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Clinical Advances in the Diagnosis and Treatment of 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 January 2025) | Viewed by 3535

Special Issue Editor


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Guest Editor
1. Division of Cardiology and Electrophysiology, GZO Regional Health Center, 8620 Wetzikon, Switzerland
2. Division of Electrophysiology, Department of Cardiology, University Heart Center, 8091 Zurich, Switzerland
3. Faculty of Medicine, University of Zurich, 8006 Zurich, Switzerland
Interests: inflammatory heart disease; atrial fibrillation; electrophysiology; heart failure

Special Issue Information

Dear Colleagues,

The prevalence of atrial fibrillation (AF) increases with age, affecting over 28% of patients > 85 years. However, there have been significant advancements in both the diagnosis and treatment of this condition over recent years. Major diagnostic improvements are centered around the integration of technology, with the adoption of wearable devices and smartphone apps that allow for the continuous monitoring and detection of arrhythmias in real time. These tools have enhanced early detection rates, especially in asymptomatic patients, and have improved the patient engagement and self-management of the condition.

Advances in treatment strategies established newer anticoagulants such as direct oral anticoagulants (DOACs) which have become preferred over traditional warfarin due to their better safety profiles and ease of use, without the need for regular blood monitoring. Moreover, catheter ablation, which uses radiofrequency energy or ballon-based cryoablation to isolate pulmonary veins and other selected areas in the heart to prevent AF episodes, has improved in safety and efficacy. Several clinical studies suggest better rhythm control for catheter ablation compared to anti-arrhythmic therapy. Invasive procedures have also benefited from technological advancements such as improved three-dimensional mapping systems or pulsed-field ablation technology, enhancing the success rates and reducing complications.

Furthermore, there has been a growing focus on personalized treatment approaches. This involves tailoring interventions based on individual risk profiles and underlying conditions, improving patient outcomes and reducing the burden of AF on healthcare systems. These clinical advances have significantly contributed to a more effective and efficient management of atrial fibrillation.

Prof. Dr. Urs Eriksson
Guest Editor

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Keywords

  • atrial fibrillation
  • early detection
  • treatment strategies
  • personalized treatment approaches

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Published Papers (2 papers)

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8 pages, 711 KiB  
Article
Association of Diagonal Earlobe Crease with Risk of Atrial Fibrillation in Stable Patients with Coronary Artery Disease
by Moo-Nyun Jin, Changho Song and Young Ju Kim
J. Clin. Med. 2024, 13(18), 5643; https://doi.org/10.3390/jcm13185643 - 23 Sep 2024
Viewed by 1864
Abstract
Background: Diagonal earlobe crease (DELC) is a proposed visible predictor of coronary artery disease (CAD). However, studies on the association between atrial fibrillation (AF) and DELC are lacking. This study evaluated the association between DELC and the incidence of AF in patients [...] Read more.
Background: Diagonal earlobe crease (DELC) is a proposed visible predictor of coronary artery disease (CAD). However, studies on the association between atrial fibrillation (AF) and DELC are lacking. This study evaluated the association between DELC and the incidence of AF in patients with CAD. Methods: A total of 669 participants aged <65 years (mean, 53.8 ± 7.5 years) diagnosed with CAD and without AF were evaluated for the presence of DELC. The study outcome was the incidence of AF based on the presence of DELC. The study period was planned for 60 months with a minimum follow-up period of 12 months. Results: Herein, the incidence of DELC was 10.8%. During the follow-up period (44.6 ± 14.9 months), the incidences of AF development were 16.4% and 8.4% in DELC and non-DELC groups, respectively. Kaplan–Meier analysis revealed that the occurrence of AF was significantly higher in the DELC group than in the non-DELC group (log-rank test, p = 0.02). Compared with patients without DELC, patients with DELC had a high risk of AF development (adjusted hazard ratio = 1.88, 95% confidence interval = 1.01–3.53). Conclusions: DELC is associated with an increased risk of AF in patients with CAD. These findings may aid in the detection of AF in patients with CAD. Full article
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21 pages, 2485 KiB  
Systematic Review
Echocardiographic Assessment of Left Atrial Mechanics in Patients with Atrial Fibrillation Undergoing Electrical Cardioversion: A Systematic Review
by Andrea Sonaglioni, Gian Luigi Nicolosi, Antonino Bruno, Michele Lombardo and Paola Muti
J. Clin. Med. 2024, 13(21), 6296; https://doi.org/10.3390/jcm13216296 - 22 Oct 2024
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Abstract
Background: To date, only a few studies have evaluated left atrial (LA) mechanics in patients with atrial fibrillation (AF) scheduled for electrical cardioversion (ECV). The present systematic review has been primarily designed to summarize the main findings of these studies and to [...] Read more.
Background: To date, only a few studies have evaluated left atrial (LA) mechanics in patients with atrial fibrillation (AF) scheduled for electrical cardioversion (ECV). The present systematic review has been primarily designed to summarize the main findings of these studies and to examine the overall effect of AF on left atrial reservoir strain (LASr) in patients undergoing ECV. Methods: All the echocardiographic studies evaluating the effect of AF on LA mechanics in patients scheduled for ECV, selected from the PubMed and EMBASE databases, were included. There was no limitation of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The full texts of 12 studies with 880 AF patients were analyzed. The pooled ECV success rate was 91.5% (range 65.8–100%). Over a median follow-up of 5.4 months (range 0.3–12 months), 35.2% of the patients (range 5–68.8%) experienced AF recurrence. At baseline, the average LASr was 11.4% (range 6.2–17.7%). A reduced LASr before ECV was strongly correlated with reduced left atrial appendage (LAA) flow velocities and/or thrombosis. The main independent predictors of cardioversion failure were impaired LASr and previous AF history. A severe LASr deterioration was independently correlated with AF recurrence after ECV. The other independent predictors of AR relapses were LA asynchrony, reduced difference between post- and pre-ECV LASr, and reduced right atrial reservoir strain. Conclusions: LASr assessment before ECV may provide useful prognostic information about AF relapses and improve the refinement of the thromboembolic risk of AF patients scheduled for ECV. Full article
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