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Diagnosis, Treatment and Prevention of Atrial Fibrillation

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Acquired Cardiovascular Disease".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 6735

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Special Issue Editors

Prof. Dr. Giuseppe Boriani

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Guest Editor

Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Modena University Hospital, University of Modena and Reggio Emilia, 41121 Modena, Italy
Interests: arrhythmias-general; atrial fibrillation; device therapy; chronic heart failure; public health and health economics
Special Issues, Collections and Topics in MDPI journals

Dr. Marco Vitolo

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Guest Editor

1. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, Italy
2. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy
Interests: arrhythmias; atrial fibrillation; coronary artery disease; device implantation

Special Issue Information

Dear Colleagues,

Atrial fibrillation is the most common sustained arrhythmia and is frequently associated with other comorbidities, quite often within complex clinical situations where decision making becomes difficult. The management of atrial fibrillation, particularly concerning the risk of thromboembolic events, has been validated by solid evidence thanks to randomized clinical trials, but there is still a need to collect observational data for “real-world” studies in order to obtain a complete picture of the clinical complexity that may characterize some patients. The most recent guidelines from the European Society of Cardiology recommend managing a patient with atrial fibrillation according to an “A, B, C” approach, where A means treatments to avoid stroke, B means better symptom control and C means controlling the impact and the course of comorbidities.

This Special Issue aims to collect a series of articles highlighting the pathophysiological basis of treatments applied to control atrial fibrillation and to define the outcome of patients affected by different patterns of atrial fibrillation, with the possibility for improved the stratification in specific patient subgroups.

The submissions presented in this Special Issue will include review articles, research manuscripts, and short contributions.

Prof. Dr. Giuseppe Boriani
Dr. Marco Vitolo
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 Cardiovascular Development and Disease is an international peer-reviewed open access monthly 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 2700 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

atrial fibrillation
stroke prevention
oral anticoagulants
integrated care
real-world data
clinical complexity

Published Papers (3 papers)

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Research

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12 pages, 1699 KiB

Open AccessArticle

Evaluation of Pulmonary Vein Fibrosis Following Cryoballoon Ablation of Atrial Fibrillation: A Semi-Automatic MRI Analysis

by Andrea Ballatore, Erika Negrello, Marco Gatti, Mario Matta, Paolo Desalvo, Lorenzo Marcialis, Stefania Marconi, Davide Tore, Massimo Magnano, Arianna Bissolino, Giulia De Lio, Gaetano Maria De Ferrari, Michele Conti, Riccardo Faletti and Matteo Anselmino

J. Cardiovasc. Dev. Dis. 2023, 10(9), 396; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd10090396 - 14 Sep 2023

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Abstract

Current guidelines recommend the use of cardiac magnetic resonance imaging (MRI) for the management of atrial fibrillation (AF). However, the widespread use of cardiac MRI in clinical practice is difficult to achieve. The aim of the present study is to assess whether cardiac MRI can be adopted to identify ablation-induced fibrosis, and its relationship with AF recurrences. Fifty patients undergoing AF cryoballoon ablation were prospectively enrolled. Cardiac MRI was performed before and 30 days after the index ablation. Commercially available software and a specifically designed image processing workflow were used to quantify left atrium (LA) fibroses. Thirty-six patients were finally included in the analysis; twenty-eight were analyzed with the dedicated workflow. Acute electrical isolation was achieved in 98% of the treated pulmonary veins (PVs). After a median follow-up of 16 months, AF recurrences occurred in 12 patients (33%). In both analyses, no differences were found between the subgroups of patients with and without recurrence in the variation of either LA fibrosis or fibrosis at the ostium of the PV, before and after ablation. The ability to predict arrhythmic recurrences evaluated via the ROC curve of the variations in both LA fibrosis (AUC 0.566) and PV fibrosis (AUC 0.600) was low. Cardiac MRI holds the potential to provide clinically significant information on LA disease and AF progression; however, LA fibrosis cannot be easily identified, either by currently available commercial programs or custom tools. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prevention of Atrial Fibrillation)

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12 pages, 1436 KiB

Open AccessArticle

Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression

by Letizia Rosa Romano, Giuseppe Scalzi, Biagio Malizia, Iolanda Aquila, Alberto Polimeni, Ciro Indolfi and Antonio Curcio

J. Cardiovasc. Dev. Dis. 2023, 10(8), 320; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd10080320 - 28 Jul 2023

Cited by 4 | Viewed by 1128

Abstract

Transcatheter edge-to-edge repair (TEER) currently represents a valuable therapeutic option for patients with severe mitral regurgitation (MR) considered at high surgical risk. Besides symptoms and left ventricular (LV) echocardiographic improvements upon TEER, it has been postulated that left atrial (LA) function plays a prognostic role. The aims of our study were to evaluate LA changes after TEER, measured by two-dimensional speckle-tracking echocardiography analysis (2D-STE), their association with atrial fibrillation (AF) occurrence, and relative arrhythmic burden. We considered in a single-center study 109 patients affected by symptomatic severe MR undergoing TEER from February 2015 to April 2022. By 2D-STE, LA reservoir (R_s), conduct (D_s), and contractile (C_s) strains were assessed along with four-chamber emptying fraction (LAEF-4CH) before, 1, 6, and 12 months following TEER. Statistical analysis for comparison among baseline, and follow-ups after TEER was carried out by ANOVA, MANOVA, and linear regression. Successful TEER significantly improved LV dimensions and LA performances, as indicated by all strain components, and LAEF-4CH after 1 year. Strikingly, a significant reduction in arrhythmic burden was observed, since only one case of subclinical AF detected by a previously implanted cardiac electronic device was found in the cohort of sinus rhythm patients (n = 48) undergone TEER; in addition, ventricular rate was reduced in the AF cohort (n = 61) compared to baseline, together with few episodes of nonsustained ventricular tachycardias (5/61, 8.2%) after MR improvement. Overall, TEER was associated with improved cardiac performance, LA function amelioration, and reduced arrhythmic burden. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prevention of Atrial Fibrillation)

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Review

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20 pages, 1866 KiB

Open AccessReview

Best Practice Guide for Cryoballoon Ablation in Atrial Fibrillation: The Compilation Experience of More than 1000 Procedures

by Dimitriοs Tsiachris, Christos-Konstantinos Antoniou, Ioannis Doundoulakis, Panagiota Manolakou, Demetrios Sougiannis, Athanasios Kordalis, Konstantinos A. Gatzoulis, Gian-Battista Chierchia, Carlo de Asmundis, Christodoulos Stefanadis and Konstantinos Tsioufis

J. Cardiovasc. Dev. Dis. 2023, 10(2), 55; https://0-doi-org.brum.beds.ac.uk/10.3390/jcdd10020055 - 30 Jan 2023

Cited by 2 | Viewed by 3712

Abstract

Nowadays, the cryoballoon (CB) constitutes an established alternative to radio frequency (RF) ablation for pulmonary vein isolation (PVI), which offers the possibility to isolate the PVs with a single application. Since the introduction of the second-generation CB, we prospectively collected our data to optimize the procedure on >1000 consecutive patients who underwent CB PVI performed in our center. It is expected that subsequent guidelines will suggest first-line PVI through CB in patients with paroxysmal AF with a class I indication. Indeed, in the long-term follow-up (36 months) of the EARLY-AF trial, CB had a lower incidence of persistent atrial fibrillation episodes compared to the anti-arrhythmic drugs group. We now review the current best practices in an effort to drive consistent outcomes and minimize complications. PV isolation through CB is the most studied single-shot technique for atrial fibrillation ablation, having shown the potential to alter the natural history of the arrhythmia. Several procedural tips and tricks can improve procedural flow and effectiveness. In the present article we provided not only technical details but measurable biophysical parameters that can reliably guide the operator into achieving the best outcome for his patients. Full article

(This article belongs to the Special Issue Diagnosis, Treatment and Prevention of Atrial Fibrillation)

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