Reversal Agents in the Era of NOACs.

The incidence and prevalence of atrial fibrillation (AF) is expected to more than double between 2010 and 2030. Accordingly, the use of non-vitamin K oral anticoagulant (NOAC) agents for thromboembolic stroke prevention is anticipated to increase. The development of effective and safe antidotes is needed to address the unmet need for rapid anticoagulation reversal.

Periprocedural Management of Novel Oral Anticoagulants During Atrial Fibrillation Ablation: Controversies and Review of the Current Evidence.

Oral anticoagulation (OAC) has been the cornerstone for the prevention of thromboembolic complications in patients with atrial fibrillation (AF) at significant risk of stroke. Catheter ablation is an established efficacious technique for the treatment of AF. Ameliorating the risk of stroke or transient ischaemic attack (TIA) in patients with AF undergoing ablation requires meticulous planning of pharmacotherapy.

Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation.

Background: Obesity and pericardial adipose tissue are independent risk factors for atrial fibrillation (AF) and adverse cardiac structural remodeling. The effect of weight reduction on pericardial adipose tissue and cardiac structure remains unknown.

Methods: We prospectively performed cardiac magnetic resonance imaging on 87 participants with AF undergoing either structured weight management (intervention) or general lifestyle advice (control).

Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial.

Importance: Obesity is a risk factor for atrial fibrillation. Whether weight reduction and cardiometabolic risk factor management can reduce the burden of atrial fibrillation is not known.

Objective: To determine the effect of weight reduction and management of cardiometabolic risk factors on atrial fibrillation burden and cardiac structure.

Aortic stiffness in lone atrial fibrillation: a novel risk factor for arrhythmia recurrence.

Background: Recent community-based research has linked aortic stiffness to the development of atrial fibrillation. We posit that aortic stiffness contributes to adverse atrial remodeling leading to the persistence of atrial fibrillation following catheter ablation in lone atrial fibrillation patients, despite the absence of apparent structural heart disease. Here, we aim to evaluate aortic stiffness in lone atrial fibrillation patients and determine its association with arrhythmia recurrence following radio-frequency catheter ablation.

Mapping and ablation of the pulmonary veins and cavo-tricuspid isthmus with a magnetic resonance imaging-compatible externally irrigated ablation catheter and integrated electrophysiology system.

Background: Magnetic resonance imaging (MRI)-guided interventional electrophysiology (EP) has rapidly emerged as a promising alternative to x-ray-guided ablation. We aimed to evaluate an externally irrigated MRI-compatible ablation catheter and integrated EP pacing and recording system, testing the feasibility of pulmonary vein and cavo-tricuspid isthmus ablation.

Methods And Results: Externally irrigated MRI-compatible ablation and diagnostic EP catheters and an integrated EP recording system (Imricor Medical Systems, Burnsville, MN) were tested in n=11 sheep in a 1.

Obesity results in progressive atrial structural and electrical remodeling: implications for atrial fibrillation.

Background: Obesity is associated with atrial fibrillation (AF); however, the mechanisms by which it induces AF are unknown.

Objective: To examine the effect of progressive weight gain on the substrate for AF.

Methods: Thirty sheep were studied at baseline, 4 months, and 8 months, following a high-calorie diet.

Importance of the underlying substrate in determining thrombus location in atrial fibrillation: implications for left atrial appendage closure.

Context: The left atrial appendage (LAA) has been suggested to be the dominant location of thrombus in atrial fibrillation (AF) and has led to the development of LAA occlusion as a therapeutic modality to reduce stroke risk. However, the patient populations that would benefit most from this therapy are not well defined.

Objective: A systematic review was performed to better define subgroups amenable to appendage closure.

Approach to the difficult transseptal: diathermy facilitated left atrial access.

Percutaneous transseptal left atrial (LA) access is increasingly becoming a routine procedure in the electrophysiology and cardiac catheterisation laboratories. Our aim was to review an unselected large series of this procedure performed over a period of five years. We clinically characterised difficult cases and presented a method of safe and expeditious LA access.

Pericardial fat is associated with atrial fibrillation severity and ablation outcome.

Objectives: The aim of this study was to characterize the relationship between pericardial fat and atrial fibrillation (AF).

Background: Obesity is an important risk factor for AF. Pericardial fat has been hypothesized to exert local pathogenic effects on nearby cardiac structures above and beyond that of systemic adiposity.

Coronary artery disease affecting the atrial branches is an independent determinant of atrial fibrillation after myocardial infarction.

Background: During acute myocardial infarction (MI), the incidence of atrial fibrillation (AF) is 6% to 22%, and its occurrence in this setting is associated with increased short- and long-term morbidity and mortality.

Objective: The purpose of this case control study was evaluate the characteristics associated with the development of new-onset AF.

Methods: Of 2,460 consecutive patients with acute MI, 149 (6%) were identified as having AF within 7 days of MI.