The abnormal neural control of atria has been considered one of the mechanisms of paroxysmal atrial fibrillation (PAF) pathogenesis. The baroreceptor reflex has an important role in cardiovascular regulation and may serve as an index of autonomic function. This study aimed to analyze the baroreceptor reflex's role in heart rate regulation during upright tilt (HUT) in patients with lone PAF. The study included 68 patients with lone PAF and 34 healthy individuals who underwent baroreflex assessment. Parameters such as baroreflex sensitivity (BRS), number of systolic blood pressure (BP) ramps, and the baroreflex effectiveness index (BEI) were evaluated. The study found that PAF patients had comparable resting BPs and heart rates (HRs) to healthy individuals. However, unlike healthy individuals, PAF patients showed a sustained increase in BP with an upright posture followed by the delayed activation of the baroreceptor function with a blunted HR response and lower BEI values. This indicates a pronounced baroreflex impairment in PAF patients, even at rest. Our data suggest that together with BRS, BEI could be used as a marker of autonomic dysfunction in PAF patients, making it important to further investigate its relationship with AF recurrence after ablation and its involvement in cardiovascular autonomic remodeling.
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http://dx.doi.org/10.3390/jcm12185857 | DOI Listing |
Crit Care
January 2025
HCor Research Institute, Hospital do Coração, Rua Desembargador Eliseu Guilherme 200, 8th Floor, São Paulo, SP, 04004-030, Brazil.
Background: Limited data is available to evaluate the burden of device associated healthcare infections (HAI) [central line associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and ventilator associated pneumonia (VAP)] in low and-middle-income countries. Our aim is to investigate the population attributable mortality fraction and the absolute mortality difference of HAI in a broad population of critically ill patients from Brazil.
Methods: Multicenter cohort study from September 2019 to December 2023 with prospective individual patient data collection.
Eur Heart J
January 2025
Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Port Rd., Adelaide 5000, Australia.
Convincing evidence for the efficacy of ablation as first-line therapy in paroxysmal AF (PAF) and its clear superiority to medical therapy for rhythm control in both PAF and persistent AF (PsAF) has generated considerable interest in the optimal timing of ablation. Based on this data, there is a widespread view that the principle of 'the earlier the better' should be generally applied. However, the natural history of AF is highly variable and non-linear, and for this reason, it is difficult to be emphatic that all patients are best served by ablation early after their initial AF episodes.
View Article and Find Full Text PDFYonsei Med J
January 2025
Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Purpose: Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF.
Materials And Methods: A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020.
Ann Noninvasive Electrocardiol
January 2025
Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
Background: Pulmonary vein isolation (PVI) is the most promising management method for paroxysmal atrial fibrillation (PAF). The P wave in the electrocardiogram (ECG) represents atrial depolarization. This study aims to correlate P-wave parameters after PVI with outcomes.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
November 2024
Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.
Background: pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) improves health-related quality of life (QoL). This study compares QoL improvement after radiofrequency ablation (RF) and cryoballoon ablation (cryo) and assesses additional ablations' role in QoL improvement.
Methods: we evaluated the QoL of consecutive patients with first-time RF and cryo for PAF between January 2017 and June 2019.
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