Use of continuous cardiac monitoring to assess the influence of atrial fibrillation burden and patterns on patient symptoms and healthcare utilization: The DEFINE AFib study.

Background: Atrial fibrillation (AF) has a significant impact on health and quality of life. The relationship of AF burden and temporal patterns of AF on patient symptoms, outcomes, and healthcare utilization is unknown. Insertable cardiac monitors (ICMs) are a strategic and as yet untapped, tool to investigate these relationships.

Changes in Cardiovascular Health at Midlife and Subsequent Cardiovascular Outcomes in Individuals With Diabetes.

Background: Whether improvements in cardiovascular health (CVH) in midlife mitigate cardiovascular disease (CVD) risk in patients with diabetes remains underexplored.

Objectives: The aim of the study was to examine the relationships between changes in CVH during midlife and subsequent risks of CVD events and all-cause mortality among individuals with and without diabetes.

Methods: The study utilized data from the Atherosclerosis Risk in Communities Study.

Proteomic signature of HIV-associated subclinical left atrial remodeling and incident heart failure.

People living with HIV are at higher risk of heart failure and associated left atrial remodeling compared to people without HIV. Mechanisms are unclear but have been linked to inflammation and premature aging. Here we obtain plasma proteomics concurrently with cardiac magnetic resonance imaging in two independent study populations to identify parallels between HIV-related and aging-related immune dysfunction that could contribute to atrial remodeling and clinical heart failure.

The Society of Thoracic Surgeons (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer.

Background: The use of local consolidative therapy (LCT) in patients with oligometastatic non-small cell lung cancer (NSCLC) is rapidly evolving, with a preponderance of data supporting the benefits of such therapeutic approaches incorporating pulmonary resection for appropriately selected candidates. However, practices vary widely institutionally and regionally, and evidence-based guidelines are lacking.

Methods: The Society of Thoracic Surgeons assembled a panel of thoracic surgical oncologists to evaluate and synthesize the available evidence regarding the role of pulmonary resection as LCT.

Effectiveness of shared decision making strategies for stroke prevention among patients with atrial fibrillation: cluster randomized controlled trial.

Objective: To evaluate the effectiveness of multiple decision aid strategies in promoting high quality shared decision making for prevention of stroke in patients with non-valvular atrial fibrillation.

Design: Cluster randomized controlled trial.

Setting: Six academic medical centers in the United States.

Desmoplakin Cardiomyopathy: Role of Inflammation and Potential Role of Disease-Modifying Therapies.

Purpose Of Review: To summarize the available data on the use of immunosuppression therapies for the management of hot phases of disease and recurrent myocarditis in patients with desmoplakin cardiomyopathy (DSP-CMP).

Recent Findings: Occurrence of myocarditis episodes has been associated with worsening of outcomes in DSP-CMP. Multiple case reports and small case series have described potential benefit in using anti-inflammatory and immunosuppressive medications for the treatment of those episodes.

Comparison of Associations of Food Security Instruments and Mediators With Premature All-Cause and Cardiovascular Disease Death in US Adults.

Background: Food insecurity is associated with high morbidity and mortality and is typically measured with the 10-item US Adult Food Security Survey Module. Shorter instruments may capture similar information, but this has not been validated against mortality in general populations.

Methods: A nationally representative sample of individuals aged 20 to 74 years from the US National Health Interview Survey 2011 to 2018 was included, with deaths linked to the National Death Index through 2019.

Postpartum Remote Health Coaching Intervention for Individuals With a Hypertensive Disorder of Pregnancy: Proof-of-Concept Study.

Background: Cardiovascular disease (CVD) is the leading cause of death among women in America. Hypertensive disorders of pregnancy (HDP) negatively impact acute and long-term cardiovascular health, with approximately 16% of all pregnancies affected. With CVD 2-4 times more likely after HDP compared to normotensive pregnancies, effective interventions to promote cardiovascular health are imperative.

Healthcare provider perspectives on barriers and facilitators to integration of cardiovascular disease-related care into HIV care and treatment clinics in urban Tanzania.

Background: The increase in the dual burden of HIV and cardiovascular diseases (CVD), calls for the provision of integrated HIV/CVD care. This study aimed to explore barriers and facilitators to the integration of HIV/CVD care within HIV care and treatment clinics (CTCs) in urban, Tanzania.

Methods: Between March and April 2023, we conducted 12 key informant interviews with healthcare providers at six HIV CTCs in urban, Tanzania.

Cost-Effectiveness of a Polypill for Cardiovascular Disease Prevention in an Underserved Population.

Importance: The Southern Community Cohort Study (SCCS) Polypill Trial showed that a cardiovascular polypill (a single pill containing a statin and 3 half-standard dose antihypertensive medications) effectively controls cardiovascular disease (CVD) risk factors in a majority Black race and low-income population. The cost-effectiveness of polypill treatment in this population has not been previously studied.

Objective: To determine the cost-effectiveness of the cardiovascular polypill.

Variance in development of early and late cardiotoxicities in patients with lymphoma and myeloma receiving CAR T-cell therapies.

Cardiovascular adverse events (CVAEs) are recognized complications of chimeric antigen receptor (CAR) T-cell therapies. However, data are lacking regarding subtypes of adverse events that develop in patients with different malignancies, and little is known about the timeframe in which different cardiotoxicities are most likely to occur post-CAR T-cell therapies. In this study, 211 patients, including 138 lymphoma patients and 66 myeloma patients who received CAR T-cell therapies were retrospectively identified.

Theoretical and Practical Aspects of the Nonlinear Dynamics' Methods of Heart Rate Variability Analyses in Tachyarrhythmia Patients Underwent Radiofrequency Catheter Ablation.

Purpose: This study explores the use of heart rate variability (HRV) analysis, a noninvasive technique for assessing the autonomic nervous system, by applying nonlinear dynamics and chaos theory to detect chaotic behavior in RR intervals and assess cardiovascular health.

Methods: Employing the "System Analysis of Heart Rate Dynamics" (SADR) program, this research combines chaos analysis with the short-time Fourier transform to assess nonlinear dynamic parameters in HRV. It includes constructing phase portraits in Takens space and calculating measures of chaos to identify deterministic chaos indicators.

Population Pharmacokinetics and Pharmacodynamics of Sotalol Following Expedited Intravenous Loading in Patients With Atrial Arrhythmias.

Sotalol, a class III antiarrhythmic agent, is used to maintain sinus rhythm in patients with atrial fibrillation or atrial flutter (AFIB/AFL). Despite its efficacy, sotalol's use is limited by its potential to cause life-threatening ventricular arrhythmias due to QT interval prolongation. Traditionally, sotalol administration required hospitalization to monitor these risks.

The impact of common and rare genetic variants on bradyarrhythmia development.

To broaden our understanding of bradyarrhythmias and conduction disease, we performed common variant genome-wide association analyses in up to 1.3 million individuals and rare variant burden testing in 460,000 individuals for sinus node dysfunction (SND), distal conduction disease (DCD) and pacemaker (PM) implantation. We identified 13, 31 and 21 common variant loci for SND, DCD and PM, respectively.

Future Training Pathways in Percutaneous Coronary Interventions: Interventional Critical Care, Complex Coronary Interventions, and Interventional Heart Failure.

While there has been a proliferation of training and practice paradigms in the realm of noncoronary interventions, coronary disease remains the predominant pathology necessitating interventional cardiology expertise. The landscape of coronary disease has also experienced a significant transformation due to rapidly evolving technologies, clinical application of mechanical circulatory support and other device innovations, and increasing acuity and complexity of patients. The modern interventional cardiologist is subject to challenges including decreasing coronary procedural volume, need to maintain clinical and financial productivity, and often also requirements of continued scholastic pursuit.

Is 70% Achievable? Hospital-Level Variation in Rates of Cardiac Rehabilitation Use Among Medicare Beneficiaries.

Background: Despite national goals to enroll 70% of cardiac rehabilitation (CR)-eligible patients, enrollment remains low.

Objectives: The purpose of this study was to evaluate how the treating hospital influences CR enrollment nationally.

Methods: We included Fee-for-Service Medicare beneficiaries aged ≥66 years who were hospitalized for acute myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, or heart valve repair/replacement.

Cardiac Recovery: Webcast September 24 2024.

This 61-minute webcast features a conversation about "Cardiac Recovery"-the focus of Issue 20.4. Led by the issue's editors, the discussion engages the authors on emerging themes and lessons learned while researching and writing the articles.

Conceptualizing patient-level adverse effects in implementation trials.

Background: Identifying and monitoring adverse effects (AEs) are integral to ensuring patient safety in clinical trials. Research sponsors and regulatory bodies have put into place a variety of policies and procedures to guide researchers in protecting patient safety during clinical trials. However, it remains unclear how these policies and procedures should be adapted for trials in implementation science.

A Podcast on Patient and Physician Perspectives in the Holistic Care of Heart-Related Challenges of Type 2 Diabetes.

Type 2 diabetes (T2D) frequently coexists with cardiorenal complications. Therefore, a holistic approach to patient management is required, with specialists such as primary care physicians, cardiologists, endocrinologists, and nephrologists working together to provide patient care. Although glycemic control is important in the management of T2D, patients with T2D and acceptable glycemic control are still at risk from cardiovascular (CV) events such as stroke, heart attack, and heart failure (HF).

Current approaches to optimize the donor heart for transplantation.

Heart transplantation remains a critical therapy for patients with end-stage heart failure, offering incremental survival and improved quality of life. One of the key components behind the success of heart transplantation is the condition and preservation of the donor's heart. In this review, we provide a comprehensive overview of ischemic reperfusion injury, risk factors associated with primary graft dysfunction, current use of various preservation solutions for organ procurement, and recent advancements in donor heart procurement technologies.

Comparison of Alcohol Septal Ablation With Mavacamten in Obstructive Hypertrophic Cardiomyopathy.

Obstructive hypertrophic cardiomyopathy (HCM) is associated with significant morbidity attributed to left ventricular outflow tract (LVOT) obstruction. Although alcohol septal ablation (ASA) is an established interventional treatment, mavacamten, a novel cardiac myosin inhibitor, has emerged as a noninvasive pharmacologic alternative. Understanding the comparative efficacy of these 2 treatments is important for optimizing patient care.

Multiparametric cardiovascular magnetic resonance is associated with outcomes in pediatric heart transplant recipients.

Background: Multiparametric cardiovascular magnetic resonance (CMR) has an emerging role in non-invasive surveillance of pediatric heart transplant recipients (PHTR). Higher myocardial T2, higher extracellular volume fraction (ECV), and late gadolinium enhancement (LGE) have been associated with adverse clinical outcomes in adult heart transplant recipients. The purpose of this study was to investigate the prognostic value of CMR-derived T1 and T2 mapping, ECV, and LGE for clinical outcomes in PHTR.