Advances in Diagnosis and Treatment of Cardiac Arrhythmias

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 8345

Special Issue Editors


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Guest Editor
Cardiothoracovascular Department, Electrophysiology Unit, Niguarda Hospital, Piazza Ospedale Maggiore 1, 20162 Milano, Italy
Interests: cardiac electrophysiology; cardiac devices; ventricular tachycardia; atrial fibrillation; left atrial appendage closure
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Cardiothoracovascular Department, Electrophysiology Unit, Niguarda Hospital, Piazza Ospedale Maggiore 1, 20162 Milano, Italy
Interests: cardiac electrophysiology; cardiac devices; ventricular tachycardia; atrial fibrillation; left atrial appendage closure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The diagnosis and treatment of cardiac arrhythmias are constantly evolving in daily clinical practice. Patients with cardiac arrhythmias such as atrial fibrillation or ventricular tachycardia often require advanced multidisciplinary assessments and treatments with the collaboration of cardiac surgeons for hybrid ablations or hemodynamic support. The use of the latest technologies in the field of cardiac electrophysiology and cardiac devices has allowed for safer treatments with better results in the follow-up of patients affected by different heart diseases. This Special Issue “Advances in Diagnosis and Treatment of Cardiac Arrhythmias” will cover a selection of recent research topics and updated manuscripts on the innovations in the field of interventional and pharmacological treatment of cardiac arrhythmias.

Dr. Fabrizio Guarracini
Dr. Patrizio Mazzone
Guest Editors

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. Diagnostics 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
  • ventricular tachycardia
  • cardiac devices
  • cardiac electrophysiology

Published Papers (5 papers)

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Research

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15 pages, 3249 KiB  
Article
Microembolizations in the Arterial Cerebral Circulation in Patients with Atrial Fibrillation Ablation Using the Cryoballoon Technique—Protocol and Methodology of a Prospective Observational Study
by Damir Erkapic, Marko Aleksic, Konstantinos Roussopoulos, Kay Felix Weipert, Korkut Sözener, Karel Kostev, Jens Allendörfer, Josef Rosenbauer, Dursun Guenduez and Christian Tanislav
Diagnostics 2023, 13(9), 1660; https://doi.org/10.3390/diagnostics13091660 - 8 May 2023
Cited by 1 | Viewed by 1184
Abstract
There is considerable uncertainty regarding the impact of microembolic signals (MESs) on neuropsychological abilities in patients receiving pulmonary vein isolation and beyond using the cryoballoon technique. We conducted the largest prospective observational study on this topic, providing insights into the gradual unmasking of [...] Read more.
There is considerable uncertainty regarding the impact of microembolic signals (MESs) on neuropsychological abilities in patients receiving pulmonary vein isolation and beyond using the cryoballoon technique. We conducted the largest prospective observational study on this topic, providing insights into the gradual unmasking of procedure-related MESs and their impacts on neuropsychological outcomes. MESs were continuously detected periprocedurally using transcranial Doppler ultrasonography. Neuropsychological status was evaluated comprehensively using the CERAD Plus test battery, which consists of 11 neuropsychological subtests. Patients with atrial fibrillation were included in the study with an equal distribution (50:50) of paroxysmal or persistent presentations. Of 167 consecutive eligible patients, 100 were included within the study enrollment period from February 2021 to August 2022. The study, including the documentation of all follow-up visits, ended in November 2022. This paper focuses on describing the study protocol and methodology and presenting the baseline data. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Cardiac Arrhythmias)
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11 pages, 1132 KiB  
Article
Post-Dilatation of New-Generation Self-Expandable Transcatheter Aortic Valves Does Not Increase Atrioventricular Conduction Abnormalities
by Grégoire Massoullié, Nicolas Combaret, Géraud Souteyrand, Jean Pascal Salazard, Bruno Pereira, Frédéric Jean, Pascal Motreff, Ouarda Taghli-Lamallem, Guillaume Clerfond and Romain Eschalier
Diagnostics 2023, 13(3), 427; https://doi.org/10.3390/diagnostics13030427 - 24 Jan 2023
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Abstract
The impact that post-dilatation has on the risk of experiencing conduction disorders after post-transcatheter aortic valve replacement with self-expanding valves (SE-TAVR) is unclear. We compared the rate of developing an atrioventricular (AV) high-grade conduction disorder and permanent pacemaker implantation (PPI) in post-TAVR patients [...] Read more.
The impact that post-dilatation has on the risk of experiencing conduction disorders after post-transcatheter aortic valve replacement with self-expanding valves (SE-TAVR) is unclear. We compared the rate of developing an atrioventricular (AV) high-grade conduction disorder and permanent pacemaker implantation (PPI) in post-TAVR patients undergoing post-dilatation. We enrolled patients with severe symptomatic calcified aortic stenosis (CAS) who were undergoing SE-TAVR between 1 January 2016, and 19 April 2019 at a single French center. Of the 532 patients treated with SE-TAVR, 417 subjects (78.4%) received Corevalve Evolute R and 115 subjects (21.6%) received the latest-generation Corevalve Evolute Pro valve. In total, 104/532 patients (19.5%; 21.6% with Evolute R vs. 12.2% with Evolute Pro, p = 0.024) required post-dilatation. Evolut R was associated with an increased risk of post-dilatation (odds ratio 2.1 (1.01–4.33, p = 0.046)). We did not observe any post-dilatation increases in AV or in intra- and interventricular conduction disorders. In total, 26.1% of participants needed PPI within the first 30 post-procedure days (p = 0.449). Post-dilatation was not associated with a higher PPI risk (subdistribution hazard ratio 1.033 (0.726–1.471); p = 0.857). No significant differences existed between the groups in terms of one-year mortality (10.3%; p = 0.507). Post-dilatation in SE-TAVR did not increase the rate of electrical conduction disorders and PPI in the early implantation phase. The latest generation of SE-TAVR valves was associated with less need for post-dilatation. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Cardiac Arrhythmias)
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Review

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19 pages, 7729 KiB  
Review
Concepts of Cardiac Dyssynchrony and Dynamic Approach
by Bianca Iulia Catrina, Florina Batar, Ioan Manitiu, Liliana Prodan, Ciprian Tanasescu and Teodora Filip
Diagnostics 2024, 14(9), 937; https://doi.org/10.3390/diagnostics14090937 - 30 Apr 2024
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Abstract
Cardiac conduction involves electrical activity from one myocyte to another, creating coordinated contractions in each. Disruptions in the conducting system, such as left bundle branch block (LBBB), can result in premature activation of specific regions of the heart, leading to heart failure and [...] Read more.
Cardiac conduction involves electrical activity from one myocyte to another, creating coordinated contractions in each. Disruptions in the conducting system, such as left bundle branch block (LBBB), can result in premature activation of specific regions of the heart, leading to heart failure and increased morbidity and mortality. Structural alterations in T-tubules and the sarcoplasmic reticulum can lead to dyssynchrony, a condition that can be treated by cardiac resynchronization therapy (CRT), which stands as a cornerstone in this pathology. The heterogeneity in patient responses underscored the necessity of improving the diagnostic approach. Vectocardiography, ultra-high-frequency ECG, 3D echocardiography, and electrocardiographic imaging seem to offer advanced precision in identifying optimal candidates for CRT in addition to the classic diagnostic methods. The advent of His bundle pacing and left bundle branch pacing further refined the approach in the treatment of dyssynchrony, offering more physiological pacing modalities that promise enhanced outcomes by maintaining or restoring the natural sequence of ventricular activation. HOT-CRT emerges as a pivotal innovation combining the benefits of CRT with the precision of His bundle or left bundle branch area pacing to optimize cardiac function in a subset of patients where traditional CRT might fall short. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Cardiac Arrhythmias)
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16 pages, 733 KiB  
Review
The Fluoroless Future in Electrophysiology: A State-of-the-Art Review
by Alberto Preda, Eleonora Bonvicini, Elena Coradello, Alessio Testoni, Lorenzo Gigli, Matteo Baroni, Marco Carbonaro, Sara Vargiu, Marisa Varrenti, Giulia Colombo, Marco Paolucci, Patrizio Mazzone and Fabrizio Guarracini
Diagnostics 2024, 14(2), 182; https://doi.org/10.3390/diagnostics14020182 - 14 Jan 2024
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Abstract
Fluoroscopy has always been the cornerstone imaging method of interventional cardiology procedures. However, radiation exposure is linked to an increased risk of malignancies and multiorgan diseases. The medical team is even more exposed to X-rays, and a higher incidence of malignancies was reported [...] Read more.
Fluoroscopy has always been the cornerstone imaging method of interventional cardiology procedures. However, radiation exposure is linked to an increased risk of malignancies and multiorgan diseases. The medical team is even more exposed to X-rays, and a higher incidence of malignancies was reported in this professional group. In the last years, X-ray exposure has increased rapidly, involving, above all, the medical team and young patients and forcing alternative fluoroless imaging methods. In cardiac electrophysiology (EP) and pacing, the advent of 3D electroanatomic mapping systems with dedicated catheters has allowed real-time, high-density reconstruction of both heart anatomy and electrical activity, significantly reducing the use of fluoroscopy. In addition, the diffusion of intracardiac echocardiography has provided high anatomical resolution of moving cardiac structures, providing intraprocedural guidance for more complex catheter ablation procedures. These methods have largely demonstrated safety and effectiveness, allowing for a dramatic reduction in X-ray delivery in most arrhythmias’ ablations. However, some technical concerns, as well as higher costs, currently do not allow their spread out in EP labs and limit their use to only procedures that are considered highly complex and time-consuming and in young patients. In this review, we aim to update the current employment of fluoroless imaging in different EP procedures, focusing on its strengths and weaknesses. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Cardiac Arrhythmias)
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27 pages, 1842 KiB  
Review
Strain Imaging and Ventricular Arrhythmia
by Caroline Løkke Bjerregaard, Kristoffer Grundtvig Skaarup, Mats Christian Højbjerg Lassen, Tor Biering-Sørensen and Flemming Javier Olsen
Diagnostics 2023, 13(10), 1778; https://doi.org/10.3390/diagnostics13101778 - 17 May 2023
Cited by 2 | Viewed by 2120
Abstract
Ventricular arrhythmia is one of the main causes of sudden cardiac death. Hence, identifying patients at risk of ventricular arrhythmias and sudden cardiac death is important but can be challenging. The indication for an implantable cardioverter defibrillator as a primary preventive strategy relies [...] Read more.
Ventricular arrhythmia is one of the main causes of sudden cardiac death. Hence, identifying patients at risk of ventricular arrhythmias and sudden cardiac death is important but can be challenging. The indication for an implantable cardioverter defibrillator as a primary preventive strategy relies on the left ventricular ejection fraction as a measure of systolic function. However, ejection fraction is flawed by technical constraints and is an indirect measure of systolic function. There has, therefore, been an incentive to identify other markers to optimize the risk prediction of malignant arrhythmias to select proper candidates who could benefit from an implantable cardioverter defibrillator. Speckle-tracking echocardiography allows for a detailed assessment of cardiac mechanics, and strain imaging has repeatedly been shown to be a sensitive technique to identify systolic dysfunction unrecognized by ejection fraction. Several strain measures, including global longitudinal strain, regional strain, and mechanical dispersion, have consequently been proposed as potential markers of ventricular arrhythmias. In this review, we will provide an overview of the potential use of different strain measures in the context of ventricular arrhythmias. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Cardiac Arrhythmias)
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