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Advances in Understanding Cardiac Arrhythmias
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Advances in Understanding Cardiac Arrhythmias

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

Deadline for manuscript submissions: closed (25 February 2024) | Viewed by 4520

Special Issue Editor

Dr. Andrea Di Cori

E-Mail Website
Guest Editor
Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
Interests: atrial fibrillation; arrhythmias; cardiovascular system; cardiac electrophysiology; catheter ablation

Special Issue Information

Dear Colleagues,

Important advances have been made in the past few years in the management of cardiac arrhythmias. There is now a greater understanding of the pathophysiological mechanisms underlying brady- and tachyarrhythmias. Bradyarrhythmias, supraventricular/ventricular tachycardias and atrial fibrillation (AF) have seen significant improvements in detection, prevention and treatments.

The development of innovative therapies such as cardiac pacing, implantable defibrillators and ablation technologies has significantly changed the prognosis of many cardiac diseases. Biotechnologies are leading actors of such a revolution. The long-term recording has increased the diagnostic accuracy of arrhythmia detection. Cardiac pacing is the clinical outcome of recurrent syncope. Implantable cardiac defibrillators (ICDs) can prevent sudden cardiac death. Transcatheter ablation can improve the quality of life of patients affected by symptomatic supraventricular and ventricular arrhythmias. Moreover, all these topics continue to be actively researched, with important new data emerging on prevention and management.

The present Special Issue aims to focus on recent advances in the knowledge and management of cardiac arrhythmias, including the development of new biological aspects, new techniques, and new equipment.

Dr. Andrea Di Cori
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

  • cardiac arrhythmias
  • supraventricular tachycardia
  • ventricular tachycardia
  • atrial fibrillation
  • ventricular fibrillation
  • sudden death
  • syncope
  • ablation
  • ICD
  • pacemakers
  • implantable loop recorders

Published Papers (3 papers)

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Research

14 pages, 4455 KiB  
Article
Genetic Susceptibility to Arrhythmia Phenotypes in a Middle Eastern Cohort of 14,259 Whole-Genome Sequenced Individuals
by Fatima Qafoud, Mohamed Elshrif, Khalid Kunji, Asma Althani, Amar Salam, Jassim Al Suwaidi, Nidal Asaad, Dawood Darbar and Mohamad Saad
J. Clin. Med. 2024, 13(4), 1102; https://doi.org/10.3390/jcm13041102 - 15 Feb 2024
Viewed by 738
Abstract
Background: The current study explores the genetic underpinnings of cardiac arrhythmia phenotypes within Middle Eastern populations, which are under-represented in genomic medicine research. Methods: Whole-genome sequencing data from 14,259 individuals from the Qatar Biobank were used and contained 47.8% of Arab ancestry, 18.4% [...] Read more.
Background: The current study explores the genetic underpinnings of cardiac arrhythmia phenotypes within Middle Eastern populations, which are under-represented in genomic medicine research. Methods: Whole-genome sequencing data from 14,259 individuals from the Qatar Biobank were used and contained 47.8% of Arab ancestry, 18.4% of South Asian ancestry, and 4.6% of African ancestry. The frequency of rare functional variants within a set of 410 candidate genes for cardiac arrhythmias was assessed. Polygenic risk score (PRS) performance for atrial fibrillation (AF) prediction was evaluated. Results: This study identified 1196 rare functional variants, including 162 previously linked to arrhythmia phenotypes, with varying frequencies across Arab, South Asian, and African ancestries. Of these, 137 variants met the pathogenic or likely pathogenic (P/LP) criteria according to ACMG guidelines. Of these, 91 were in ACMG actionable genes and were present in 1030 individuals (~7%). Ten P/LP variants showed significant associations with atrial fibrillation p < 2.4 × 10−10. Five out of ten existing PRSs were significantly associated with AF (e.g., PGS000727, p = 0.03, OR = 1.43 [1.03, 1.97]). Conclusions: Our study is the largest to study the genetic predisposition to arrhythmia phenotypes in the Middle East using whole-genome sequence data. It underscores the importance of including diverse populations in genomic investigations to elucidate the genetic landscape of cardiac arrhythmias and mitigate health disparities in genomic medicine. Full article
(This article belongs to the Special Issue Advances in Understanding Cardiac Arrhythmias)
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9 pages, 1665 KiB  
Article
Feasibility and Accuracy of Noninvasive Continuous Arterial Pressure Monitoring during Transcatheter Atrial Fibrillation Ablation
by Andrea Di Cori, Matteo Parollo, Federico Fiorentini, Salvatore Della Volpe, Lorenzo Mazzocchetti, Valentina Barletta, Luca Segreti, Stefano Viani, Raffaele De Lucia, Luca Paperini, Antonio Canu, Gino Grifoni, Ezio Soldati, Maria Grazia Bongiorni and Giulio Zucchelli
J. Clin. Med. 2023, 12(6), 2388; https://doi.org/10.3390/jcm12062388 - 20 Mar 2023
Cited by 1 | Viewed by 1615
Abstract
Introduction: Transcatheter atrial fibrillation (AF) ablation is still carried out with continuous invasive radial arterial blood pressure (IBP) monitoring in many centers. Continuous noninvasive blood pressure (CNBP) measurement using the volume-clamp method is a noninvasive alternative method used in ICU. No data on [...] Read more.
Introduction: Transcatheter atrial fibrillation (AF) ablation is still carried out with continuous invasive radial arterial blood pressure (IBP) monitoring in many centers. Continuous noninvasive blood pressure (CNBP) measurement using the volume-clamp method is a noninvasive alternative method used in ICU. No data on CNBP reliability are available in the electrophysiology lab during AF ablation, where rhythm variations are common. Background: The objective of the present study was to compare continuous noninvasive arterial pressure measured with the ClearSight device (Edwards Lifesciences, Irvine, CA, USA) with invasive radial artery pressure used as the reference method during AF ablation. Methods: We prospectively enrolled 55 consecutive patients (age 62 ± 11 years, 80% male) undergoing transcatheter AF ablation (62% paroxysmal, 38% persistent) at our center. Standard of care IBP monitoring via a radial cannula and a contralateral noninvasive finger volume-clamp CNBP measurement device were positioned simultaneously in all patients for the entire procedure. Bland-Altman analysis was used to analyze the agreement between the two techniques. Results: A total of 1219 paired measurements for systolic, diastolic, and mean arterial pressure were obtained in 55 subjects, with a mean (SD) of 22 (9) measurements per patient. The mean bias (SD) was −12.97 (13.89) mmHg for systolic pressure (level of agreement −14.24–40.20; correlation coefficient 0.84), −1.85 (8.52) mmHg for diastolic pressure (level of agreement −18.54–14.84; correlation coefficient 0.77) and 2.31 (8.75) mmHg for mean pressure (level of agreement −14.84–19.46; correlation coefficient 0.85). Conclusion: In patients undergoing AF ablation, CNBP monitoring with the ClearSight device showed acceptable agreement with IBP monitoring. Larger studies are needed to confirm the potential clinical implications of continuous noninvasive BP monitoring during AF ablation. Full article
(This article belongs to the Special Issue Advances in Understanding Cardiac Arrhythmias)
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11 pages, 1530 KiB  
Article
Spontaneous Variation of Ventriculo-Atrial Interval after Tachycardia Induction: Determinants and Usefulness in the Diagnosis of Supraventricular Tachycardias with Long Ventriculoatrial Interval
by Olga Durán-Bobin, Jesús Hernández, José Moríñigo, Manuel Sánchez-García, Loreto Bravo, Javier Fernández-Portales, Armando Oterino, Alba Cruz, Carlos González-Juanatey, Pedro L. Sánchez and Javier Jiménez-Candil
J. Clin. Med. 2023, 12(2), 409; https://doi.org/10.3390/jcm12020409 - 4 Jan 2023
Viewed by 1719
Abstract
Background: Determining the mechanism of supraventricular tachycardias with prolongedP ventriculoatrial (VA) intervals is sometimes a challenge. Our objective is to analyse the determinants, time course and diagnostic accuracy (atypical atrioventricular nodal reentrant tachycardias [AVNRT] versus orthodromic reentrant tachycardias through an accessory pathway [ORT]) [...] Read more.
Background: Determining the mechanism of supraventricular tachycardias with prolongedP ventriculoatrial (VA) intervals is sometimes a challenge. Our objective is to analyse the determinants, time course and diagnostic accuracy (atypical atrioventricular nodal reentrant tachycardias [AVNRT] versus orthodromic reentrant tachycardias through an accessory pathway [ORT]) of spontaneous VA intervals variation in patients with narrow QRS tachycardias and prolonged VA. Methods: A total of 156 induced tachycardias were studied (44 with atypical AVNRT and 112 with ORT). Two sets of 10 measurements were performed for each patient—after tachycardia induction and one minute later. VA and VV intervals were determined. Results: The difference between the longest and the shortest VA interval (Dif-VA) correlates significantly with the diagnosis of atypical AVNRT (C coefficient = 0.95 and 0.85 after induction and at one minute, respectively; p < 0.001). A Dif-VA ≥ 15 ms presents a sensitivity and specificity for atypical AVNRT of 50% and 99%, respectively after induction, and of 27% and 100% one minute later. We found a robust and significant correlation between the fluctuations of VV and VA intervals in atypical AVNRTs (Coefficient Rho: 0.56 and 0.76, after induction and at one minute, respectively; p < 0.001 for both) but not in ORTs. Conclusions: The analysis of VA interval variability after induction and one minute later correctly discriminates atypical AVNRT from ORT in almost all cases. Full article
(This article belongs to the Special Issue Advances in Understanding Cardiac Arrhythmias)
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