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Clinical Perspectives on Cardiac Electrophysiology and Arrhythmias
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Clinical Perspectives on Cardiac Electrophysiology and Arrhythmias

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

Deadline for manuscript submissions: closed (8 March 2025) | Viewed by 4864

Special Issue Editors

Prof. Dr. Constantin T. Luca

E-Mail Website
Guest Editor
1. Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
2. Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
3. Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
Interests: cardiac arrhythmias; arrhythmogenic disorders; atrial fibrillation; cardiac pacing; implantable cardioverter-defibrillators; cardiac resynchronization therapy; heart failure; acute coronary syndromes; electrical storm; acute cardiovascular care
Dr. Simina Crisan

E-Mail Website
Guest Editor
1. Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
2. Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
3. Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
Interests: cardiac arrhythmias; atrial fibrillation; heart failure; acute coronary syndromes; electrical storm; acute cardiovascular care

Special Issue Information

Dear Colleagues,

The field of electrophysiology and cardiac arrhythmias is experiencing consistent growth, with new therapeutic procedures emerging to improve the prognosis of cardiovascular patients. Great progress has been achieved in terms of pacing therapy, cardiac resynchronization therapy, and catheter ablation, introducing important clinical implications. Moreover, the significant burden of atrial fibrillation on healthcare systems persists, despite substantial research efforts, and remains an important issue; thus, further studies regarding underlying mechanisms and effective treatments are of great interest.

This Special Issue of the Journal of Clinical Medicine, on “Clinical Perspectives on Cardiac Electrophysiology and Arrhythmias”, will focus on recent research in the field of diagnostics and the treatment of arrhythmias and electrophysiology. We welcome papers summarizing the current state of knowledge, those related to specific arrhythmogenic diseases (e.g., atrial fibrillation, cardiomyopathies, electrical storm), as well as those highlighting the field of interventional electrophysiology.

Prof. Dr. Constantin T. Luca
Dr. Simina Crisan
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

  • cardiac arrhythmias
  • atrial fibrillation
  • cardiac pacing
  • implantable cardioverter-defibrillators
  • cardiac resynchronization therapy
  • catheter ablation
  • arrhythmogenic disorders
  • cardiomyopathy
  • electrical storm
  • heart failure

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Published Papers (3 papers)

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Research

14 pages, 1753 KiB  
Article
Long-Term Outcomes after Convergent Procedure for Atrial Fibrillation
by Borut Geršak, Veronika Podlogar, Tine Prolič Kalinšek and Matevž Jan
J. Clin. Med. 2024, 13(18), 5508; https://doi.org/10.3390/jcm13185508 - 18 Sep 2024
Viewed by 1816
Abstract
Background: The aim of this single-center retrospective study was to evaluate the long-term outcomes after the convergent procedure (CP) for treatment of AF. Methods: We analyzed the outcomes of patients that underwent CP from January 2009 until July 2020. A total [...] Read more.
Background: The aim of this single-center retrospective study was to evaluate the long-term outcomes after the convergent procedure (CP) for treatment of AF. Methods: We analyzed the outcomes of patients that underwent CP from January 2009 until July 2020. A total of 119 patients with paroxysmal AF (23.5%), persistent AF (5.9%), or long-standing persistent AF (70.6%) that attended long-term follow-up were included. The outcomes were assessed 1 year after the CP and at long-term follow-up. At the 1-year follow-up, rhythm and AF burden were assessed for patients with an implantable loop recorder (61.2%). For others, rhythm was assessed by clinical presentation and 12-lead ECG. At long-term follow-up, patients with sinus rhythm (SR) or an unclear history were assessed with a 7-day Holter ECG monitor, and AF burden was determined. Long-term success was defined as freedom from AF/atrial flutter (AFL) with SR on a 12-lead ECG and AF/AFL burden < 1% on the 7-day Holter ECG. Results: At 1-year follow-up, 91.4% of patients had SR and 76.1% of patients had AF/AFL burden < 1%. At long-term follow-up (8.3 ± 2.8 years), 65.5% of patients had SR and 53.8% of patients had AF/AFL burden < 1% on the 7-day Holter ECG. Additional RFAs were performed in 32.8% of patients who had AF or AFL burden < 1%. At long-term follow-up, age, body mass index, and left atrial volume index were associated with an increased risk of AF recurrence. Conclusions: CP resulted in high long-term probability of SR maintenance. During long-term follow-up, additional RFAs were required to maintain SR in a substantial number of patients. Full article
(This article belongs to the Special Issue Clinical Perspectives on Cardiac Electrophysiology and Arrhythmias)
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12 pages, 843 KiB  
Article
Left Atrium Reverse Remodeling in Fusion CRT Pacing: Implications in Cardiac Resynchronization Response and Atrial Fibrillation Incidence
by Cristina Văcărescu, Dragoș Cozma, Simina Crișan, Dan Gaiță, Debora-Delia Anutoni, Mădălin-Marius Margan, Adelina-Andreea Faur-Grigori, Romina Roteliuc, Silvia-Ana Luca, Mihai-Andrei Lazăr, Oana Pătru, Liviu Cirin, Petru Baneu and Constantin-Tudor Luca
J. Clin. Med. 2024, 13(16), 4814; https://doi.org/10.3390/jcm13164814 - 15 Aug 2024
Viewed by 1312
Abstract
Background: When compared to biventricular pacing, fusion CRT pacing was linked to a decreased incidence of atrial fibrillation (AF). There is a gap in the knowledge regarding exclusive fusion CRT without interference with RV pacing, and all the current data are based [...] Read more.
Background: When compared to biventricular pacing, fusion CRT pacing was linked to a decreased incidence of atrial fibrillation (AF). There is a gap in the knowledge regarding exclusive fusion CRT without interference with RV pacing, and all the current data are based on populations of patients with intermittent fusion pacing. Purpose: To assess left atrium remodeling and AF incidence in a real-life population of permanent fusion CRT-P. Methods: Retrospective data were analyzed from a cohort of patients with exclusive fusion CRT-P. Device interrogation, exercise testing, transthoracic echocardiography (TE), and customized medication optimization were all part of the six-monthly individual follow-up. Results: Study population: 73 patients (38 males) with non-ischemic dilated cardiomyopathy aged 63.7 ± 9.3 y.o. Baseline characteristic: QRS 159.8 ± 18.2 ms; EF 27.9 ± 5.1%; mitral regurgitation was severe in 38% of patients, moderate in 47% of patients, and mild in 15% of patients; 43% had type III diastolic dysfunction (DD), 49% had type II DD, 8% had type I DD. Average follow-up was 6.4 years ± 27 months: 93% of patients were responders (including 31% super-responders); EF increased to 40.4 ± 8.5%; mitral regurgitation decreased in 69% of patients; diastolic profile improved in 64% of patients. Paroxysmal and persistent AF incidence was 11%, with only 2% of patients developing permanent AF. Regarding LA volume, statistically significant LA reverse remodeling was observed. Conclusions: Exclusive fusion CRT-P was associated with important LA reverse remodeling and a low incidence of AF. Full article
(This article belongs to the Special Issue Clinical Perspectives on Cardiac Electrophysiology and Arrhythmias)
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14 pages, 936 KiB  
Article
Use of Neutrophil-to-Lymphocyte Ratio to Predict In-Hospital Mortality in Patients Admitted with Acute Decompensation of Atrial Fibrillation
by Nilima Rajpal Kundnani, Abhinav Sharma, Daniel Florin Lighezan, Doina Georgescu, Stelian I. Morariu, Daniel Dumitru Nisulescu, Romina Georgiana Bita and Ciprian Ilie Rosca
J. Clin. Med. 2024, 13(16), 4719; https://doi.org/10.3390/jcm13164719 - 12 Aug 2024
Cited by 4 | Viewed by 1189
Abstract
Background/Objectives: The prevalence of atrial fibrillation (AF) has been on the rise over the last 20 years. It is considered to be the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The need for in-hospital management of patients having [...] Read more.
Background/Objectives: The prevalence of atrial fibrillation (AF) has been on the rise over the last 20 years. It is considered to be the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The need for in-hospital management of patients having AF is increasing. Acute decompensation of cardiac rhythm is an indication for hospital admission. In the existing literature, several studies on different pathologies have observed that the risk of death was greater for patients with an increased neutrophil-to-lymphocyte ratio (NLR) and suggested that the NLR can be a useful biomarker to predict in-hospital mortality. This study aims to evaluate the link between the neutrophil-to-lymphocyte ratio at admission and death among the patients admitted to the medical ward for the acute manifestation of AF, and to gain a better understanding of how we can predict in-hospital all-cause death based on the NLR for these patients. Methods: A single-center retrospective study in an academic medical clinic was conducted. We analyzed if the NLR at in-hospital admission can be related to in-hospital mortality among the patients admitted for AF at the Medical Ward of Municipal Emergency University Hospital Timisoara between 2015 and 2016. After identifying a total of 1111 patients, we divided them into two groups: in-hospital death patients and surviving patients. We analyzed the NLR in both groups to determine if it is related to in-hospital mortality or not. One patient was excluded because of missing data. Results: Our analysis showed that patients who died during in-hospital admission had a significantly higher NLR compared to those who survived (p < 0.0001, 95% CI (1.54 to 3.48)). The NLR was found to be an independent predictor of in-hospital death among patients with AF, even for the patients with no raised level of blood leukocytes (p < 0.0001, 95% CI (0.6174 to 3.0440)). Additionally, there was a significant correlation between the NLR and the risk of in-hospital death for patients admitted with decompensated AF (p < 0.0001), with an area under the ROC curve of 0.745. Other factors can increase the risk of death for these patients (such as the personal history of stroke, HAS-BLED score, and age). Conclusions: The NLR is a useful biomarker to predict in-hospital mortality in patients with AF and can predict the risk of death with a sensitivity of 72.8% and a specificity of 70.4%. Further studies are needed to determine the clinical utility of the NLR in risk stratification and management of patients with AF. Full article
(This article belongs to the Special Issue Clinical Perspectives on Cardiac Electrophysiology and Arrhythmias)
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