Review
Cardiac & Cardiovascular Systems
Raquel Lopez-Galvez, Jose Miguel Rivera-Caravaca, Vanessa Roldan, Esteban Orenes-Pinero, Maria Asuncion Esteve-Pastor, Cecilia Lopez-Garcia, Daniel Saura, Josefa Gonzalez, Gregory Y. H. Lip, Francisco Marin
Summary: The 2020 ESC guidelines propose the 4S-AF scheme for characterizing atrial fibrillation (AF), and emphasize the importance of imaging techniques in everyday clinical practice to aid treatment decision-making and management of AF patients. Different imaging techniques, such as transthoracic echocardiography, transesophageal echocardiography, speckle tracking echocardiography, multidetector-row computed tomography, and cardiac magnetic resonance, are discussed in this review. These imaging techniques provide valuable information on the mechanisms of atrial fibrosis, assist in selecting appropriate therapies, and help assess the risk of stroke. Overall, imaging evaluation of atrial remodeling and fibrosis should be considered as a routine part of comprehensive AF evaluation.
AMERICAN HEART JOURNAL
(2023)
Article
Multidisciplinary Sciences
Ahmet Demirkiran, Raquel P. Amier, Mark B. M. Hofman, Rob J. van der Geest, Lourens F. H. J. Robbers, Luuk H. G. A. Hopman, Mark J. Mulder, Peter van de Ven, Cornelis P. Allaart, Albert C. van Rossum, Marco J. W. Gotte, Robin Nijveldt
Summary: The study revealed that the global left atrial flow dynamics in patients with paroxysmal atrial fibrillation are impaired even during sinus rhythm, showing lower flow velocities, increased stasis of blood, and decreased kinetic energy compared to patients without cardiac disease. These pathophysiological flow patterns may help explain the increased incidence of thromboembolic events in paroxysmal AF patients, independent of actual AF or left atrial remodeling.
SCIENTIFIC REPORTS
(2021)
Review
Physiology
Yajun Yao, Mei Yang, Dishiwen Liu, Qingyan Zhao
Summary: Immune remodeling is a new direction for research and therapeutic strategies for atrial fibrillation (AF) as it has complex relationships with atrial electrical, structural, and neural remodeling. It may provide effective therapies for AF.
FRONTIERS IN PHYSIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Shirui Lu, Hongyun Liu, Jie Sun, Jun Zhang, Li Li, Qiaoying Tang, Yani Liu, Youbin Deng
Summary: We investigated the changes in left atrial (LA) and left ventricular (LV) in different subtypes of atrial fibrillation (AF) using two-dimensional echocardiography strain techniques. Patients with AF had dilated LA volume, decreased LA reservoir strain, lower LV ejection fraction (LVEF), and impaired global longitudinal strain (GLS). The impairments in LA function were more severe in persistent AF (PerAF) compared to paroxysmal AF (PAF) patients, regardless of LA enlargement.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Jan Stassen, Steele C. Butcher, Farnaz Namazi, Nina Ajmone Marsan, Jeroen J. Bax, Victoria Delgado
Summary: This study found that left atrial reservoir strain and strain rate are impaired in patients with rheumatic mitral stenosis, and the degree of impairment is associated with new-onset atrial fibrillation at follow-up.
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
(2022)
Article
Cardiac & Cardiovascular Systems
Christoph Beyer, Lyudmyla Tokarska, Markus Stuhlinger, Gudrun Feuchtner, Florian Hintringer, Sarah Honold, Lukas Fiedler, Marie-Sophie Schonbauer, Robert Schonbauer, Fabian Plank
Summary: Atrial wall thickness, epicardial fat volume, and attenuation are associated with AF recurrence in patients undergoing ablation therapy.
JACC-CARDIOVASCULAR IMAGING
(2021)
Article
Pharmacology & Pharmacy
Guang Zhong Liu, Wei Xu, Yan Xiang Zang, Qi Lou, Peng Zhou Hang, Qiang Gao, Hang Shi, Qi Yun Liu, Hong Wang, Xin Sun, Cheng Liu, Peng Zhang, Hua Dong Liu, Shao Hong Dong
Summary: The study revealed that Sirt3 was significantly down-regulated in AF patients and models, but restored by HL treatment. Sirt3 could regulate the acetylated modification of key metabolic enzymes, and increasing Sirt3 levels rescued AF-induced atrial metabolic remodeling.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Jen-Yuan Kuo, Xuanyi Jin, Jing-Yi Sun, Sheng-Hsiung Chang, Po-Ching Chi, Kuo-Tzu Sung, Greta S. P. Mok, Chun-Ho Yun, Shun-Chuan Chang, Fa-Po Chung, Ching-Hsiang Yu, Tung-Hsin Wu, Chung-Lieh Hung, Hung- Yeh, Carolyn S. P. Lam
Summary: This study investigated the different patterns of left atrial wall remodeling in patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF). Despite a similar extent of left atrial enlargement and dysfunction in HFpEF vs. AF alone, larger left atrial wall volume (LAWV) and wall thickness heterogeneity (LAWT [SD]) can distinguish AF from HFpEF alone, suggesting distinct underlying pathophysiological mechanisms of left atrial remodeling in AF vs. HFpEF.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Hailan Liu, Lili Chen, Yan Song, Yanlin He, Ruirui Kang, Shengbo Liu, Chunquan Zhang
Summary: This study analyzed the correlation between left atrial (LA) function parameters measured by AFILA echocardiography and the risk of cerebral ischemic stroke (CIS) in patients with non-valvular paroxysmal atrial fibrillation (NVPAF). The results showed that S_CT could independently predict the risk of CIS in patients with NVPAF.
QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
(2023)
Article
Biochemistry & Molecular Biology
Pawel Walek, Urszula Grabowska, Elzbieta Ciesla, Janusz Sielski, Joanna Roskal-Walek, Beata Wozakowska-Kaplon
Summary: This study showed a significant negative correlation between galectin-3 concentration and the size, systolic function, and compliance of the left atrium in patients with persistent atrial fibrillation.
Article
Cardiac & Cardiovascular Systems
Ryo Nishinarita, Shinichi Niwano, Hiroe Niwano, Hironori Nakamura, Daiki Saito, Tetsuro Sato, Gen Matsuura, Yuki Arakawa, Shuhei Kobayashi, Yuki Shirakawa, Ai Horiguchi, Naruya Ishizue, Tazuru Igarashi, Tomoharu Yoshizawa, Jun Oikawa, Yoshinobu Hara, Takafumi Katsumura, Jun Kishihara, Akira Satoh, Hidehira Fukaya, Hiroyuki Sakagami, Junya Ako
Summary: This study found that the SGLT2 inhibitor canagliflozin may be beneficial for preventing atrial fibrillation and suppressing atrial remodeling, by reducing atrial effective refractory period, decreasing conduction velocity, and inhibiting the inducibility of AF.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Cardiac & Cardiovascular Systems
Yoshiko Murakata, Fumi Yamagami, Nobuyuki Murakoshi, DongZhu Xu, Zhonghu Song, Siqi Li, Yuta Okabe, Kazuhiro Aonuma, ZiXun Yuan, Haruka Mori, Kazutaka Aonuma, Kazuko Tajiri, Masaki Ieda
Summary: Inflammatory atrial cardiomyopathy can lead to atrial fibrillation, characterized by enlarged atria, infiltration of inflammatory cells, and fibrosis. These changes increase susceptibility to arrhythmias by affecting electrical conduction, genetic factors, and autonomic regulation. Therefore, reducing inflammation is important in preventing atrial fibrillation.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Medicine, General & Internal
Nathalie Noirclerc, Olivier Huttin, Christian de Chillou, Christine Selton-Suty, Laura Fillipetti, Jean Marc Sellal, Erwan Bozec, Erwan Donal, Zohra Lamiral, Masatake Kobayashi, Joao Pedro Ferreira, Patrick Rossignol, Nicolas Girerd
Summary: The study found that patients with paroxysmal atrial fibrillation exhibit early cardiac remodeling, characterized by increased left ventricular mass and left atrial enlargement. Although less than 10% of patients show diastolic dysfunction, there is a significant association with atrial fibrillation.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Biochemistry & Molecular Biology
Megan Watts, Gopi K. Kolluru, Parinita Dherange, Sibile Pardue, Man Si, Xinggui Shen, Krystle Trosclair, John Glawe, Zaki Al-Yafeai, Mazen Iqbal, Brenna H. Pearson, Kathryn A. Hamilton, A. Wayne Orr, Edward Glasscock, Christopher G. Kevil, Paari Dominic
Summary: Oxidative stress is a driving factor in the pathogenesis of atrial fibrillation (AF), with hydrogen sulfide (H2S) playing an important role in regulating electrical remodeling and susceptibility to AF. Patients with AF had significantly lower plasma sulfide levels, and those with persistent AF had even lower levels compared to paroxysmal AF patients. Additionally, CSE knockout mice showed decreased atrial sulfide levels, increased atrial superoxide levels, and enhanced propensity for induced persistent AF compared to wild type mice.
Review
Biochemistry & Molecular Biology
Francisco Javier Sanchez, Esther Pueyo, Emiliano Raul Diez
Summary: Postoperative atrial fibrillation (POAF) is a complication of cardiovascular surgeries that increases the risk of embolic stroke, prolonged hospital stay, and cardiovascular mortality. While many pathophysiological mechanisms are known, predicting POAF remains a hot topic. Doppler echocardiogram and strain echocardiography have shown significant predictive capacity for POAF.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Medicine, General & Internal
Francis J. Ha, Hui-Chen Han, Prashanthan Sanders, Andre La Gerche, Andrew W. Teh, Omar Farouque, Han S. Lim
Summary: This study evaluated the causes and circumstances of exercise-related sudden cardiac death (SCD) in young people in Australia. The most common causes were coronary artery disease (CAD) and sudden arrhythmic death syndrome (SADS). Aboriginal and Torres Strait Islanders were disproportionately affected by CAD. Although many cases were witnessed, automated external defibrillator (AED) use prior to ambulance arrival was low.
INTERNAL MEDICINE JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Jan-Hendrik van den Bruck, Melissa Middeldorp, Arian Sultan, Cornelia Scheurlen, Katharina Seuthe, Jonas Woermann, Karlo Filipovic, Kadhim Kadhim, Prashanthan Sanders, Daniel Steven, Jakob Lueker
Summary: In this study, the effects of ventricular arrhythmia treatment on reduced biventricular pacing (BiVP) in cardiac resynchronization therapy (CRT) patients were evaluated. The results showed that catheter ablation treatment, especially for premature ventricular contractions (PVC), was more effective in improving BiVP and patients' cardiac function compared to intensified medical therapy.
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Jeroen M. Hendriks, Adrian D. Elliott, Melissa E. Middeldorp, Prashanthan Sanders
Article
Medicine, General & Internal
Peter M. Kistler, David Chieng, Hariharan Sugumar, Liang-Han Ling, Louise Segan, Sonia Azzopardi, Ahmed Al-Kaisey, Ramanathan Parameswaran, Robert D. Anderson, Joshua Hawson, Sandeep Prabhu, Aleksandr Voskoboinik, Geoffrey Wong, Joseph B. Morton, Bhupesh Pathik, Alex J. McLellan, Geoffrey Lee, Michael Wong, Sue Finch, Rajeev K. Pathak, Deep Chandh Raja, Laurence Sterns, Matthew Ginks, Christopher M. Reid, Prashanthan Sanders, Jonathan M. Kalman
Summary: This randomized clinical trial compares pulmonary vein isolation (PVI) vs PVI with posterior wall isolation for achieving freedom from atrial arrhythmia in adult patients with persistent atrial fibrillation undergoing first-time catheter ablation in Australia, the UK, and Canada. The study findings suggest that adding posterior wall isolation to PVI does not significantly improve freedom from atrial arrhythmias in patients with persistent AF. Therefore, the empirical inclusion of posterior wall isolation for ablation of persistent AF may not be supported.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Pediatrics
Emma Payne, Frances Garden, Yves d'Udekem, Robert Weintraub, Zoe McCallum, Helen Wightman, Dominica Zentner, Rachael Cordina, Thomas G. Wilson, Julian Ayer
Summary: This study investigated the association between long-term enteral tube feeding (TF) and growth as well as long-term outcomes after Fontan procedure in single ventricle patients. The results showed that TF was associated with poor growth and increased risk of severe Fontan failure. Prolonged infant enteral tube feeding is an independent marker of adverse clinical outcomes extending long-term post-Fontan procedure.
JOURNAL OF PEDIATRICS
(2023)
Article
Sport Sciences
Christian V. Verdicchio, Celine Gallagher, Rajiv Mahajan, Melissa E. Middeldorp, Dominik Linz, Dennis H. Lau, Prashanthan Sanders, Adrian D. Elliott
Summary: The study aimed to assess the validity of heart rate reserve (HRR) as a surrogate for oxygen uptake reserve (VO2R) to guide exercise intensity in patients with atrial fibrillation (AF). The results showed a significant difference between HRR and VO2R, suggesting that an individualized HRR-VO2R relationship should be considered when prescribing exercise intensity for AF patients.
JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
(2023)
Review
Cardiac & Cardiovascular Systems
Adrian D. Elliott, Melissa E. Middeldorp, Isabelle C. Van Gelder, Christine M. Albert, Prashanthan Sanders
Summary: The global prevalence of atrial fibrillation (AF) has significantly increased over the past three decades to approximately 60 million cases. Various risk factors, including lifestyle choices, can modify the lifetime risk of AF. This review provides evidence on the epidemiology of AF, both non-modifiable and modifiable risk factors, and strategies for primary and secondary prevention. It also discusses potential interventions to reduce the frequency and severity of subsequent AF episodes and proposes strategies and global policy changes for the prevention and management of AF.
NATURE REVIEWS CARDIOLOGY
(2023)
Correction
Cardiac & Cardiovascular Systems
Adrian D. Elliott, Melissa E. Middeldorp, Isabelle C. Van Gelder, Christine M. Albert, Prashanthan Sanders
NATURE REVIEWS CARDIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Edgar T. Hoorntje, Charlotte Burns, Luisa Marsili, Ben Corden, Victoria N. Parikh, Gerard J. te Meerman, Belinda Gray, Ahmet Adiyaman, Richard D. Bagnall, Daniela Q. C. M. Barge-Schaapveld, Maarten P. van den Berg, Marianne Bootsma, Laurens P. Bosman, Gemma Correnti, Johan Duflou, Ruben N. Eppinga, Diane Fatkin, Michael Fietz, Eric Haan, Jan D. H. Jongbloed, Arnaud D. Hauer, Lien Lam, Freyja H. M. van Lint, Amrit Lota, Carlo Marcelis, Hugh J. McCarthy, Anneke M. van Mil, Rogier A. Oldenburg, Nicholas Pachter, R. Nils Planken, Chloe Reuter, Christopher Semsarian, Jasper J. van der Smagt, Tina Thompson, Jitendra Vohra, Paul G. A. Volders, Jaap I. van Waning, Nicola Whiffin, Arthur van den Wijngaard, Ahmad S. Amin, Arthur A. M. Wilde, Gijs van Woerden, Laura Yeates, Dominica Zentner, Euan A. Ashley, Matthew T. Wheeler, James S. Ware, J. Peter van Tintelen, Jodie Ingles
Summary: This study investigated the clinical characteristics, genotype, and genetics of arrhythmogenic cardiomyopathy caused by truncating variants in the desmoplakin gene (DSPtv). The results showed that the location of DSPtv and individual disease status were independent risk factors for ventricular arrhythmia. Furthermore, the study found that disease-associated gene variants were more likely to occur in important regions of the DSP gene compared to the control group. This study highlights the importance of gene variants in arrhythmogenic cardiomyopathy and provides critical insights for clinical management.
CIRCULATION-GENOMIC AND PRECISION MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Jonathan M. Kalman, Ahmed M. Al-Kaisey, Ramanathan Parameswaran, Joshua Hawson, Robert D. Anderson, Michael Lim, David Chieng, Stephen A. Joseph, Alex McLellan, Joseph B. Morton, Paul B. Sparks, Geoffrey Lee, Prashanthan Sanders, Peter M. Kistler
Summary: This study aimed to determine if the timing of catheter ablation for atrial fibrillation (AF) affects arrhythmia outcomes. The results showed that there was no significant difference in the atrial arrhythmia free survival at 12 months post-ablation between patients who underwent early ablation and those who underwent delayed ablation. Other secondary outcomes also showed no significant difference. Therefore, delaying AF ablation by 12 months for antiarrhythmic drug management does not reduce the efficacy of ablation.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Jeremy William, Jack Shembrey, Edward Quine, Mark Perrin, Daryl Ridley, Ramanathan Parameswaran, Peter M. Kistler, Aleksandr Voskoboinik
Summary: This study presents a case series of three patients who developed polymorphic ventricular tachycardia storm after coronary artery bypass graft surgery. The recurrent episodes of ventricular tachycardia in these cases were initiated by short-coupled ventricular ectopy, with no evidence of acute coronary ischemia. Two out of three patients achieved rapid suppression of the arrhythmia with oral quinidine sulfate.
HEART LUNG AND CIRCULATION
(2023)
Article
Cardiac & Cardiovascular Systems
Jeremy William, Xiaoman Xiao, Anita Shirwaiker, Hitesh Patel, Sandeep Prabhu, Liang-Han Ling, Hariharan Sugamar, Justin Mariani, Peter Kistler, Aleksandr Voskoboinik
Summary: This study reviewed the diagnostic work-up of cardiac arrest patients with ventricular tachyarrhythmias and normal hearts. The results showed that the work-up was often incomplete, especially in younger adults. The utilization of second-line cardiac investigations, such as cardiac magnetic resonance imaging (CMR), was low, and there is a need for further study to establish a systematic diagnostic protocol.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Adrian D. Elliott, Jonathan Ariyaratnam, Erin J. Howden, Andre La Gerche, Prashanthan Sanders
Summary: The left atrium (LA) plays a critical role in receiving pulmonary venous return and modulating left ventricular filling, with its function contributing to the augmentation in stroke volume during exercise. Structural remodeling and dysfunction of the LA are associated with adverse outcomes in cardiovascular disease, leading to exercise intolerance and increased risk of hospital admissions and mortality. Exercise training is recommended in patients with cardiovascular disease to improve outcomes and maintain functional capacity, with less attention given to the changes in LA structure and function compared to the left ventricle.
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY
(2023)
Review
Rheumatology
Jessica L. Fairley, Laura Ross, Alannah Quinlivan, Dylan Hansen, Elizabeth Paratz, Wendy Stevens, Peter M. Kistler, Alex McLellan, Andre La Gerche, Mandana Nikpour
Summary: This study aimed to investigate the occurrence rate of sudden cardiac death (SCD), arrhythmia, and conduction defects in SSc patients. The findings showed that the annual incidence of SCD in SSc patients ranged from 1.0% to 3.3%, which is at least 10 times higher than the general population. Additionally, arrhythmias were common even in SSc patients without known or suspected SSc-associated heart involvement.
SEMINARS IN ARTHRITIS AND RHEUMATISM
(2023)
Article
Cardiac & Cardiovascular Systems
Jeremy William, David Chieng, Hariharan Sugumar, Liang-Han Ling, Louise Segan, Rose Crowley, Ahmed Al-Kaisey, Joshua Hawson, Sandeep Prabhu, Aleksandr Voskoboinik, Geoffrey Wong, Joseph B. Morton, Geoffrey Lee, Alex J. Mclellan, Michael Wong, Rajeev K. Pathak, Laurence Sterns, Matthew Ginks, Christopher M. Reid, Prashanthan Sanders, Jonathan M. Kalman, Peter M. Kistler
Summary: Catheter ablation for patients with atrial fibrillation and heart failure with reduced ejection fraction (HFrEF) can improve left ventricular ejection fraction and survival. However, the addition of posterior wall isolation (PWI) to pulmonary vein isolation (PVI) does not improve freedom from arrhythmia recurrence or recovery of left ventricular ejection fraction in patients with HFrEF.
