New Research on Atrial Fibrillation

Topic Information

Dear Colleagues,

Atrial fibrillation is the most common sustained arrhythmia in adults, with an estimated prevalence ranging between 2% and 4%. Atrial fibrillation is responsible for 20%–30% of all ischemic strokes and significantly increases the risk of heart failure, dementia and chronic kidney disease. Moreover, atrial fibrillation has a significant impact on quality of life and functional status, especially in patients with a high burden of cardiovascular comorbidities.

Atrial fibrillation poses a considerable burden for healthcare systems, requiring a multidisciplinary approach for early detection, effective pharmacological and/or interventional treatments, and complication prevention.

In recent years, multiple efforts have been devoted to obtaining an effective rhythm control strategy and stroke prophylaxis. Transcatheter ablation has become the most effective arrhythmia control strategy currently available. Specifically, the adoption of novel nonthermal energy sources for cardiac tissue ablation has substantially improved the safety and efficacy of this approach. Similarly, new devices with which to exclude the left atrial appendage from systemic circulation have proven noninferior in preventing thromboembolic events compared to oral anticoagulation in high-risk patients. Researchers in this field are encouraged to submit an original research or review article to this Topic that can provide useful insights into the clinical updates and perspectives directed to the management of atrial fibrillation, with a particular emphasis on catheter ablation and stroke prophylaxis.

Dr. Michele Magnocavallo
Dr. Domenico G. Della Rocca
Dr. Stefano Bianchi
Dr. Pietro Rossi
Dr. Antonio Bisignani
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Diagnostics diagnostics	3.3	5.9	2011	21.6 Days	CHF 2600	Submit
Geriatrics geriatrics	2.1	3.4	2016	27.3 Days	CHF 1800	Submit
Journal of Cardiovascular Development and Disease jcdd	2.3	3.7	2014	24.7 Days	CHF 2700	Submit
Journal of Personalized Medicine jpm	-	6.0	2011	25 Days	CHF 2600	Submit
Medicina medicina	2.4	4.1	1920	17.5 Days	CHF 2200	Submit
Medicines medicines	-	-	2014	27.7 Days	CHF 1400	Submit

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Published Papers (3 papers)

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All Diagnostics Geriatrics JCDD Medicina JPM Medicines

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20 pages, 16534 KB  

Open AccessArticle

Single-Nucleus RNA Sequencing Reveals SPP1⁺ Macrophages Induce Cardiomyocyte Apoptosis to Promote Atrial Fibrillation Susceptibility

by Weixue Wang, Youzheng Dong, Hong Yi, Lei He, Yuwen Jiang, Lu Long, Zhen Xia and Juxiang Li

J. Cardiovasc. Dev. Dis. 2026, 13(2), 80; https://doi.org/10.3390/jcdd13020080 - 5 Feb 2026

Viewed by 394

Abstract

Atrial fibrillation (AF) is closely linked to atrial remodeling, while its underlying immune mechanisms remain elusive. This study sought to investigate the role of SPP1⁺ macrophages in the development and progression of AF and further elucidate the underlying mechanisms. Single-nucleus RNA sequencing [...] Read more.

Atrial fibrillation (AF) is closely linked to atrial remodeling, while its underlying immune mechanisms remain elusive. This study sought to investigate the role of SPP1⁺ macrophages in the development and progression of AF and further elucidate the underlying mechanisms. Single-nucleus RNA sequencing was performed on right atrial tissues from 3 patients with persistent AF and 3 with sinus rhythm (all with rheumatic valvular heart disease). The results revealed significant immune cell infiltration in AF atrial tissues, with a marked increase in the proportion of SPP1⁺ macrophages, which exhibited the strongest intercellular communication with cardiomyocytes. Phenotypic scoring indicated that apoptosis was the dominant mode of cardiomyocyte death in AF. Immunohistochemical and Western blot analyses confirmed elevated levels of pro-apoptotic proteins (Bax, Cleaved-Caspase3) and reduced levels of the anti-apoptotic protein Bcl2 in AF tissues. In a mouse model with macrophage-specific SPP1 overexpression, increased AF inducibility and duration were observed, accompanied by enhanced cardiomyocyte apoptosis. In vitro co-culture experiments using SPP1-overexpressing RAW264.7 macrophages and HL-1 cardiomyocytes confirmed that SPP1⁺ macrophages could induce cardiomyocyte apoptosis. Mechanistically, KEGG and GSEA analyses identified downregulation of the PI3K/AKT pathway in AF. Treatment with the PI3K/AKT activator Recilisib reversed apoptosis and restored p-PI3K/p-AKT levels in HL-1 cells co-cultured with SPP1-overexpressing RAW264.7 macrophages. These findings demonstrate that SPP1⁺ macrophages accumulate in atrial tissues of AF patients and induce cardiomyocyte apoptosis by downregulating the PI3K/AKT pathway, thereby increasing AF susceptibility. Full article

(This article belongs to the Topic New Research on Atrial Fibrillation)

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16 pages, 1930 KB  

Open AccessArticle

Left Atrial Appendage Closure in Patients with Atrial Fibrillation and Intermediate-to-Borderline High Cardiovascular Risk: A Retrospective Propensity Match Cohort Study

by Jiayi Liu, Ningjing Qian, Ying Gao, Junyan Jin, Bingqi Wang, Muhua Luo and Yaping Wang

J. Cardiovasc. Dev. Dis. 2026, 13(1), 41; https://doi.org/10.3390/jcdd13010041 - 11 Jan 2026

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Abstract

Background and objective: Evidence of percutaneous left atrial appendage closure (LAAC) and oral anticoagulants (OACs) in non-valvular atrial fibrillation (NVAF) patients with intermediate-to-borderline high stroke risk is scarce. We aimed to compare the efficacy and safety of these treatments in the latter clinical [...] Read more.

Background and objective: Evidence of percutaneous left atrial appendage closure (LAAC) and oral anticoagulants (OACs) in non-valvular atrial fibrillation (NVAF) patients with intermediate-to-borderline high stroke risk is scarce. We aimed to compare the efficacy and safety of these treatments in the latter clinical population. Methods: This retrospective cohort study included NVAF patients with CHA₂DS₂-VA scores of 1–2 and used 1:1 propensity score matching (184 patients per group) to compare efficacy and safety outcomes. The primary efficacy outcome was a composite of stroke, transient ischemic attacks, systemic embolism, and cardiovascular death during follow-up. Adverse safety events were categorized into peri-procedure (LAAC group) and non-procedural (both groups) events. Results: Over a mean follow-up of 48.93 ± 28.50 months, a total of 26 patients (7.07%) reached the primary composite efficacy endpoint. The LAAC group showed a significantly higher incidence of the efficacy endpoint compared to the OAC group (HR = 3.09; 95% CI 1.22–7.85; log-rank p = 0.01). Procedure-related events occurred in five LAAC patients (one contributing to primary endpoint), while non-procedural bleeding rates were similar (0.54% vs. 1.09%; p = 0.56). Subgroup analyses suggested concomitant ablation of NVAF in LAAC group did not significantly improve efficacy composite endpoints (HR = 0.47). Conclusions: In NVAF patients with intermediate-to-high stroke risk, OACs were more effective than LAAC in preventing thromboembolic events, with comparable rates of clinically relevant bleeding. Full article

(This article belongs to the Topic New Research on Atrial Fibrillation)

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17 pages, 1314 KB  

Open AccessReview

Biophysics and Clinical Effectiveness of Irreversible Electroporation for Catheter Ablation of Atrial Fibrillation

by Anna-Sophie Eberl, Gernot Plank, Martin Manninger, Ursula Rohrer, Laura Stix, Stefan Kurath-Koller, Andreas Zirlik and Daniel Scherr

J. Cardiovasc. Dev. Dis. 2025, 12(6), 218; https://doi.org/10.3390/jcdd12060218 - 7 Jun 2025

Cited by 1 | Viewed by 3285

Abstract

Understanding the biophysics of electroporation—the mechanism by which pulsed electric fields achieve tissue ablation—is essential for advancing this emerging technology. In this review, we summarize key publications from past years to provide an overview of current knowledge and future perspectives. We discuss the [...] Read more.

Understanding the biophysics of electroporation—the mechanism by which pulsed electric fields achieve tissue ablation—is essential for advancing this emerging technology. In this review, we summarize key publications from past years to provide an overview of current knowledge and future perspectives. We discuss the fundamental principles of PFA at the cellular, physical, and technical levels, along with its potential benefits and limitations. A deeper understanding of these biophysical mechanisms and the parameters required to create durable lesions may contribute to improved clinical outcomes and drive future innovation. Full article

(This article belongs to the Topic New Research on Atrial Fibrillation)

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