Atrial Fibrillation: Clinical Complications and Treatment

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 388

Special Issue Editor


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Guest Editor
1. Department of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
2. Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia
Interests: cardiology; atrial fibrillation; pharmacological and non-pharmacological treatment

Special Issue Information

Dear Colleagues,

Atrial fibrillation remains the most common arrhythmia. Although a large amount of scientific research has been continuously conducted for decades to tackle this issue, many uncertainties remain, and the complications caused by atrial fibrillation still pose a great burden on the health care system.

This Special Issue aims to promote the exchange of information between various clinicians and scientists, sharing experience both on the use of instrumental methods and the nuances associated with them, and on the prevention of complications, including the prevention of strokes and systemic embolisms. Notability, AFib contributes to the development of heart failure and we should be mindful that prothrombotic problems are present throughout the circulatory system. Finally, the classic question in arrhythmia research, "Which came first—the chicken or the egg?", may be approached, and discussion on rhythm and rate control, for which patient, at which stage, under what conditions, may be investigated.

EAST-AFNET 4, CABANA, STROKESTOP, EARLY-AF, RACE study group, RATE-AF, GARFIELD-AF, and many other large-scale clinical trials show progress in the research into the pathophysiology of AFib, and the introduction of new catheter ablation methods and direct oral anticoagulants into clinical practice have significantly improved the management prospects for patients with atrial fibrillation, but the condition remains very significant.

I invite you to submit the results of your scientific work on various aspects and directions of atrial fibrillation treatment to help us address this disease with even more success.

With sincere respect,

Prof. Dr. Oskars Kalejs
Guest Editor

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Keywords

  • atrial fibrillation [AFib]
  • rhythm control
  • rate control
  • triggers of AFib
  • antiarrhythmic pharmacy
  • upstream therapy
  • non-direct antiarrhythmic pharmacy
  • catheter ablation
  • prevention of stroke and systemic embolism
  • anticoagulants
  • AF-CARE concept

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Published Papers (1 paper)

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Research

11 pages, 827 KB  
Article
Comparison of Cryoballoon Ablation Methods in Pulmonary Vein Isolation
by Kaspars Kupics, Raivis Bricis, Kristine Jubele, Ieva Ansaberga, Oskars Kalējs and Andrejs Erglis
Medicina 2025, 61(11), 1920; https://doi.org/10.3390/medicina61111920 - 26 Oct 2025
Viewed by 232
Abstract
Background and Objectives: Cryoballoon ablation is a well-established therapy for atrial fibrillation (AF), enabling pulmonary vein isolation (PVI) using a single-shot technique. The two primary systems—Medtronic Arctic Front and the newer Boston Scientific POLARx—differ in design and performance characteristics, but few direct comparisons [...] Read more.
Background and Objectives: Cryoballoon ablation is a well-established therapy for atrial fibrillation (AF), enabling pulmonary vein isolation (PVI) using a single-shot technique. The two primary systems—Medtronic Arctic Front and the newer Boston Scientific POLARx—differ in design and performance characteristics, but few direct comparisons exist. This study aimed to compare the biophysical parameters and mid-term outcomes of the POLARx and Arctic Front cryoballoon systems. Materials and Methods: In a retrospective analysis of 200 patients who underwent cryoballoon ablation for paroxysmal or persistent AF, patients were grouped by ablation system: POLARx (n = 107) and Arctic Front (n = 93). Key parameters including nadir balloon temperatures, time to reach −40 °C, procedure duration, dose area product (DAP), complication rates, and recurrence of AF were assessed. Results: The POLARx system achieved significantly lower nadir temperatures in all pulmonary veins compared to Arctic Front (left superior PV: −57.6 ± 5.0 °C vs. −50.1 ± 5.7 °C, p < 0.001). Time to reach −40 °C was also shorter with POLARx (left superior PV: 23.3 ± 7.3 s vs. 33.3 ± 11.5 s, p < 0.001). Despite these advantages, procedure time was longer in the POLARx group (64.7 ± 14.8 min vs. 51.6 ± 19.7 min, p < 0.001). AF recurrence at 11.8 months was similar (33.6% in POLARx vs. 39.8% in Arctic Front, p = 0.93). Phrenic nerve palsy occurred in 5.0% (POLARx) and 4.3% (Arctic Front), with no cases of cardiac tamponade. Conclusions: While both systems demonstrated similar efficacy and safety, POLARx was associated with superior cooling kinetics and biophysical performance. Full article
(This article belongs to the Special Issue Atrial Fibrillation: Clinical Complications and Treatment)
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