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Atrial Fibrillation: Screening, Management and Outcomes

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

Deadline for manuscript submissions: 20 September 2026 | Viewed by 891

Special Issue Editors


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Guest Editor
Division of Cardiology, McGill University Health Center, Montreal, QC, Canada
Interests: atrial fibrillation; cardiac electrophysiology; cardiac implantable device
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Division of Cardiology, McGill University Health Center, Montreal, QC, Canada
2. Division of Cardiology, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, QC, Canada
Interests: cardiac electrophysiology; atrial fibrillation; cardiac implantable device; cardiac defibrillator
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia observed in clinical practice. AF is an important contributor to cardiovascular mortality as well as morbidity and can considerably reduce quality of life. Cardiovascular morbidity also occurs through an increased risk of stroke and heart failure. Recent evidence suggests that the morbidity and mortality associated with AF occur regardless of whether patients are symptomatic. This highlights the importance of screening for and detecting subclinical AF, an area with exciting developments in diagnostic tools, such as mobile technologies. The management of AF is also critical to reduce adverse cardiovascular outcomes, and there is now increasing evidence for early intervention to achieve rhythm control and prevent the progression of AF. AF ablation is an important tool for achieving rhythm control and is an area of ongoing technological advancements, including cryoablation and pulse field ablation, that aim to improve efficacy and reduce procedural complications. Finally, there has also been increasing evidence that early rhythm control, including AF ablation, can reduce adverse cardiovascular events. This Special Issue aims to provide insights into the advances in AF, with a focus on AF screening, management, and outcomes.

We look forward to receiving your submissions.

Dr. Ahmed AlTurki
Prof. Dr. Vidal Essebag
Guest Editors

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Keywords

  • atrial fibrillation
  • ablation
  • pulmonary vein isolation
  • atrial fibrillation screening
  • wearable devices
  • anti-arrhythmic drugs
  • cardiovascular outcomes
  • subclinical atrial fibrillation

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Published Papers (1 paper)

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Research

11 pages, 1253 KB  
Article
Preoperative Inflammatory Burden Index Predicts Atrial Fibrillation After Coronary Artery Bypass Grafting: A Retrospective Cohort Study
by Florian Osmanaj, Mingyang Zhou, Kun Hua and Xiubin Yang
J. Clin. Med. 2026, 15(3), 1246; https://doi.org/10.3390/jcm15031246 - 4 Feb 2026
Viewed by 636
Abstract
Background/Objectives: Postoperative atrial fibrillation (POAF) is a common and serious complication after coronary artery bypass grafting (CABG), leading to increased morbidity and healthcare utilization. Although systemic inflammation is a well-established driver of POAF pathogenesis, no composite preoperative inflammatory biomarker has been validated for [...] Read more.
Background/Objectives: Postoperative atrial fibrillation (POAF) is a common and serious complication after coronary artery bypass grafting (CABG), leading to increased morbidity and healthcare utilization. Although systemic inflammation is a well-established driver of POAF pathogenesis, no composite preoperative inflammatory biomarker has been validated for risk stratification in this population. This study aimed to evaluate the novel Inflammatory Burden Index (IBI)—the first composite biomarker combining acute-phase (C-reactive protein, CRP) and chronic cellular (neutrophil-to-lymphocyte ratio, NLR) inflammation—as a preoperative predictor of POAF after CABG. Methods: In this large retrospective cohort study, we included 3481 consecutive patients who underwent isolated CABG at a high-volume cardiac center between 2019 and 2024. Preoperative IBI was calculated as CRP (mg/dL) × NLR. The primary outcome was new-onset POAF within the first 7 postoperative days, confirmed by continuous telemetry on 12-lead ECG. Predictive performance was assessed using multivariable logistic regression, receiver operating characteristic (ROC) curve analysis (area under the curve, AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), and internal validation via bootstrapping (1000 resamples). Results: POAF developed in 866 patients (24.9%). Patients with POAF exhibited significantly higher preoperative IBI levels (39.4 ± 18.6 vs. 26.3 ± 16.7, p < 0.01). In multivariable analysis adjusted for age, hypertension, left atrial diameter, and other clinical covariates, IBI emerged as a strong independent predictor of POAF (adjusted OR 1.041, 95% CI 1.036-1.046, p < 0.01). The IBI alone demonstrated moderate-to-good discriminative performance (AUC 0.72, 95% CI 0.70–0.74), significantly outperforming the Systemic Immune/Inflammation Index (SII; AUC 0.61, DeLong test p < 0.001) and providing superior reclassification (NRI 0.150, IDI 0.032) and model fit (lower AIC). Combining IBI with established clinical risk factors further improved predictive accuracy (combined AUC 0.74, specificity 72.4%). Tertile-based stratification revealed a clear graded relationship with POAF incidence (low IBI: 16.6%, medium: 21.3%, high: 35.1%; p = 0.02). Notably, the medium IBI stratum (11.18-25.44) displayed the highest discriminative power (AUC 0.87, 95% CI 0.85-0.88), with bootstrap validation confirming model stability (minimal bias, robust 95% CI). Conclusions: This study establishes the preoperative Inflammatory Burden Index (IBI) as the first validated composite inflammatory biomarker independently associated with POAF following CABG. Its superior performance over existing indices (SII), graded risk stratification, and peak accuracy in the moderate inflammation window highlight its potential for personalized preoperative risk assessment and targeted perioperative intervention strategies. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Screening, Management and Outcomes)
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