Review
Cardiac & Cardiovascular Systems
Fatima M. Ezzeddine, Kolade M. Agboola, Leslie C. Hassett, Ammar M. Killu, Freddy Del-Carpio Munoz, Christopher DeSimone, Gurukripa N. Kowlgi, Abhishek J. DeSimone, Konstantinos C. Siontis
Summary: Compared to non-HCM patients, those with HCM had higher rates of recurrent atrial arrhythmias, AAD use, and need for repeat AF ablation after initial ablation of AF.
Review
Cardiac & Cardiovascular Systems
Dorottya Debreceni, Kristof Janosi, Botond Bocz, Marton Turcsan, Reka Lukacs, Tamas Simor, Bor Antolic, Mate Vamos, Andras Komocsi, Peter Kupo
Summary: This meta-analysis compared the effectiveness of zero fluoroscopy (ZF) and non-zero fluoroscopy (NZF) strategies for atrial fibrillation (AF) ablation procedures. The ZF approach significantly reduced procedure time, fluoroscopy time, and fluoroscopy dose without compromising acute and long-term success rates or complication rates.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Review
Clinical Neurology
Pengfei Chen, Zhuhong Chen, Deng Pan, Lina Miao, Yujiao Shi, Ming Guo, Jianpeng Du
Summary: Atrial fibrillation (AF) is a risk factor for cognitive dysfunction. This systematic review and meta-analysis evaluated the cognitive outcome post-catheter ablation (CA) procedure in AF patients. The results showed that AF ablation was associated with a lower risk of dementia incidence, a reduced incidence of new-onset dementia, and improvements in Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) scores.
FRONTIERS IN NEUROLOGY
(2022)
Review
Medicine, General & Internal
Ioannis Anagnostopoulos, Maria Kousta, Charalampos Kossyvakis, Nikolaos Taxiarchis Paraskevaidis, Dimitrios Vrachatis, Spyridon Deftereos, Georgios Giannopoulos
Summary: This study investigated the relationship between total and peri-left atrium (peri-LA) epicardial adipose tissue (EAT) and post-ablation atrial fibrillation (AF) recurrence. The results suggest that only peri-LA EAT may be predictive of post-ablation AF recurrence.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Stergios Intzes, Konstantinos Zagoridis, Marianthi Symeonidou, Emmanouil Spanoudakis, Arash Arya, Borislav Dinov, Nikolaos Dagres, Gerhard Hindricks, Andreas Bollmann, Emmanuel Kanoupakis, Emmanuel Koutalas, Sotirios Nedios
Summary: P-wave duration is an independent predictor for atrial fibrillation recurrence after left atrium ablation, and the risk of recurrence increases exponentially with prolonged P-wave duration. This finding can facilitate risk stratification by identifying high-risk patients and adjusting follow-up or interventions.
Review
Cardiac & Cardiovascular Systems
Pengfei Chen, Yujiao Shi, Jianqing Ju, Deng Pan, Lina Miao, Xiaolin Guo, Zhuhong Chen, Jianpeng Du
Summary: Through a systematic review and meta-analysis, we found that lower left atrial appendage flow velocity may be associated with an increased risk of atrial fibrillation recurrence after catheter ablation.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Yaqiong Zhou, Huamin Zhang, Peng Yan, Peng Zhou, Peijian Wang, Xiaoping Li
Summary: This study evaluated the efficacy of low-voltage area (LVA)-guided substrate modification catheter ablation in patients with atrial fibrillation (AF). The results showed that patients who underwent LVA-guided substrate modification ablation had a lower risk of all-atrial tachycardia recurrence compared to control ablation. Subgroup analysis indicated that this decreased risk was primarily observed in patients with non-paroxysmal AF.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Fatima Faraz, Mohammad Ebad Ur Rehman, Beenish Sabir, Areeba Ghaffar, Ahmad Iftikhar, Aimen Maqsood, Huzaifa Ahmad Cheema, Farah Yasmin, Muhammad Aamir, Muhammad Umer Ahmed, Muhammad Sohaib Asghar
Summary: Atrial fibrillation is a common arrhythmia in patients with hypertrophic cardiomyopathy. Catheter ablation has been found to be an effective therapy for atrial fibrillation in these patients. A meta-analysis of 25 studies involving 1817 patients showed that catheter ablation had a high success rate, especially for paroxysmal atrial fibrillation. Multiple procedures and antiarrhythmic drugs also increased the success rate.
CURRENT PROBLEMS IN CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Jacopo F. Imberti, Wern Yew Ding, Agnieszka Kotalczyk, Juqian Zhang, Giuseppe Boriani, Gregory Lip, Jason Andrade, Dhiraj Gupta
Summary: First-line treatment with CA is superior to AAD therapy in patients with symptomatic paroxysmal AF, as it significantly reduces the recurrence of any atrial arrhythmias and symptomatic atrial arrhythmias, and healthcare resource utilisation with comparable safety profile.
Article
Cardiac & Cardiovascular Systems
Antonio Creta, Perry Elliott, Mark J. Earley, Mehul Dhinoja, Malcolm Finlay, Simon Sporton, Anthony Chow, Ross J. Hunter, Nikolaos Papageorgiou, Martin Lowe, Saidi A. Mohiddin, Serge Boveda, Pedro Adragao, Zeynab Jebberi, Daniel Matos, Richard J. Schilling, Pier D. Lambiase, Rui Providencia
Summary: Late AF relapses post-ablation are common in HCM patients, especially in those with persistent AF. Left atrium size, LV apical aneurysm, and the APPLE score might help identify subjects at higher risk of arrhythmia recurrence. The outcome of first-time cryoballoon ablation is comparable to radiofrequency ablation.
Review
Cardiac & Cardiovascular Systems
Xinyi Peng, Xiao Liu, Hongbo Tian, Yu Chen, Xuexun Li
Summary: This study compared the characteristics and prognosis differences between hot balloon ablation (HBA) and cryoballoon ablation (CBA) in the treatment of atrial fibrillation. Results showed that patients who received HBA treatment were more likely to require touch-up ablation and had longer procedure times. However, clinical outcomes between HBA and CBA were comparable during mid-term follow-up.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Medicine, General & Internal
Emmanuel Androulakis, Catrin Sohrabi, Alexandros Briasoulis, Constantinos Bakogiannis, Bunny Saberwal, Gerasimos Siasos, Dimitris Tousoulis, Syed Ahsan, Nikolaos Papageorgiou
Summary: Catheter ablation (CA) may be beneficial in improving functional status and reducing AF recurrence in patients with HFpEF, but it also comes with risks of post-procedural complications, hospitalization, and all-cause mortality.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Zhi-Jie Mao, Yan Pei, Hui Lin, Yin Xiang, Zhou-Qing Huang, Fang-Yi Xiao, Yi-He Chen
Summary: High-power radiofrequency catheter ablation shows superior efficacy in maintaining sinus rhythm for patients with atrial fibrillation, while also reducing procedure and fluoroscopy times. Additionally, there is no significant difference in the risk of complications between high-power and conventional-power ablation techniques.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Cardiac & Cardiovascular Systems
Tiffany T. S. Ye, Qi Zhuang Siah, Benjamin Y. Q. Tan, Jamie S. Y. Ho, Nicholas L. X. Syn, Yao Hao Teo, Yao Neng Teo, James W. Yip, Tiong-Cheng Yeo, Weiqin Lin, Raymond C. C. Wong, Ping Chai, Bernard Chan, Vijay Kumar Sharma, Leonard L. L. Yeo, Ching-Hui Sia
Summary: Hypertrophic cardiomyopathy patients are at risk of acute cerebrovascular events, such as ischemic stroke, transient ischemic attack, and systemic thromboembolism. Atrial fibrillation further increases this risk. The presence of atrial fibrillation in hypertrophic cardiomyopathy patients significantly raises the risk of thromboembolic events, including ischemic stroke and transient ischemic attack.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2023)
Review
Cardiac & Cardiovascular Systems
Yujiro Yokoyama, Tomonari Shimoda, Yuichi J. Shimada, Junichi Shimamura, Keitaro Akita, Risako Yasuda, Hiroo Takayama, Toshiki Kuno
Summary: A meta-analysis compared alcohol septal ablation (ASA) and septal myectomy as septal reduction therapies for obstructive hypertrophic cardiomyopathy. The results showed similar all-cause mortality between the two treatments, but ASA was associated with less reduction of left ventricular outflow tract (LVOT) pressure gradient and a higher reoperation rate. Subgroup analysis with follow-up >= 5 years revealed higher long-term mortality with ASA.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Clinical Neurology
Sheng-Chia Chung, Rui Providencia, Reecha Sofat, Mar Pujades-Rodriguez, Ana Torralbo, Ghazaleh Fatemifar, Natalie K. Fitzpatrick, Julie Taylor, Ken Li, Caroline Dale, Martin Rossor, Dionisio Acosta-Mena, John Whittaker, Spiros Denaxas
Summary: This study analyzed longitudinal cohort data of 4.3 million individuals in the UK to examine dementia incidence and mortality. The results showed that dementia incidence was higher in individuals living in high deprivation areas. Prior to dementia diagnosis, patients experienced repeated hospitalizations and multiple primary care visits. The findings highlight the importance of addressing the disparities in dementia for prevention and patient care.
ALZHEIMERS & DEMENTIA
(2023)
Article
Cardiac & Cardiovascular Systems
Sheng-Chia Chung, Alvina Lai, Gregory Y. H. Lip, Pier D. Lambiase, Rui Providencia
Summary: Using real-world data from the UK, this study aimed to investigate the effectiveness of anti-arrhythmic drugs and catheter ablation in improving the survival of atrial fibrillation patients. The study found that patients receiving rhythm control treatment had lower mortality rates, with pulmonary vein isolation showing the most pronounced survival benefit.
Review
Cardiac & Cardiovascular Systems
Jack W. O'Sullivan, Euan A. Ashley, Perry M. Elliott
Summary: Cardiometabolic diseases have a significant impact on global health. Polygenic risk scores (PRS) are an advanced method for predicting the development and complications of these diseases. The use of PRS in clinical risk assessment tools has been shown to improve prediction for coronary artery disease, atrial fibrillation, and type 2 diabetes mellitus. More research is needed for the application of PRS in other areas such as ischemic stroke and hypertension.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Matthew T. T. Wheeler, Daniel Jacoby, Perry M. M. Elliott, Sara Saberi, Sheila M. M. Hegde, Neal K. K. Lakdawala, Jonathan Myers, Amy J. J. Sehnert, Jay M. M. Edelberg, Wanying Li, Iacopo Olivotto
Summary: In the EXPLORER-HCM trial, mavacamten improved exercise capacity and symptoms in patients with obstructive hypertrophic cardiomyopathy. The effects of mavacamten were greater in patients not receiving beta-blockers than in those receiving beta-blockers. The effect of background treatment was consistent across other clinically meaningful parameters.
EUROPEAN JOURNAL OF HEART FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Robert D. Anderson, Sachin Nayyar, Stephane Masse, Pier D. Lambiase, Kumaraswamy Nanthakumar
Summary: The re-emerging interest in ventricular electrophysiology and repolarization has led to the development of wave tail mapping, which can identify critical sites beyond the traditional depolarization mapping techniques. While various techniques can study diseased substrate in detail, clinical outcomes remain unchanged. Wave tail mapping has the potential to fill this gap, particularly in cases where conventional scar ablation endpoints are limited. However, there are barriers to its clinical use, and further improvements in repolarization mapping are needed.
Article
Cardiac & Cardiovascular Systems
Matthew T. Wheeler, Iacopo Olivotto, Perry M. Elliott, Sara Saberi, Anjali T. Owens, Mathew S. Maurer, Ahmad Masri, Amy J. Sehnert, Jay M. Edelberg, Yu-Mao Chen, Victoria Florea, Rajeev Malhotra, Andrew Wang, Artur Oreziak, Jonathan Myers
Summary: Mavacamten improves peak oxygen uptake in patients with symptomatic obstructive hypertrophic cardiomyopathy. This study investigates the effect of mavacamten on exercise physiology using cardiopulmonary exercise testing (CPET). The results show significant improvements in peak-exercise CPET parameters, as well as nonpeak-exercise CPET parameters, with mavacamten compared to placebo.
Editorial Material
Cardiac & Cardiovascular Systems
Massimiliano Lorenzini, Perry M. Elliott
EUROPEAN HEART JOURNAL
(2023)
Article
Multidisciplinary Sciences
William J. Young, Jeffrey Haessler, Jan-Walter Benjamins, Linda Repetto, Jie Yao, Aaron Isaacs, Andrew R. Harper, Julia Ramirez, Sophie Garnier, Stefan van Duijvenboden, Antoine R. Baldassari, Maria Pina Concas, ThuyVy Duong, Luisa Foco, Jonas L. Isaksen, Hao Mei, Raymond Noordam, Casia Nursyifa, Anne Richmond, Meddly L. Santolalla, Colleen M. Sitlani, Negin Soroush, Sebastien Theriault, Stella Trompet, Stefanie Aeschbacher, Fariba Ahmadizar, Alvaro Alonso, Jennifer A. Brody, Archie Campbell, Adolfo Correa, Dawood Darbar, Antonio De Luca, Jean-Francois Deleuze, Christina Ellervik, Christian Fuchsberger, Anuj Goel, Christopher Grace, Xiuqing Guo, Torben Hansen, Susan R. Heckbert, Rebecca D. Jackson, Jan A. Kors, Maria Fernanda Lima-Costa, Allan Linneberg, Peter W. Macfarlane, Alanna C. Morrison, Pau Navarro, David J. Porteous, Peter P. Pramstaller, Alexander P. Reiner, Lorenz Risch, Ulrich Schotten, Xia Shen, Gianfranco Sinagra, Elsayed Z. Soliman, Monika Stoll, Eduardo Tarazona-Santos, Andrew Tinker, Katerina Trajanoska, Eric Villard, Helen R. Warren, Eric A. Whitsel, Kerri L. Wiggins, Dan E. Arking, Christy L. Avery, David Conen, Giorgia Girotto, Niels Grarup, Caroline Hayward, J. Wouter Jukema, Dennis O. Mook-Kanamori, Morten Salling Olesen, Sandosh Padmanabhan, Bruce M. Psaty, Cristian Pattaro, Antonio Luiz P. Ribeiro, Jerome I. Rotter, Bruno H. Stricker, Pim van der Harst, Cornelia M. van Duijn, Niek Verweij, James G. Wilson, Michele Orini, Philippe Charron, Hugh Watkins, Charles Kooperberg, Henry J. Lin, James F. Wilson, Jrgen K. Kanters, Nona Sotoodehnia, Borbala Mifsud, Pier D. Lambiase, Larisa G. Tereshchenko, Patricia B. Munroe
Summary: Using multi-ancestry genome-wide association studies, this research identified 61 loci related to spatial QRS-T angle and 11 loci related to frontal QRS-T angle. These loci also showed shared genetic influences with classical ECG traits and were associated with cardiovascular diseases. The findings provide insights into the biology of QRS-T angles and their relationships with cardiovascular traits and diseases, which can inform future research and risk prediction.
NATURE COMMUNICATIONS
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Emanuele Monda, Perry Mark Elliott
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Perry Elliott
Summary: The purpose of this paper is to briefly summarize the clinical approach to disease notation for cardiomyopathies and highlight the limitations of current classification systems in integrating new knowledge about etiology. The recently advocated concept of arrhythmogenic cardiomyopathy is used as an example to illustrate these limitations. Currently, there is no single classification system that meets the needs of all potential users, and future disease notation should be modified to incorporate new and more complete phenotypes and etiologies.
CURRENT CARDIOLOGY REPORTS
(2023)
Article
Cardiac & Cardiovascular Systems
Stefan van Duijvenboden, Julia Ramirez, Michele Orini, Nay Aung, Steffen E. Petersen, Aiden Doherty, Andrew Tinker, Patricia B. Munroe, Pier D. Lambiase
Summary: This study found that exercise-induced premature ventricular contractions (PVCs) are closely associated with major adverse cardiovascular events, all-cause mortality, and heart failure in asymptomatic individuals. The risk increases as the PVC burden increases, and complex PVC rhythms pose a higher risk compared to PVC count alone. The study also suggests the presence of subclinical cardiomyopathy.
Article
Biochemistry & Molecular Biology
Martin Rees, Roksana Nikoopour, Alexander Alexandrovich, Mark Pfuhl, Luis R. Lopes, Mohammed M. Akhtar, Petros Syrris, Perry Elliott, Gerry Carr-White, Mathias Gautel
Summary: Titin, the largest protein in nature, has multiple functions and is primarily composed of tandem repeats of immunoglobulin and fibronectin type III domains. The crystal structures of wild type titin Fn3 domains and domains with missense variants were determined, revealing differences in folding and stability. The study also identified residues associated with congenital myopathies and ruled out one hypothesized mechanism of pathological effects.
JOURNAL OF STRUCTURAL BIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Nathan Green, Yang Chen, Constantinos O'Mahony, Perry M. Elliott, Roberto Barriales-Villa, Lorenzo Monserrat, Aristides Anastasakis, Elena Biagini, Juan Ramon Gimeno, Giuseppe Limongelli, Menelaos Pavlou, Rumana Z. Omar
Summary: This study provides a contemporary cost-effectiveness analysis of using implantable cardioverter defibrillators (ICDs) for primary prevention in patients with hypertrophic cardiomyopathy (HCM). The researchers found that using a 5-year sudden cardiac death (SCD) risk threshold of 6% was cheaper and had marginally better total quality adjusted life years (QALYs) compared to current practice. The main factors driving this decision are the health-related quality of life (HRQL) attributed to ICD patients and the time horizon.
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2023)
Article
Cardiac & Cardiovascular Systems
Gurpreet Dhillon, Shohreh Honarbakhsh, Hakam Abbas, Peter Waddingham, Adam S. Dennis, Nikhil Ahluwalia, Malcolm Finlay, Afzal Sohaib, Sophie Welch, Holly Daw, Simon Sporton, Anthony Chow, Mark J. Earley, Pier D. Lambiase, Ross J. Hunter
Summary: This study evaluated the clinical outcomes and response to ablation of potential drivers in patients with recurrent persistent AF following pulmonary vein isolation (PVI). The study found that ECGI-guided ablation caused an acute response in a majority of patients and had reasonable long-term outcomes.
Article
Cardiac & Cardiovascular Systems
Charles Butcher, Caroline Roney, Amy Wharmby, Nikhil Ahluwalia, Anthony Chow, Pier D. Lambiase, Ross J. Hunter, Shohreh Honarbakhsh
Summary: This study evaluated different methods for assessing atrial voltage and their accuracy in identifying pulmonary vein reconnection sites (PVRSs) in atrial fibrillation (AF). The results showed that omnipoar voltage atrial fibrillation (OV AF) maps improve voltage assessment by overcoming the impact of wavefront collision and fractionation, leading to improved accuracy.
JACC-CLINICAL ELECTROPHYSIOLOGY
(2023)
