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Therapeutic Innovations in the Management of Patients with Atrial Fibrillation
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Therapeutic Innovations in the Management of Patients with Atrial Fibrillation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 September 2023) | Viewed by 5134

Special Issue Editor

Dr. Ghanshyam Shantha

E-Mail Website
Guest Editor
Cardiac Electrophysiology, Wake Forest University, Winston-Salem, NC, USA
Interests: atrial fibrillation; catheter ablation; novel therapies; individualistic medicine

Special Issue Information

Dear Colleagues,

With the global burden of obesity on the rise, it is expected that one in five human beings will have atrial fibrillation during their lifetime. Although we have come a long way in terms of effective anticoagulation, better diagnosis and advanced treatment options, critical knowledge gaps exist. Since patients with atrial fibrillation are a heterogenous group, one-size-fits-all is an ineffective approach when designing treatment options in this group. Individualistic medicine is the need of the hour. On these grounds, this Special Issue of Journal of Clinical Medicine has as its main objective to synthesize papers focused on the comprehensive management of atrial fibrillation. Special emphasis will be placed on individualizing the upcoming therapeutic innovations in this field to individual patient needs, and on identifying knowledge gaps to stimulate future research. Original investigations, review articles, and short communications are welcome. Case reports will not be considered.

In summary, this Special Issue aims to place therapeutic innovations in the perspective of individualistic care of patients with atrial fibrillation. Potential topics include but are not limited to the following:

  • Anticoagulation;
  • Refining stroke risk algorithms;
  • Gender- and ethnicity-specific demographics;
  • Use of digital technology for early diagnosis and monitoring;
  • Risk factor modification;
  • Anti-arrhythmic medications;
  • Advances in catheter ablation of atrial fibrillation.

All papers submitted to this Special Issue are reviewed by independent referees, and the final decision is made by a JCM Editorial Board Member who does not have any conflicts of interest with the submission.

Dr. Ghanshyam Shantha
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. Journal of Clinical Medicine 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
  • anticoagulation
  • stroke
  • catheter ablation
  • anti-arrhythmic medications

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Published Papers (2 papers)

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Review

14 pages, 2676 KiB  
Review
Electric Cardioversion vs. Pharmacological with or without Electric Cardioversion for Stable New-Onset Atrial Fibrillation: A Systematic Review and Meta-Analysis
by Paritosh Prasai, Dhan Bahadur Shrestha, Eltaib Saad, Angkawipa Trongtorsak, Aarya Adhikari, Suman Gaire, Prakash Raj Oli, Jurgen Shtembari, Pabitra Adhikari, Yub Raj Sedhai, Muhammad Sikander Akbar, Islam Y. Elgendy and Ghanshyam Shantha
J. Clin. Med. 2023, 12(3), 1165; https://doi.org/10.3390/jcm12031165 - 1 Feb 2023
Cited by 3 | Viewed by 2577
Abstract
Background: There is no clear consensus on the preference for pharmacological cardioversion (PC) in comparison to electric cardioversion (EC) for hemodynamically stable new-onset atrial fibrillation (NOAF) patients presenting to the emergency department (ED). Methods: A systematic review and meta-analysis was conducted to assess [...] Read more.
Background: There is no clear consensus on the preference for pharmacological cardioversion (PC) in comparison to electric cardioversion (EC) for hemodynamically stable new-onset atrial fibrillation (NOAF) patients presenting to the emergency department (ED). Methods: A systematic review and meta-analysis was conducted to assess PC (whether being followed by EC or not) vs. EC in achieving cardioversion for hemodynamically stable NOAF patients. PubMed, PubMed Central, Embase, Scopus, and Cochrane databases were searched to include relevant studies until 7 March 2022. The primary outcome was the successful restoration of sinus rhythm, and secondary outcomes included emergency department (ED) revisits with atrial fibrillation (AF), hospital readmission rate, length of hospital stay, and cardioversion-associated adverse events. Results: A total of three randomized controlled trials (RCTs) and one observational study were included. There was no difference in the rates of successful restoration to sinus rhythm (88.66% vs. 85.25%; OR 1.14, 95% CI 0.35–3.71; n = 868). There was no statistical difference across the two groups for ED revisits with AF, readmission rates, length of hospital stay, and cardioversion-associated adverse effects, with the exception of hypotension, whose incidence was lower in the EC group (OR 0.11, 95% CI 0.04–0.27: n = 727). Conclusion: This meta-analysis suggests that there is no difference in successful restoration of sinus rhythm with either modality among patients with hemodynamically stable NOAF. Full article
(This article belongs to the Special Issue Therapeutic Innovations in the Management of Patients with Atrial Fibrillation)
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11 pages, 532 KiB  
Review
Efficacy and Safety of Pulsed Field Ablation in Atrial Fibrillation: A Systematic Review
by Jurgen Shtembari, Dhan Bahadur Shrestha, Bishnu Deep Pathak, Bishal Dhakal, Binit Upadhaya Regmi, Nimesh K. Patel, Ghanshyam Palamaner Subash Shantha, Gautham Kalahasty, Karoly Kaszala and Jayanthi N. Koneru
J. Clin. Med. 2023, 12(2), 719; https://doi.org/10.3390/jcm12020719 - 16 Jan 2023
Cited by 10 | Viewed by 4155
Abstract
Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia associated with high morbidity and mortality. AF treatment is guided by a patient–provider risk–benefit discussion regarding drug versus ablation or combination. Thermal ablation has a high rate of adverse events compared to pulsed [...] Read more.
Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia associated with high morbidity and mortality. AF treatment is guided by a patient–provider risk–benefit discussion regarding drug versus ablation or combination. Thermal ablation has a high rate of adverse events compared to pulsed field ablation (PFA). In this systematic review, we aimed to determine the safety and efficacy of PFA. Methods: The electronic search for relevant articles in English was completed in PubMed, PubMed Central, Cochrane library, Scopus, and Embase databases till July 2022. The screening was completed via the use of Covidence software. The risk of bias assessment and data extraction from the included studies was performed, and the narrative synthesis was performed accordingly. Results: A total of six studies were selected for review and 1897 patients receiving PFA were involved in these studies. Our review was focused on pulmonary vein isolation success, major adverse events, and arrhythmia recurrence. Successful pulmonary vein isolation (PVI) was completed in 100% of cases except in two studies. In one of them, six out of seven patients (86%) in the epicardial cohort had successful PVI. In the MANIFEST-PF survey, the acute PVI success rate was 99.9%. The major complications were rare and included pericardial tamponade, vascular complications requiring surgery, and stroke. The atrial arrhythmia recurrence was higher in the thermal group than in the PFA group (39% vs. 11%). Conclusions: The success rate of PVI by PFA is high, and major adverse events are low. PFA is found to decrease the recurrence of atrial arrhythmia compared to thermal ablation. Substantial randomized controlled trials (RCTs) are needed to validate the efficacy and safety of PFA over conventional methods. Full article
(This article belongs to the Special Issue Therapeutic Innovations in the Management of Patients with Atrial Fibrillation)
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