fuding Guo and Jun Wang et al. Incremental Metabolic Benefits from Cryoablation for Paroxysmal Atrial Fibrillation: Insights from Metabolomic Profiling. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2023.0079

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Atrial Fibrillation Follow-up Investigation to Recover Memory and Learning Trial (AFFIRMING): Rationale and Design of a Multi-center, Double-blind, Randomized Controlled Trial

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   People with atrial fibrillation (AF) have elevated risk of developing cognitive impairment. At present, there is a dearth of randomized controlled trials investigating cognitive impairment management in patients with AF. The Atrial Fibrillation Follow-up Investigation to Recover Memory and learning (AFFIRMING) study is aimed at evaluating the potential for computerized cognitive training to improve cognitive function in patients with AF.

This study is a multi-center, double-blind, randomized controlled study using a 1:1 parallel design. A total of 200 patients with AF and mild cognitive decline without dementia are planned to be recruited. The intervention group will use the adaptive training software with changes in difficulty, whereas the positive control group will use basic training software with minimal or no variation in difficulty level. At the end of 12 weeks, the participants will be unblinded, and the positive control group will stop training. The intervention group will be rerandomized 1:1 to stop training or continue training. All participants will be followed up until 24 weeks. The primary endpoint is the proportion of the improvement of the global cognitive function at week 12 compared with baseline, using the Basic Cognitive Ability Test (BCAT).

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0080

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Zhiyan Wang, Yiqun Zhang and Chao Jiang et al. Atrial Fibrillation Follow-up Investigation to Recover Memory and Learning Trial (AFFIRMING): Rationale and Design of a Multi-center, Double-blind, Randomized Controlled Trial. CVIA. 2024. Vol. 9(1). DOI: 10.15212/CVIA.2023.0080

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Tyrosine Kinase Inhibitor Antitumor Therapy and Atrial Fibrillation: Potential Off-Target Effects on Mitochondrial Function and Cardiac Substrate Utilization

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Tyrosine kinase inhibitors (TKIs) are a novel category of antitumor agents with remarkable efficacy in extending patient survival. However, clinical use of TKIs has been hindered by the major adverse effect of atrial fibrillation (AF).

Recent studies have revealed that TKIs induce metabolic alterations and remodeling in cardiomyocytes, thus perturbing energy metabolism. Specifically, mitochondrial dysfunction and shifts in cardiac substrate utilization have been implicated in the mechanisms underlying TKI-induced AF.

This article reviews the energy metabolism-associated pathways involved in TKI-induced AF, identifies precise therapeutic targets for managing this condition, and discusses evidence that may contribute to the development of novel TKIs without cardiac adverse effects.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0070

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Yukun Li, Xiaodong Peng and Rong Lin et al. Tyrosine Kinase Inhibitor Antitumor Therapy and Atrial Fibrillation: Potential Off-Target Effects on Mitochondrial Function and Cardiac Substrate Utilization. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0070

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It’s Time to Consider Ablation as First-Line Therapy for Atrial Fibrillation

Announcing a new article publication for Cardiovascular Innovations and Applications journal.   Atrial fibrillation is the most common arrhythmia worldwide, affecting millions of the general population. It is a leading cause of stroke and is associated with many other long-term adverse cardiovascular issues. Long-term management of atrial fibrillation can involve simply controlling the ventricular rate with AV nodal blocking agents (rate control strategy) versus restoring and maintaining sinus rhythm (rhythm control strategy). For many years, pharmacologic rate control or rhythm control were both considered acceptable first-line therapeutic strategies. More recently, however, catheter ablation has emerged as a viable and potentially more effective treatment option than drug therapy, especially in patients with heart failure. Given the increasing efficacy and safety of ablation, practice is evolving toward ablation being considered first-line therapy for more patients. Indeed, both the 2014 AHA/ACC/HRS guidelines and the 2020 ESC guidelines for management of atrial fibrillation state that ablation can be considered as a first-line approach in patients with either symptomatic paroxysmal or persistent atrial fibrillation. In this article the authors discuss evidence supporting catheter ablation as first-line therapy for atrial fibrillation.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0052

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Steven Ross and William Miles. It’s Time to Consider Ablation as First-Line Therapy for Atrial Fibrillation. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0052

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Deep Learning-based Handheld Device-Enabled Symptom-driven Recording: A Pragmatic Approach for the Detection of Post-ablation Atrial Fibrillation Recurrence

Announcing a new article publication for Cardiovascular Innovations and Applications journal.  Symptom-driven electrocardiogram (ECG) recording plays a significant role in the detection of post-ablation atrial fibrillation recurrence (AFR). However, making timely medical contact whenever symptoms occur may not be practical. The authors of this article deployed a deep learning (DL)-based handheld device to facilitate symptom-driven monitoring.

A cohort of patients with paroxysmal atrial fibrillation (AF) was trained to use a DL-based handheld device to record ECG signals whenever symptoms presented after the ablation. Additionally, 24-hour Holter monitoring and 12-lead ECG were scheduled at 3, 6, 9, and 12 months post-ablation. The detection of AFR by the different modalities was explored.

A total of 22 of 67 patients experienced AFR. The handheld device and 24-hour Holter monitor detected 19 and 8 AFR events, respectively, five of which were identified by both modalities. A larger portion of ECG tracings was recorded for patients with than without AFR [362(330) vs. 132(133), P=0.01)], and substantial numbers of AFR events were recorded from 18:00 to 24:00. Compared to Holter, more AFR events were detected by the handheld device in earlier stages (HR=1.6, 95% CI 1.2–2.2, P<0.01).

The DL-based handheld device-enabled symptom-driven recording, compared with the conventional monitoring strategy, improved AFR detection and enabled more timely identification of symptomatic episodes.

https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2023.0048

CVIA is available on the ScienceOpen platform and at Cardiovascular Innovations and Applications. Submissions may be made using ScholarOne Manuscripts. There are no author submission or article processing fees. Cardiovascular Innovations and Applications is indexed in the EMBASE, EBSCO, ESCI, OCLC, Primo Central (Ex Libris), Sherpa Romeo, NISC (National Information Services Corporation), DOAJ, Index Copernicus, Research4Life and Ulrich’s web Databases. Follow CVIA on Twitter @CVIA_Journal; or Facebook.

Laite Chen and Chenyang Jiang. Deep Learning-based Handheld Device-Enabled Symptom-driven Recording: A Pragmatic Approach for the Detection of Post-ablation Atrial Fibrillation Recurrence. CVIA. 2023. Vol. 8(1). DOI: 10.15212/CVIA.2023.0048

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