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Clinical Updates and Perspectives in 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: 25 September 2026 | Viewed by 636

Special Issue Editors


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Guest Editor
1. Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
2. Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
Interests: cardiac electrophysiology; atrial fibrillation; arrhythmia

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Guest Editor
1. Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester LE3 9QP, UK
2. Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
Interests: cardiac electrophysiology; cardiac care; atrial fibrillation

Special Issue Information

Dear Colleagues,

Atrial fibrillation remains the most common sustained cardiac arrhythmia and a leading cause of stroke, heart failure, hospitalisation, and healthcare burden worldwide. Despite major advances, significant gaps remain in early detection, risk stratification, and durable rhythm control. Current research highlights persistent challenges in translating mechanistic insights into personalised, effective, and scalable care.

This Special Issue aims to provide a focused update on contemporary advances and unresolved problems in atrial fibrillation. It will address epidemiology, mechanisms of atrial cardiomyopathy, risk prediction, and thromboprophylaxis, as well as evolving strategies in rhythm and rate control. Emphasis will be placed on modern diagnostic tools, continuous and remote monitoring, catheter ablation techniques, and emerging technologies, including digital health and artificial intelligence.

We invite high-quality original research and reviews that advance understanding and improve clinical practice in atrial fibrillation. By bringing together multidisciplinary perspectives, this Special Issue seeks to stimulate collaboration, guide future research priorities, and support evidence-based, patient-centred management of atrial fibrillation.

Dr. Riyaz Somani
Dr. Ibrahim Antoun
Guest Editors

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.

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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
  • catheter ablation
  • risk prediction
  • stroke prevention
  • digital health and artificial intelligence

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Published Papers (1 paper)

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9 pages, 507 KB  
Opinion
Device-Detected Atrial Fibrillation: Why Time-Based Thresholds Are No Longer Fit for Purpose
by Ahmed El-Medany
J. Clin. Med. 2026, 15(8), 2961; https://doi.org/10.3390/jcm15082961 - 14 Apr 2026
Viewed by 375
Abstract
Advances in implantable and wearable cardiac monitoring technologies have led to widespread detection of brief, often asymptomatic atrial high-rate episodes, frequently labelled as device-detected atrial fibrillation (AF). While detection has increased substantially, the clinical interpretation of these findings remains uncertain. Observational studies demonstrate [...] Read more.
Advances in implantable and wearable cardiac monitoring technologies have led to widespread detection of brief, often asymptomatic atrial high-rate episodes, frequently labelled as device-detected atrial fibrillation (AF). While detection has increased substantially, the clinical interpretation of these findings remains uncertain. Observational studies demonstrate associations between AF burden and stroke risk but reveal marked inter-individual heterogeneity and no consistent temporal threshold below which risk is eliminated. Recent randomised controlled trials show that anticoagulation guided solely by arrhythmia duration confers limited net clinical benefit, with modest reductions in ischaemic stroke offset by increased bleeding. These findings challenge the biological and clinical validity of rigid time-based thresholds for intervention. Increasing evidence suggests that AF may act primarily as a marker of underlying atrial disease rather than the sole mechanistic cause of thromboembolism. This article provides an evidence-informed perspective on the interpretation of device-detected AF in contemporary clinical practice and argues for a shift away from duration-based triggers toward a longitudinal, risk-adapted approach that integrates AF trajectory, atrial substrate, and clinical context. Emerging tools such as artificial intelligence-enhanced electrocardiography may help identify occult atrial pathology but must augment rather than replace clinical judgement. Proportionate, individualised care should supersede reflexive treatment strategies in the management of device-detected AF. Full article
(This article belongs to the Special Issue Clinical Updates and Perspectives in Atrial Fibrillation)
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