ANXA1-FPR2 axis mitigates the susceptibility to atrial fibrillation in obesity via rescuing AMPK activity in response to lipid overload.

Atrial fibrillation (AF) is the most prevalent arrhythmia in clinical practice, and obesity serves as a significant risk factor for its development. The underlying mechanisms of obesity-related AF remain intricate and have yet to be fully elucidated. We have identified FPR2 as a potential hub gene involved in obesity-related AF through comprehensive analysis of four transcriptome datasets from AF patients and one transcriptome dataset from obese individuals, and its expression is up-regulated in both AF and obese individuals.

Catheter Ablation of Paroxysmal Atrial Fibrillation and Disease Progression: Magnitude of the anti-progression effect and role of intervention timing.

Background: Recent randomized controlled trials(RCT) have shown that catheter ablation of paroxysmal atrial fibrillation(AF) is associated with a lower incidence of progression to persistent AF compared to the use of antiarrhythmic drug(AAD) therapy.

Objective: This meta-analysis aimed to investigate the magnitude of the anti-progression effect of catheter ablation, as well as the effect of intervention timing.

Methods: MEDLINE/EMBASE databases were searched until April 1 2024 for RCTs comparing catheter ablation and AAD therapy for the treatment of paroxysmal AF and reporting the rate of progression to persistent AF at 3 years (PROSPERO CRD42024534288).

Diagnosis of Atrial Fibrillation as the Source of Cryptogenic Retrieved Clots by a Novel Thrombin Secretion Assay.

Background: Secondary prevention of acute ischemic stroke depends on identifying the source of cryptogenic clots. We previously reported that secreted thrombin activity from endovascularly retrieved clots is significantly different in atrial fibrillation (AF) versus atherosclerosis (AS) related, probably due to the in-vivo biology of the clots.

Objectives: To validate and optimize thrombin secretion for clot source diagnosis.

Periprosthetic Joint Infection and Concomitant Sepsis: Unveiling Clinical Manifestation, Risk Factors, and Patient Outcome.

Purpose: This study investigated the epidemiology, risk factors, and outcomes of sepsis, a life-threatening complication, in the context of periprosthetic joint infections (PJI) of the hip and knee.

Methods: Sepsis was determined using the Sepsis-1 criteria. The cohort with PJI and sepsis was compared to patients who had PJI without sepsis.

Vagal response during radiofrequency catheter ablation initiated from right superior pulmonary vein: Incidence, risk factors, and clinical outcomes.

Background: The vagal response (VR) is unavoidable during pulmonary vein isolation (PVI) for atrial fibrillation (AF). In this study, we aimed to investigate the incidence, risk factors, and clinical outcomes of VR during PVI initiated from the right superior pulmonary vein (RSPV).

Methods: Patients with AF were consecutively enrolled.

Antithrombotic therapy in patients with atrial high-rate episodes (AHREs): Current evidence and open questions.

With the increasing use of cardiac electronic implantable devices in recent years, the identification of asymptomatic atrial arrhythmias, including atrial high-rate episodes (AHREs) and device-detected subclinical atrial fibrillation (SCAF), has become common in clinical practice. AHREs have potentially important clinical implications because they are considered precursors of atrial fibrillation (AF). Although to a lesser extent than clinical AF, both AHREs and device-detected SCAF are associated with thromboembolic events, however routine use of anticoagulants in these conditions is not recommended.

Stroke-bleeding risk score pairings within individuals in the outcomes registry for better informed treatment of atrial fibrillation (ORBIT-AF) registry.

Background: Decisions about stroke prevention strategies in atrial fibrillation (AF) typically balance thromboembolism reduction against increased bleeding from oral anticoagulation therapy (OAC). When determining eligibility for OAC, guidelines recommend calculation of thromboembolic event rates using a validated score such as CHA2DS2-VASc. In contrast, routine calculation of bleeding scores is not recommended, in part because many patient factors associated with an increased risk of bleeding are associated with an even larger increased risk of ischemic stroke.

Obstructive sleep apnea syndrome (OSAS) in women: A forgotten cardiovascular risk factor.

Sleep-disordered breathing is a highly prevalent disorder with negative impact on healthcare systems worldwide. This condition has detrimental effects on cardiovascular health and quality of life, and is frequently associated with a variety of comorbidities, including cardiovascular disease, heart failure, diabetes and atrial fibrillation. Nevertheless, it remains frequently undiagnosed and undertreated, especially in specific populations.

Extracorporeal membrane oxygenation vs cardiopulmonary bypass in lung transplantation: an updated meta-analysis.

Aim: This meta-analysis aimed to compare the outcomes of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB) in lung transplantation.

Methods: We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation. Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs).

Image quality assessment and automation in late gadolinium-enhanced MRI of the left atrium in atrial fibrillation patients.

Background: Late gadolinium-enhanced (LGE) MRI has become a widely used technique to non-invasively image the left atrium prior to catheter ablation. However, LGE-MRI images are prone to variable image quality, with quality metrics that do not necessarily correlate to the image's diagnostic quality. In this study, we aimed to define consistent clinically relevant metrics for image and diagnostic quality in 3D LGE-MRI images of the left atrium, have multiple observers assess LGE-MRI image quality to identify key features that measure quality and intra/inter-observer variabilities, and train and test a CNN to assess image quality automatically.

Bradyarrhythmias in patients with embolic stroke of undetermined source: a tight relationship with atrial cardiomyopathy.

Background: Implantable loop recorders (ILRs) have been shown to significantly improve the detection of atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). The incidence and characterization of bradyarrhythmias in this subset of patients is still unknown.

Methods: All consecutive patients who received ILRs, after an ESUS, between March 2015 and December 2022 in our Center were retrospectively enrolled and analyzed.

Atrial Tachyarrhythmias With Ultra-Rapid Ventricular Response and Sudden Death in Patients Without Structural Heart Disease.

Background: Sudden cardiac death (SCD) is generally associated with life-threatening ventricular arrhythmias. Supraventricular arrhythmias are an accepted cause of SCD in Wolff-Parkinson-White syndrome and complex congenital heart disease. However, the role of atrial tachyarrhythmias (ATAs) in SCD in patients with structurally normal hearts is unclear.

High-Power Short-Duration Radiofrequency Application for Faster and Safer Pulmonary Vein Isolation: The POWER-FAST III Trial.

Background: The optimal radiofrequency application (RFa) parameters for safe and durable pulmonary vein isolation (PVI) are debated. High-power short-duration (HPSD) has been used as an alternative to conventional power delivery (CPD).

Objectives: This study sought to compare HPSD 70 W/9-10 s (HPSD-70) with CPD 25-40 W in patients undergoing PVI.

Temporal Trends of Ischemic Stroke Risk in Patients With Incident Atrial Fibrillation Before Anticoagulation.

Background: Atrial fibrillation (AF) is a major risk factor for ischemic stroke (IS), but whether the magnitude of this risk has changed over time is unknown.

Objectives: This study sought to investigate temporal trends in IS rates in patients with incident AF before oral anticoagulant agent (OAC) therapy.

Methods: The nationwide FinACAF (Finnish Anticoagulation in Atrial Fibrillation) study covers patients with AF at all levels of care in Finland from 2007 to 2018.

Racial Differences in Device-Detected Incident Atrial Fibrillation.

Background: Prior research suggests Black individuals have a lower risk of atrial fibrillation (AF) than White individuals, but this may be related to the underdetection of AF. Whether this trend persists using highly sensitive methods of AF diagnosis has not been well-studied.

Objectives: The objective of this study was to use cardiac implantable electronic devices (CIEDs) capable of AF diagnosis to compare AF incidence between Black and White individuals.

Targeted Ganglionated Plexi Ablation With Nanoformulated Calcium Suppresses Postoperative AF Via Vagosympatholytic and Anti-Inflammatory Effects.

Background: The mechanisms underlying postoperative atrial fibrillation (POAF) remain unclear.

Objectives: The aim of this study was to test the hypothesis that targeted chemical ganglionated plexi (GP) modulation of all major left atrial-pulmonary vein GP using novel nanoformulated calcium chloride (nCaCl) can reverse postoperative neuroelectrical remodeling by suppressing vagosympathetic nerve activity and the localized inflammatory process, both critical substrates of POAF.

Methods: In a novel canine model of POAF with serial thoracopericardiotomies, sympathetic nerve activity (SNA), vagal nerve activity (VNA) and GP nerve activity (GPNA) were recorded; spontaneous and in vivo AF vulnerability were assessed; and atrial and circulating inflammatory markers and norepinephrine (NE) were measured to determine the neuroelectrical remodeling that promotes POAF and its subsequent modulation with nCaCl GP treatment (n = 6) vs saline sham controls (n = 6).

Clinical and Proteomic Risk Profiles of New-Onset Heart Failure in Men and Women.

Background: Previous studies have examined clinical predictors of incident heart failure (HF) in men and women. However, potential mechanisms through which these clinical predictors relate to the onset of HF remain to be established.

Objectives: The authors studied the association between clinical and proteomic risk profiles of new-onset HF in men and women.

Endpoint Selection in Randomized Clinical Trials for Hypertrophic Cardiomyopathy.

Randomized clinical trials (RCTs) for hypertrophic cardiomyopathy (HCM) have long been challenging caused by the condition's rarity, low event rates, and diverse clinical presentations. However, recent advances in targeted therapies have sparked increased interest in HCM research. Despite this, designing effective RCTs remains complex, particularly in identifying clinically meaningful endpoints.

Low-Gradient Severe Aortic Stenosis: Insights From the CURRENT AS Registry-2.

Background: Low-gradient (LG) aortic stenosis (AS) has not been fully characterized compared with high-gradient (HG) AS in terms of cardiac damage, frailty, aortic valve calcification, and clinical outcomes.

Objectives: The aim of this study was to compare the clinical characteristics and outcomes between each hemodynamic type of LG AS and HG AS.

Methods: The current study included 3,363 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) Registry-2 after excluding patients without indexed stroke volume or left ventricular ejection fraction (LVEF) data.

Hypoperfusion intensity ratio to differentiate between stroke etiologies in patients with a large vessel occlusion.

Background: Collateral circulation plays a key role in acute ischemic stroke. We sought to determine the association between the arterial collateral status, estimated by the Hypoperfusion Intensity Ratio (HIR) on perfusion MRI, and stroke etiology in anterior circulation large vessel occlusion (LVO).

Methods: We retrospectively analyzed anterior circulation LVO acute stroke patients with a baseline perfusion MRI performed within 24 h from symptom onset.

The predictive value of monocyte count to high-density lipoprotein cholesterol ratio combined with left atrial diameter for post-radiofrequency ablation recurrence of paroxysmal atrial fibrillation in patients.

Background: Paroxysmal atrial fibrillation (PAF) usually recurs after radiofrequency ablation (RFA). This study probed the predictive value of monocyte count to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) with left atrial diameter (LAD) for post-RFA recurrence in PFA patients.

Methods: Totally 210 RFA-treated PAF patients were selected and assigned into Recurrence and Non-Recurrence groups, with clinical baseline data recorded.

Risk factors of delirium after cardiac surgery: a systematic review and meta-analysis.

Background: Post-operative delirium (POD) is a relatively common occurrence following surgical procedures, particularly cardiac surgeries. Given that the majority of pharmacologic treatments for delirium have demonstrated inadequate efficacy, it is of great importance to identify risk factors to prevent delirium or reduce its complications. Consequently, in this systematic review and meta-analysis, we identified risk factors of POD after cardiac surgery.

Vascular Cell Adhesion Molecule 1 in atrial fibrillation.

Objective: Assessing whether serum Vascular Cell Adhesion Molecule 1(VCAM-1) concentration in the left atrial appendage(LAA) and the expression of VCAM-1 in LAA tissues are associated with the risk of atrial fibrillation-related stroke.

Method: Blood samples were collected from atrial fibrillation(AF) patients scheduled for catheter ablation of AF, both from within the LAA and peripheral veins(PV). The serum concentration of VCAM-1 was quantitatively analyzed using ELISA.