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Clinical Aspects of Cardiac Arrhythmias and Arrhythmogenic Disorders
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Clinical Aspects of Cardiac Arrhythmias and Arrhythmogenic Disorders

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

Deadline for manuscript submissions: 25 December 2025 | Viewed by 1684

Special Issue Editors

Dr. Piotr Bienias

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Guest Editor
Department of Internal Medicine & Cardiology, Medical University of Warsaw, Lindleya 4 St., 02-005 Warsaw, Poland
Interests: electrocardiography; ambulatory electrocardiography monitoring; arrhythmias non invasive assessment; cardiac involvement and arrhythmias in rare and genetic disorders
Dr. Jakub Baran

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Guest Editor
1. Department of Internal Medicine & Cardiology, Medical University of Warsaw, Lindleya 4 St., 02-005 Warsaw, Poland
2. Division of Clinical Electrophysiology, Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Grenadierów 51/59, 04-073 Warsaw, Poland
Interests: invasive arrhythmia assessment and treatment; catheter ablation; ventricular arrhythmia; sudden cardiac death risk stratification

Special Issue Information

Dear Colleagues,

Issues related to cardiac arrhythmias constitute an inherent problem in modern cardiology and internal medicine in general. In everyday clinical practice, we encounter cases that are seemingly easy but actually extremely difficult. Expanding our knowledge on various aspects of arrhythmology is extremely important for every cardiologist. We are currently focusing on the development of knowledge in this area, acquiring more and more experience with modern therapeutic technologies.

It is extremely important that our own research and observation results be presented to the international cardiology community. Only in this way can we exchange experiences and scientific progress moving forward. This is the purpose of the current Special Issue of the Journal of Clinical Medicine, entitled “Clinical Aspects of Cardiac Arrhythmias and Arrhythmogenic Disorders”.

Therefore, researchers in the field of cardiac arrhythmias are encouraged to submit their findings to this Special Issue in the form of original articles or reviews. We are excited to invite you to contribute to this Special Issue.

Dr. Piotr Bienias
Dr. Jakub Baran
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 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

  • non-invasive arrhythmia assessment
  • electrocardiography
  • invasive arrhythmia assessment
  • invasive electrophysiology
  • catheter ablation
  • implantable devices
  • rare diseases and arrhythmias
  • arrhythmia risk stratification
  • genetics aspects of arrhythmogenesis
  • channelopathy

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Published Papers (3 papers)

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Research

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14 pages, 631 KB  
Article
The Impact of Obesity on the Left Atrium and Arrhythmia Recurrence in Patients with Atrial Fibrillation Undergoing Ablation
by Beata Uziębło-Życzkowska, Marek Kiliszek, Krystian Krzyżanowski and Paweł Krzesiński
J. Clin. Med. 2025, 14(19), 7043; https://doi.org/10.3390/jcm14197043 - 5 Oct 2025
Viewed by 542
Abstract
Objectives: Obesity and atrial fibrillation (AF) are strongly linked and are both associated with significant left atrial (LA) pathology. This study aimed to assess differences in LA size and function between obese and non-obese AF patients and to evaluate AF recurrence in [...] Read more.
Objectives: Obesity and atrial fibrillation (AF) are strongly linked and are both associated with significant left atrial (LA) pathology. This study aimed to assess differences in LA size and function between obese and non-obese AF patients and to evaluate AF recurrence in both groups. Materials and Methods: We retrospectively analyzed patients undergoing first-time ablation for AF. Obesity was defined as body mass index ≥30 kg/m2, and patients were divided accordingly into obese and non-obese groups. Results: Among 672 patients (median age of 66 years; 39.1% women), 308 (45.8%) were obese. Obese patients had significantly larger LA dimensions (LA area, LA volume, and LAVI indexed to height2 (but not that indexed to body surface area (BSA)); p < 0.001), as well as higher LA-pressure-related parameters (LA stiffness index (p = 0.004), E-wave velocity (p = 0.002), and E/e′ ratio (p < 0.001)) and invasively measured mean LA pressure (p < 0.0001). However, there were no significant differences in parameters directly reflecting LA function, such as LA emptying fraction, LA reservoir strain, or LA appendage velocity. These findings remained consistent in the sinus rhythm subgroup (n = 374). The 1-year AF recurrence rate did not differ between obese and non-obese groups (data available for 73.8% (496) patients; p = 0.40), regardless of baseline rhythm. Conclusions: In AF patients undergoing their first ablation, obesity was associated with a larger LA size and higher LA pressure. In obese individuals, indexing LA dimensions to height2 seems to better reflect LA enlargement than indexing to BSA. LA function and AF recurrence rates after a 1-year follow-up period were similar between obese and non-obese patients. Full article
(This article belongs to the Special Issue Clinical Aspects of Cardiac Arrhythmias and Arrhythmogenic Disorders)
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15 pages, 651 KB  
Article
The Impact of Comorbidities on Pulmonary Function Measured by Spirometry in Patients After Percutaneous Cryoballoon Pulmonary Vein Isolation Due to Atrial Fibrillation
by Monika Różycka-Kosmalska, Marcin Kosmalski, Michał Panek, Alicja Majos, Izabela Szymczak-Pajor, Agnieszka Śliwińska, Jacek Kasznicki, Jerzy Krzysztof Wranicz and Krzysztof Kaczmarek
J. Clin. Med. 2025, 14(15), 5431; https://doi.org/10.3390/jcm14155431 - 1 Aug 2025
Viewed by 616
Abstract
Background/Objectives: Pulmonary vein isolation (PVI) via cryoballoon ablation (CBA) is a recommended therapeutic strategy for patients with symptomatic paroxysmal and persistent atrial fibrillation (AF) who are refractory to antiarrhythmic drugs. Although PVI has demonstrated efficacy in reducing AF recurrence and improving patients’ quality [...] Read more.
Background/Objectives: Pulmonary vein isolation (PVI) via cryoballoon ablation (CBA) is a recommended therapeutic strategy for patients with symptomatic paroxysmal and persistent atrial fibrillation (AF) who are refractory to antiarrhythmic drugs. Although PVI has demonstrated efficacy in reducing AF recurrence and improving patients’ quality of life, its impact on respiratory function is not well understood, particularly in patients with comorbid conditions. The aim of the study was to search for functional predictors of the respiratory system in the process of evaluating the efficiency of clinical assessment of CBA in patients with AF. Methods: We conducted a prospective study on 42 patients with symptomatic AF who underwent CBA, assessing their respiratory function through spirometry before and 30 days after the procedure. Exclusion criteria included pre-existing lung disease and cardiac insufficiency. The impact of variables such as body mass index (BMI), coronary artery disease (CAD) and heart failure (HF) on spirometry parameters was analyzed using statistical tests. Results: No significant changes were observed in overall post-PVI spirometry parameters for the full cohort. However, post hoc analyses revealed a significant decline in ΔMEF75 in patients with CAD and BMI ≥ 30 kg/m2, whereas ΔFEV1/FVCex was significantly increased in patients with HF, as well as in patients with ejection fraction (EF) < 50%. Conclusions: CBA for AF does not universally affect respiratory function in the short term, but specific subgroups, including patients with CAD and a higher BMI, may require post-procedure respiratory monitoring. In addition, PVI may improve lung function in patients with HF and reduced EF. Full article
(This article belongs to the Special Issue Clinical Aspects of Cardiac Arrhythmias and Arrhythmogenic Disorders)
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Other

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12 pages, 10732 KB  
Case Report
One Shot, One Rhythm: Termination of Refractory Persistent Atrial Fibrillation in a Young Patient via Single Pulmonary Vein Application: A Case Report
by Jonasz Kozielski, Alicja Dąbrowska-Kugacka, Ludmiła Daniłowicz-Szymanowicz and Marek Szołkiewicz
J. Clin. Med. 2025, 14(20), 7297; https://doi.org/10.3390/jcm14207297 - 16 Oct 2025
Viewed by 300
Abstract
Background/Objectives: Atrial fibrillation (AF) is the most common sustained arrhythmia, with catheter ablation outcomes differing significantly between paroxysmal and persistent forms. While pulmo-nary vein isolation (PVI) remains the cornerstone of ablation, persistent AF is often associ-ated with atrial remodeling and non-pulmonary vein triggers, [...] Read more.
Background/Objectives: Atrial fibrillation (AF) is the most common sustained arrhythmia, with catheter ablation outcomes differing significantly between paroxysmal and persistent forms. While pulmo-nary vein isolation (PVI) remains the cornerstone of ablation, persistent AF is often associ-ated with atrial remodeling and non-pulmonary vein triggers, reducing procedural success rates and necessitating repeat interventions. However, in selected patients with minimal atrial substrate, a single PVI may achieve durable rhythm control. This case report illus-trates such a scenario in a young patient with persistent AF and tachyarrhythmia-induced cardiomyopathy (TIC). Methods: A 42-year-old previously healthy male presented with newly diagnosed persistent AF complicated by TIC and heart fail-ure (left ventricular ejection fraction [LVEF] 25%). Despite rate control, anticoagulation, guideline-directed heart failure therapy, amiodarone pretreatment, and two failed electrical cardioversions, the patient remained symptomatic. Elec-troanatomic mapping was performed to assess atrial substrate prior to radiofrequency ablation. Results: Mapping revealed no extensive low-voltage zones, indicating absence of significant atrial fibrosis. During ablation, si-nus rhythm was restored spontaneously with a single application targeting the infero-posterior aspect of the right infe-rior pulmonary vein. No additional arrhythmogenic substrate was identified. The patient maintained sinus rhythm throughout 14 months of follow-up, with marked clinical improvement, normalization of LVEF (55%), regression of atrial and ventricular enlargement, and resolution of heart failure symptoms. Quality of life, assessed by the ASTA question-naire, improved from 24 to 0 points. Conclusions: This case highlights that even in therapy-resistant persistent AF with severe structural and functional cardiac impairment, arrhythmia may be driven by discrete pulmonary vein-dependent mechanisms. Careful patient selection, particu-larly in younger individuals without advanced atrial remodeling, can identify those in whom PVI alone achieves durable rhythm control and reverse cardiac remodeling. Full article
(This article belongs to the Special Issue Clinical Aspects of Cardiac Arrhythmias and Arrhythmogenic Disorders)
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