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Biomedicines
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Advanced Research in Atrial Fibrillation
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Advanced Research in Atrial Fibrillation

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 3625

Special Issue Editor

Dr. Wern Yew Ding

E-Mail Website
Guest Editor
Liverpool Heart and Chest Hospital, Liverpool, UK
Interests: atrial fibrillation; electrophysiology; thrombosis

Special Issue Information

Dear Colleagues,

Atrial fibrillation is the most common sustained arrhythmia that is associated with significant morbidity and mortality. Over the past decades, there have been significant advances in the field of atrial fibrillation—both in the understanding of the disease process and various different treatment approaches. Nonetheless, our knowledge on certain aspects of atrial fibrillation such as electrophysiology and arrhythmia mechanisms is lacking. This limits our ability to develop novel therapies in high-risk populations with atrial fibrillation.

In the current Special Issue of Biomedicines entitled ‘Advanced Research in Atrial Fibrillation’, we aim to provide a collection of articles focused on contemporary laboratory and/or experimental research in the field of atrial fibrillation.

We encourage clinicians and scientists to submit original research data, review articles, protocols, etc., relating to atrial fibrillation.

Dr. Wern Yew Ding
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. Biomedicines is an international peer-reviewed open access monthly 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
  • arrhythmia
  • electrophysiology
  • cardiovascular
  • mechanism
  • laboratory
  • experimental

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Published Papers (4 papers)

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Research

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17 pages, 641 KiB  
Article
Effect of Enhanced Recovery After Surgery (ERAS) Implementation on Postoperative Atrial Fibrillation in Cardiac Surgery
by Romain Niessen, Valentina Rancati, Mario Verdugo-Marchese, Ziyad Gunga, Anna Nowacka, Valentine Melly, Christophe Abellan, Karima Alouazen, Tamila Abdurashidova, Caroline Botteau, Matthias Kirsch and Zied Ltaief
Biomedicines 2025, 13(5), 1212; https://doi.org/10.3390/biomedicines13051212 - 16 May 2025
Viewed by 203
Abstract
Background/Objectives: Postoperative atrial fibrillation (POAF) is the most frequent arrhythmic complication following cardiac surgery and is associated with increased morbidity and prolonged recovery. This study aimed to evaluate the impact of an enhanced recovery after surgery (ERAS) program on the incidence of [...] Read more.
Background/Objectives: Postoperative atrial fibrillation (POAF) is the most frequent arrhythmic complication following cardiac surgery and is associated with increased morbidity and prolonged recovery. This study aimed to evaluate the impact of an enhanced recovery after surgery (ERAS) program on the incidence of POAF and broader perioperative outcomes. Methods: In this monocentric, observational cohort study, we compared a retrospective pre-ERAS cohort (n = 162) with a prospective ERAS cohort (n = 321). The primary outcome was the incidence of POAF, assessed using two definitions: (1) the American Association for Thoracic Surgery (AATS) 2014 clinical definition, identifying POAF as atrial fibrillation requiring treatment; and (2) the European Society of Cardiology (ESC) 2024 definition, describing new-onset atrial fibrillation occurring immediately after surgery. Secondary outcomes included compliance with POAF prophylaxis measures, length of hospital stay, and the occurrence of postoperative complications. Statistical analyses included propensity score matching and multivariate logistic regression to identify independent predictors of POAF. Results: ERAS implementation was associated with a significant reduction in POAF incidence across both definitions. According to the AATS 2014 definition, POAF occurred in 20% of ERAS patients vs. 39% in the pre-ERAS group (p = 0.001), and 23% vs. 39% in the matched cohort (p = 0.004). Using the ESC 2024 definition, POAF was observed in 21% vs. 37% (p = 0.001) in unmatched and 20% vs. 36% (p = 0.005) in matched populations. Compliance with POAF prophylaxis improved markedly in the ERAS group (70% vs. 21%, p = 0.001). ERAS patients also experienced shorter hospital stays and fewer postoperative complications (26% vs. 38% in the matched cohort, p = 0.033). Conclusions: The implementation of a structured ERAS protocol significantly reduced POAF incidence, improved compliance with preventive strategies, and enhanced key aspects of postoperative recovery. Full article
(This article belongs to the Special Issue Advanced Research in Atrial Fibrillation)
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10 pages, 200 KiB  
Article
The Importance of Timing in Performing a Holter ECG in Patients Diagnosed with an Embolic Stroke of Undetermined Source
by Dia Alwilly, Saher Srour, Irina Nordkin, Asaf Honig, Karine Beiruti Wiegler, Ronen R. Leker and Naaem Simaan
Biomedicines 2025, 13(4), 771; https://doi.org/10.3390/biomedicines13040771 - 21 Mar 2025
Viewed by 384
Abstract
Background/Objectives: Previously undiagnosed atrial fibrillation (PUAF) is a significant cause of embolic stroke of undetermined source (ESUS). This study aimed to determine whether early heart rhythm monitoring with a Holter ECG after acute stroke enhances the detection of PUAF compared to standard [...] Read more.
Background/Objectives: Previously undiagnosed atrial fibrillation (PUAF) is a significant cause of embolic stroke of undetermined source (ESUS). This study aimed to determine whether early heart rhythm monitoring with a Holter ECG after acute stroke enhances the detection of PUAF compared to standard ambulatory monitoring in ESUS patients, assuming that early cardiac monitoring would lead to a higher detection rate of PUAF. Methods: This cohort study included 100 patients aged 50 and older diagnosed with ESUS and exhibiting sinus rhythm for at least 24 h. All participants were hospitalized in a stroke unit and underwent 48 h of Holter ECG monitoring. A group of 100 ESUS patients who underwent outpatient delayed Holter ECG monitoring served as controls. Results: This study revealed a significantly higher detection rate of AF in the hospitalized group compared to the outpatient group (20% vs. 5%; p = 0.001). The mean age and distribution of risk factors, including hypertension, diabetes, hyperlipidemia, ischemic heart disease, heart failure, chronic kidney disease, smoking, previous stroke, and malignancy, did not differ between the groups. There were no significant differences in initial stroke severity or in outcomes between the groups. Conclusions: Early Holter ECG monitoring in the hospitalized ESUS patients significantly increased the detection rate of PUAF compared to ambulatory monitoring, highlighting the importance of timely cardiac assessment in stroke management. Full article
(This article belongs to the Special Issue Advanced Research in Atrial Fibrillation)
14 pages, 2136 KiB  
Article
Predictive Value of N-Terminal Pro B-Type Natriuretic Peptide for Short-Term Outcome of Cardioversion in Patients with First-Diagnosed or Paroxysmal Atrial Fibrillation Presenting to the Emergency Department
by Antonios Diakantonis, Christos Verras, Sofia Bezati, Vasiliki Bistola, Ioannis Ventoulis, Maria Velliou, Antonios Boultadakis, Ignatios Ikonomidis, John T. Parissis and Effie Polyzogopoulou
Biomedicines 2024, 12(12), 2895; https://doi.org/10.3390/biomedicines12122895 - 19 Dec 2024
Viewed by 956
Abstract
Background: Atrial fibrillation (AF) is a common arrhythmia in the emergency department (ED). We investigated the role of N-terminal pro b-type natriuretic peptide (NT-proBNP) in predicting both the outcome of AF cardioversion and the risk of AF recurrence or persistence on the [...] Read more.
Background: Atrial fibrillation (AF) is a common arrhythmia in the emergency department (ED). We investigated the role of N-terminal pro b-type natriuretic peptide (NT-proBNP) in predicting both the outcome of AF cardioversion and the risk of AF recurrence or persistence on the 8th (D8) and 30th (D30) day post-cardioversion. Methods: This prospective, observational study evaluated patients with recent-onset AF, managed by either pharmacological (PC) or electrical cardioversion (EC) in the ED. Patients were treated either immediately or electively after 3 weeks of anticoagulation. NT-proBNP assessments were performed prior to cardioversion. Results: Of the 148 patients enrolled, 56% had paroxysmal AF, 85% underwent immediate cardioversion and 72% received EC. Successful cardioversion to sinus rhythm (SR) was achieved in 85% of patients. Patients with successful cardioversion and those who remained free from AF on D8 had lower NT-proBNP levels compared to patients with failed cardioversion or with AF recurrence or persistence on D8 [day of cardioversion, D0: SR vs. non-SR, 387 (127–1095) pg/mL vs. 1262 (595–2295), p = 0.004; D8: SR vs. non-SR, 370 (127–1095) vs. 1366 (718–2295), p = 0.002]. In multivariate analysis, higher logNT-proBNP was associated with higher risk of cardioversion failure [OR, 95%CI: 4.80 (1.58–14.55), p = 0.006] and AF recurrence or persistence on D8 [OR, 95%CI: 3.65 (1.06–12.59), p = 0.041]. ROC analysis confirmed the predictive ability of NT-proBNP for both outcomes (D0: AUC 0.735, p < 0.001; D8: AUC 0.761, p < 0.001). A cut-off value of NT-proBNP > 580 pg/mL was able to predict failure of AF conversion and occurrence of recurrent/persistent AF at D8. Conclusions: NT-proBNP is a promising biomarker for identifying patients presenting to the ED with recent-onset AF who run a greater risk of cardioversion failure and post-discharge AF recurrence/persistence in the immediate and short term. Full article
(This article belongs to the Special Issue Advanced Research in Atrial Fibrillation)
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Review

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13 pages, 1326 KiB  
Review
Could the Early Detection of Atrial Fibrillation Reduce the Risk of Developing Dementia?
by Fabrice Demoniere, Rim Abdelli and Léna Rivard
Biomedicines 2024, 12(8), 1931; https://doi.org/10.3390/biomedicines12081931 - 22 Aug 2024
Viewed by 1542
Abstract
Atrial fibrillation (AF) and dementia are major global public health issues and share common risk factors, especially after the age of 65 and regardless of the presence of stroke. Despite accounting for potential confounders, AF appears to be an independent risk factor for [...] Read more.
Atrial fibrillation (AF) and dementia are major global public health issues and share common risk factors, especially after the age of 65 and regardless of the presence of stroke. Despite accounting for potential confounders, AF appears to be an independent risk factor for cognitive decline and dementia. The mechanisms are likely to be multifactorial and may include AF-related ischemic stroke, cerebral hypoperfusion, microbleeds, systemic inflammation, genetic factors, and small vessel disease, leading to brain atrophy and white matter damage. The early aggressive management of AF and comorbidities may reduce the risk of dementia. Indeed, the early detection of AF-related cognitive impairment should allow for the early implementation of measures to prevent the development of dementia, mainly through integrative approaches involving the correction of risk factors and maintenance of rhythm control. Well-designed prospective studies are needed to determine whether early detection and AF treatment can prevent dementia and identify whether optimal integrative measures are effective in preventing cognitive impairment and dementia. Full article
(This article belongs to the Special Issue Advanced Research in Atrial Fibrillation)
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