Rationale and Design of OPT-RATE AF: A Randomized Clinical Trial of Increased Physiologic Pacing Rates in Heart Failure With Preserved Ejection Fraction.

Cardiac physiologic pacing (CPP) after atrioventricular node (AVN) ablation for persistent atrial fibrillation (AF) has improved outcomes in patients with heart failure with reduced and preserved ejection fraction (HFpEF). Emerging evidence suggests patients with HFpEF benefit from higher heart rates, yet the optimal pacing rate after AVN ablation remains unknown. Optimal Pacing Rate for cardiac resynchronization therapy after atrioventricular node ablation in persistent Atrial Fibrillation and heart failure (OPT-RATE AF) is a prospective, randomized crossover study of patients with HFpEF after AVN ablation for persistent AF (NCT06445439).

Diabetes is accompanied by secretion of pro-atherosclerotic exosomes from vascular smooth muscle cells.

Background: Atherosclerosis is a common co-morbidity of type 2 diabetes mellitus. Monocyte recruitment by an activated endothelium and the pro-inflammatory activity of the resulting macrophages are critical components of atherosclerosis. Exosomal transfer of microRNAs has emerged as a paracrine signaling mechanism regulating atherosclerotic plaque development.