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Atrial Fibrillation: Risk Stratification, Epidemiology, Treatment Advances and Prognostic Interventions
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Atrial Fibrillation: Risk Stratification, Epidemiology, Treatment Advances and Prognostic Interventions

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Electrophysiology and Cardiovascular Physiology".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 1972

Special Issue Editor

Prof. Dr. Rui Bebiano Da Providencia E Costa

E-Mail Website
Guest Editor
1. Institute of Health Informatics Research, University College London, London NW1 2DA, UK
2. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London EC1 7BE, UK
3. Department of Cardiology, Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
Interests: atrial fibrillation; sudden cardiac death; catheter ablation; genetics; drug discovery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will explore current knowledge and innovations in managing atrial fibrillation (AF). AF is the most common sustained arrhythmia, with increasing prevalence linked to aging populations and lifestyle factors such as obesity. Obesity significantly elevates the risk of AF by promoting atrial remodeling, inflammation, and electrophysiological changes, making weight management a critical component of therapy. We are looking for submissions on risk stratification tools that can help to identify patients at higher risk of stroke and mortality, guiding anticoagulation and intervention strategies.

Recent advances in treatment include pulsed field ablation (PFA), a novel non-thermal technique offering precise and safe pulmonary vein isolation with reduced collateral damage. We also seek manuscripts exploring ablation outside the pulmonary veins, targeting additional atrial substrates responsible for more persistent and complex AF.

Overall, the progress in AF management emphasizes personalized therapies, incorporating cutting-edge procedures like PFA and targeted ablation outside pulmonary veins in more complex scenarios, with lifestyle modifications such as obesity reduction and management of multiple comorbidities playing a vital role in reducing disease burden and enhancing quality of life.

Prof. Dr. Rui Bebiano Da Providencia E Costa
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 250 words) can be sent to the Editorial Office for assessment.

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. Journal of Cardiovascular Development and Disease 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 2700 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

  • pulsed field ablation
  • arrhythmia
  • pulmonary veins
  • obesity
  • multi-morbidity

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Published Papers (2 papers)

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15 pages, 3488 KB  
Systematic Review
Pulsed Field Ablation Versus High-Power Short-Duration Ablation for Atrial Fibrillation—A Meta-Analysis of Reconstructed Time-to-Event Data
by Pedro B. Bregion, Felipe S. Passos, Stefano Schena, Luca Fazzini, Hristo Kirov, Camilla S. Rossi, Torsten Doenst, Antonino Di Franco and Tulio Caldonazo
J. Cardiovasc. Dev. Dis. 2026, 13(5), 181; https://doi.org/10.3390/jcdd13050181 - 26 Apr 2026
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Abstract
Background: Pulsed field ablation (PFA) has shown promising results for atrial fibrillation (AF), with efficacy comparable to established ablation techniques. High-power short-duration (HPSD) ablation has also emerged as a potential alternative. However, the relative superiority between these approaches remains uncertain. We performed a [...] Read more.
Background: Pulsed field ablation (PFA) has shown promising results for atrial fibrillation (AF), with efficacy comparable to established ablation techniques. High-power short-duration (HPSD) ablation has also emerged as a potential alternative. However, the relative superiority between these approaches remains uncertain. We performed a systematic review and meta-analysis to address this gap. Methods: Three databases were searched. The primary outcome was freedom from AF recurrence. Secondary outcomes included tamponade and other complications, procedure and fluoroscopy durations. Time-to-event data were reconstructed, and a random-effects model was employed. Given variability in post-ablation blanking periods across studies, landmark analyses were performed using a 3-month cut-off to account for the potential under-detection of early recurrence events. Results: Eight studies (1369 patients [PFA: 642; HPSD: 727]) were included. PFA was associated with greater freedom from AF recurrence (HR 0.751; 95% CI 0.57 to 0.99; p = 0.044). Landmark analyses showed no difference in the 0–3 month period; a significant benefit of PFA was observed thereafter (HR 0.72; 95% CI 0.54 to 0.98; p = 0.033). There were no significant differences between groups in the incidence of tamponade (p = 0.73) or overall complications (p = 0.99). PFA was associated with shorter procedure duration (MD 37.05; 95% CI 27.69 to 46.41; p < 0.01), whereas fluoroscopy duration was significantly shorter in the HPSD group (MD −9.04; 95% CI −11.71 to −6.37; p < 0.001). Conclusion: PFA was associated with a lower risk of AF recurrence compared to HPSD, particularly beyond the late post-ablation period, with similar rates of complications. Although PFA was associated with shorter procedure duration, HPSD demonstrated reduced fluoroscopy time. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Risk Stratification, Epidemiology, Treatment Advances and Prognostic Interventions)
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13 pages, 4743 KB  
Systematic Review
Impact of Atrial Fibrillation on the Outcome of Patients with Brugada Syndrome: A Meta-Analysis
by Max Aboutorabi, Mahmood Ahmad, Jonathan J. H. Bray, Daniel A. Gomes and Rui Providencia
J. Cardiovasc. Dev. Dis. 2025, 12(10), 391; https://doi.org/10.3390/jcdd12100391 - 3 Oct 2025
Cited by 1 | Viewed by 1288
Abstract
Introduction: Atrial fibrillation (AF) is common in patients with Brugada syndrome (BrS). The impact and significance of AF in this patient population needs to be further clarified. Method: We performed a systematic review and meta-analysis of studies comparing the risks of developing major [...] Read more.
Introduction: Atrial fibrillation (AF) is common in patients with Brugada syndrome (BrS). The impact and significance of AF in this patient population needs to be further clarified. Method: We performed a systematic review and meta-analysis of studies comparing the risks of developing major arrhythmic events (MAEs) in patients with BrS with and without AF. Databases including MEDLINE, Embase, and Cochrane CENTRAL were searched from inception to July 2024, using appropriate search and MeSH terms. Data were sought on the comparison of patients with BrS with and without AF. The protocol was specified prior to the searches being performed, and standard meta-analytic techniques were used. Results: Thirteen observational studies were included (a total of 5413 patients). A significant increase in MAEs was observed in patients with both BrS and AF (20.6% vs. 7.8%; OR 2.81, 95% CI 1.82–4.34; p < 0.0001; I2 = 46%). Significantly higher rates of syncope (33.3% vs. 23.4%; OR 1.97, 95% CI 1.04–3.76; p = 0.04, I2 = 59%) and a significant increase in all-cause mortality (11.3% vs. 3.7%; OR 4.21, 95% CI 1.69–10.45; p = 0.002, I2 = 0%) and sodium channel mutations (43.1% vs. 29.9%; OR 1.87, 95% CI 1.07–3.29; p = 0.028, I2 = 0%) were observed for patients with BrS and AF. Conclusions: Patients with both BrS and AF seem to have a more severe disease phenotype. More research into the added role of AF in risk stratification of asymptomatic BrS patients is needed, but the prognostic implications of AF may need to be considered when developing future personalised medicine approaches in the BrS population. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Risk Stratification, Epidemiology, Treatment Advances and Prognostic Interventions)
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