Paroxysmal Atrial Fibrillation during Spasm Provocation Test with Acetylcholine: Clinical Characteristics of Patients and Effect on Coronary Microvascular Function Measurements.
Rev Cardiovasc Med
Department of Cardiovascular Medicine, JR Hiroshima Hospital, 732-0057 Hiroshima, Japan.
Published: February 2025
Background: Atrial fibrillation (AF) is a complication that occurs following a spasm provocation test (SPT) with acetylcholine (ACh). However, the characteristics of patients with AF remain unclear. Furthermore, the association of AF with the outcome of the coronary microvascular function test (CMFT) is unknown. This study aimed to evaluate whether patients with angina with non-obstructive coronary artery disease (ANOCA) who developed AF during SPT with ACh had any clinical characteristics. Additionally, we assessed the association of AF with the CMFT results.
Methods: We included 123 patients with ANOCA who underwent SPT and CMFT. We defined AF as AF during ACh provocation. The coronary arteries that demonstrated AF before CMFT were defined as AF vessels (n = 21) and those in sinus rhythm (SR) were defined as SR-1 vessels (n = 165). Vessels that were restored to sinus rhythm immediately following AF were defined as AF-SR vessels (n = 29) and those that remained in sinus rhythm for some time were defined as SR-2 vessels (n = 136). Coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) were obtained, and CFR of <2.0 and/or IMR of ≥25 were diagnosed as coronary microvascular dysfunction (CMD).
Results: Of the 123 patients, 31 (25%) had AF but with no characteristic patient background. CFR was significantly lower in AF vessels than in SR-1 vessels ( = 0.035) and IMR did not differ between the two groups ( = 0.918). A study of the three groups that included AF-SR vessels revealed that IMR tended to be lower in AF-SR vessels than in the SR-2 and AF vessels ( = 0.089), and that the frequency of IMR of ≥25 was significantly lower than in the other two groups ( = 0.016).
Conclusions: AF occurred in 25% of SPTs with ACh, but the predictive clinical context remains unclear. Our results indicated that AF may affect the outcome of the CMFT. Thus, decisions for CMD management should be made with caution in the presence of AF.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868906 | PMC |
| http://dx.doi.org/10.31083/RCM26456 | DOI Listing |
Similar Publications
Identifying Extra Pulmonary Vein Targets for Persistent Atrial Fibrillation Ablation: Bridging Advanced and Conventional Mapping Techniques.
Europace
March 2025
Cardiology Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, United Kingdom.
Background And Aims: Advanced technologies such as charge density mapping (CDM) show promise in guiding adjuvant ablation in patients with persistent atrial fibrillation (AF); however, their limited availability restricts widespread adoption. We sought to determine whether regions of the left atrium containing CDM-identified pivoting and rotational propagation patterns during AF could also be reliably identified using more conventional contact mapping techniques.
Methods: Twenty-two patients undergoing de novo ablation of persistent AF underwent both CDM and electroanatomic voltage mapping during AF and sinus rhythm with multiple pacing protocols.
High-Power Short-Duration Temperature-Controlled Radiofrequency Ablation for the Treatment of Outflow Tract Ventricular Arrhythmias.
J Cardiovasc Electrophysiol
March 2025
2nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece.
Introduction: The tissue temperature-controlled DiamondTemp ablation (DTA) catheter has been mainly used for atrial fibrillation ablation. We report our initial experience in using this catheter for the treatment of outflow premature ventricular contractions (PVCs) or repetitive non-sustained monomorphic ventricular tachycardias (VTs).
Methods: Twenty patients were studied: 10 with right ventricular outflow tract PVCs/VTs, eight with PVCs/VTs from the aortic sinus cusps, and two with left ventricular outflow tract PVCs.
Background: In the context of cardiovascular disease (CVD), iron metabolism assessment plays a pivotal role in the diagnosis of anemia and chronic inflammation. However, data regarding the prevalence of anemia, iron deficiency, and iron overload among outpatients in real-world clinical settings remain limited. Moreover, the influence of specific diseases on iron kinetics within the CVD spectrum has not been fully elucidated.
View Article and Find Full Text PDFAtrial fibrillation in non-ST-elevation myocardial infarction patients - worse clinical presentation and adverse long term prognosis.
Pol Merkur Lekarski
March 2025
DEPARTMENT OF CORONARY ARTERY DISEASE AND CARDIAC REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND.
Objective: . Aim: The aim of this ambispective, two-center, observational study was to evaluate the clinical characteristics and 3-years prognosis of patients with non-STelevation myocardial infarction (NSTEMI) and AF.
Patients And Methods: Materials and methods: Patients hospitalized with a diagnosis of NSTEMI were included.
Deep learning-based prediction of atrial fibrillation from polar transformed time-frequency electrocardiogram.
PLoS One
March 2025
Medical Artificial Intelligence Laboratory, Division of Digital Healthcare, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea.
Portable and wearable electrocardiogram (ECG) devices are increasingly utilized in healthcare for monitoring heart rhythms and detecting cardiac arrhythmias or other heart conditions. The integration of ECG signal visualization with AI-based abnormality detection empowers users to independently and confidently assess their physiological signals. In this study, we investigated a novel method for visualizing ECG signals using polar transformations of short-time Fourier transform (STFT) spectrograms and evaluated the performance of deep convolutional neural networks (CNNs) in predicting atrial fibrillation from these polar transformed spectrograms.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!
© LitMetric 2025. All rights reserved.