Extensive Approach to Atrial Fibrillation: Background and Future Perspectives

Special Issue Editors


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Guest Editor
Division of Cardiology, “Città della Salute e della Scienza di Torino” Hospital, Department of Medical Sciences, University of Turin, 10126 Torino, Italy
Interests: mechanisms and pathophysiology of cardiac arrhythmias; clinical and epidemiological aspects of patients with arrhythmia; technological innovation (devices and mapping systems) for the improvement of safety and efficacy of the treatment of complex cardiac arrhythmias; optimization and research of alternative energy sources for the percutaneous treatment of cardiac arrhythmias; computational models of systemic and cerebral circulation in the course of arrhythmia; epidemiological aspects, risk stratification and innovative treatments of sudden death; statistical models of risk stratification

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Guest Editor
Division of Cardiology, “Città della Salute e della Scienza di Torino” Hospital, Department of Medical Sciences, University of Turin, 10126 Torino, Italy
Interests: electrophysiology; arrhythmology; radiation risks

Special Issue Information

Dear Colleagues,

This Special Issue is focused on atrial fibrillation, aiming to assess  the complex interactions between prevention, prognostic and metabolic markers and therapies of atrial fibrillation (AF) from a comprehensive point of view. AF management cannot be limited to stroke prevention by anticoagulants and rhythm/rate control by drugs and/or transcatheter ablation. Increasing evidence has demonstrated the importance of a more extensive management and international guidelines have highlighted the importance of comorbidities optimization and risk factors management to improve symptoms and to reduce AF burden and complications. The final goal is to slow disease progression or even, ideally, avoid AF. On top of well-known factors, new parameters such as alcohol consumption, physical activity, social stress, autonomic tone, adipose tissue, lipid profile, diabetes, obstructive sleep apnea, and genetics are emerging. In this Special Issue we are aiming to collect articles focusing on comprehensive approaches to AF. Moreover, we seek scientific works which transfer this knowledge in therapeutic actions, overcoming the standard electrophysiological management of AF.

Prof. Dr. Matteo Anselmino
Dr. Henri Xhakupi
Guest Editors

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Keywords

  • atrial fibrillation
  • omic approach
  • metabolomics
  • genomics
  • risk factors
  • prevention
  • ablation
  • stroke
  • dementia

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Published Papers (2 papers)

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Research

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19 pages, 551 KiB  
Article
The Role of P Wave Parameters in Predicting Pulmonary Vein Isolation Outcomes for Paroxysmal Atrial Fibrillation: An Observational Cohort Study
by Ibrahim Antoun, Xin Li, Ahmed I. Kotb, Zakkariya Vali, Ahmed Abdelrazik, Abdulmalik Koya, Akash Mavilakandy, Ivelin Koev, Ali Nizam, Hany Eldeeb, Riyaz Somani and André Ng
J. Cardiovasc. Dev. Dis. 2024, 11(9), 277; https://doi.org/10.3390/jcdd11090277 - 5 Sep 2024
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Abstract
Background: Pulmonary vein isolation (PVI) is an effective management method for paroxysmal atrial fibrillation (PAF). The P wave in the 12-lead electrocardiogram (ECG) represents atrial depolarisation. This study aims to utilise the P wave to predict PVI outcomes for PAF. Methods: This single-centre [...] Read more.
Background: Pulmonary vein isolation (PVI) is an effective management method for paroxysmal atrial fibrillation (PAF). The P wave in the 12-lead electrocardiogram (ECG) represents atrial depolarisation. This study aims to utilise the P wave to predict PVI outcomes for PAF. Methods: This single-centre retrospective study aimed to predict PVI outcomes using P wave parameters. It included 211 consecutive patients with first PVI for PAF between 2018 and 2019 and targeted the pulmonary veins (PVs). Procedure success was defined by freedom of ECG-documented AF at 12 months. Digital 12-lead ECGs with 1–50 hertz bandpass filters were monitored before the procedure. Corrected P wave duration (PWDc), P wave amplitude (PWV), P wave dispersion (PWDisp), intra-atrial block (IAB), P wave area (PWA), and P wave terminal force in V1 (PTFV1) were measured before ablation and correlated with the outcomes. Results: Successful PVI occurred in 154 patients (73%). Demographics were similar between both arms. P wave parameters correlated with PVI failure included increased PWDc in all leads except for lead III, aVR, and V3, decreased PWV in lead I (hazard ratio [HR]: 0.7, 95% confidence interval [CI]: 0.53–0.95), lead II (HR: 0.45, 95% CI: 0.22–0.65), aVL (HR: 0.58, 95% CI: 0.22–0.98), and aVF (HR: 0.67, 95% CI: 0.58–0.87), decreased PWA in lead I (HR: 0.55, 95% CI: 0.21–0.76), lead II (HR: 0.48, 95% CI: 0.34–0.87), aVL (HR: 0.65, 95% CI: 0.45–0.96), and aVF (HR: 0.61, 95% CI: 0.32–0.89), and the presence of IAB (HR: 2, 95% CI: 1.4–4.2, p = 0.02). PWDisp and PTFV1 were not correlated with PVI outcome. Conclusions: PWDc, PWA, PWV, and IAB are valuable predictors for PVI outcome for PAF at 12 months. Full article
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Review

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19 pages, 1677 KiB  
Review
Beyond Clinical Factors: Harnessing Artificial Intelligence and Multimodal Cardiac Imaging to Predict Atrial Fibrillation Recurrence Post-Catheter Ablation
by Edward T. Truong, Yiheng Lyu, Abdul Rahman Ihdayhid, Nick S. R. Lan and Girish Dwivedi
J. Cardiovasc. Dev. Dis. 2024, 11(9), 291; https://doi.org/10.3390/jcdd11090291 - 19 Sep 2024
Viewed by 480
Abstract
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, with catheter ablation being a key alternative to medical treatment for restoring normal sinus rhythm. Despite advances in understanding AF pathogenesis, approximately 35% of patients experience AF recurrence at 12 months after [...] Read more.
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, with catheter ablation being a key alternative to medical treatment for restoring normal sinus rhythm. Despite advances in understanding AF pathogenesis, approximately 35% of patients experience AF recurrence at 12 months after catheter ablation. Therefore, accurate prediction of AF recurrence occurring after catheter ablation is important for patient selection and management. Conventional methods for predicting post-catheter ablation AF recurrence, which involve the use of univariate predictors and scoring systems, have played a supportive role in clinical decision-making. In an ever-changing landscape where technology is becoming ubiquitous within medicine, cardiac imaging and artificial intelligence (AI) could prove pivotal in enhancing AF recurrence predictions by providing data with independent predictive power and identifying key relationships in the data. This review comprehensively explores the existing methods for predicting the recurrence of AF following catheter ablation from different perspectives, including conventional predictors and scoring systems, cardiac imaging-based methods, and AI-based methods developed using a combination of demographic and imaging variables. By summarising state-of-the-art technologies, this review serves as a roadmap for developing future prediction models with enhanced accuracy, generalisability, and explainability, potentially contributing to improved care for patients with AF. Full article
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