Catheter ablation of paroxysmal atrial fibrillation and disease progression: Magnitude of the antiprogression effect and role of intervention timing.

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

Objective: This meta-analysis aimed to investigate the magnitude of the antiprogression 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).

Novel cardiac CT method for identifying the atrioventricular conduction axis by anatomic landmarks.

Background: Understanding the conduction axis location aids in avoiding iatrogenic damage and guiding targeted heart rhythm therapy.

Objective: Cardiac structures visible with clinical imaging have been demonstrated to correlate with variability in the conduction system course. We aimed to standardize and assess the reproducibility of predicting the location of the atrioventricular conduction axis by cardiac computed tomography.

A Study Of the effect of Sex on drug dosing, concentrations, and pharmacogenomics in the Montreal Heart Institute Hospital Cohort (SOS-PGx): methodology and research progress.

Background: Women are underrepresented in drug development trials and there is no sex-tailored drug regimen for most medications. It has been repeatedly shown that women have more adverse drug reactions than men for several medications. These differences could be explained by higher dose-adjusted drug concentrations in women.

Sex differences in mitochondrial gene expression during viral myocarditis.

Background: Myocarditis is an inflammation of the heart muscle most often caused by viral infections. Sex differences in the immune response during myocarditis have been well described but upstream mechanisms in the heart that might influence sex differences in disease are not completely understood.

Methods: Male and female BALB/c wild type mice received an intraperitoneal injection of heart-passaged coxsackievirus B3 (CVB3) or vehicle control.

Where's the Remote? Failure to Report Clinical Workflows in Heart Failure Remote Monitoring Studies.

Background: Remote patient monitoring (RPM) clinical trials have reported mixed results in improving outcomes for patients with chronic heart failure (HF). The impact of clinical workflows that could impact RPM effectiveness is often overlooked. We sought to characterize workflows and response protocols that could impact outcomes in studies of noninvasive RPM in HF.

Prospective validation of a prespecified algorithm for the management of conduction disturbances after transcatheter aortic valve replacement: The PROMOTE study.

Background: There is a large variability in the management of conduction disturbances (CDs) after transcatheter aortic valve replacement (TAVR).

Objective: This study aimed to validate a prespecified algorithm for managing CDs in patients undergoing TAVR.

Methods: This was a prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.

Factor XIII-A Transglutaminase Contributes to Neutrophil Extracellular Trap (NET)-mediated Fibrin(ogen) Network Formation and Crosslinking.

Background:  Neutrophil extracellular traps can contribute to thrombosis via stabilization of fibrin network, which is normally conducted by plasma transglutaminase, Factor XIII-A as part of coagulation cascade. The possible presence and activity of FXIII-A in neutrophils or during NETosis are unknown. Here, we investigated potential presence of FXIII-A in neutrophils and participation in NET-fibrin(ogen) interaction in vitro METHODS:  Data mining of human and mouse mRNA expression in whole-body scRNA sequence atlases was conducted.

Adequacy of oral intakes after cardiac surgery within an ERAS pathway: A prospective observational study.

Background: The 2019 Enhanced Recovery After Cardiac Surgery (ERACS) guidelines presented perioperative recommendations to optimize treatment for patients undergoing cardiac surgery (CS). However, the guidelines have not established postoperative nutrition recommendations. Limited studies have analyzed oral intakes after CS, but to our knowledge, none have done so in an ERACS pathway.

Percutaneous Atrial Septostomy in Adult Patients on Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock: A Canadian Single-Center Experience.

Patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) frequently develop left ventricular (LV) distension and pulmonary edema due to an increased LV afterload. A balloon atrial septostomy (BAS) is a technique used to alleviate LV pressure and facilitate left atrial decompression. While primarily performed in pediatric populations, this procedure's feasibility in adult patients is less studied.

Long Sleep Duration, Cognitive Performance, and the Moderating Role of Depression: A Cross-Sectional Analysis in the Framingham Heart Study.

Introduction: We investigated whether depression modified the associations between sleep duration and cognitive performance.

Methods: Multivariable linear regression models examined the associations between sleep duration and cognition in 1,853 dementia- and stroke-free participants from the Framingham Heart Study. Participants were categorized in four groups: no depressive symptoms, no antidepressants; depressive symptoms without antidepressants use; antidepressant use without depressive symptoms; both depressive symptoms and antidepressant use.

Acute kappa opioid receptor blocking disrupts the pro-cognitive effect of cannabidiol in neuropathic rats.

Cannabidiol has been shown to ameliorate neuropathic pain and its affective components. Previous studies highlighted the pharmacological interaction between the CBD and opioid system, particularly the MOR, but the understanding of the interaction between CBD and kappa opioid receptor (KOR), physiologically stimulated by the endogenous opioid dynorphin, remains elusive. We assessed the pharmacological interactions between CBD and nor-BNI, a selective KOR antagonist in a rat neuropathic pain model.

Epidemiology and Outcomes of Antibiotic De-escalation in Patients with Suspected Sepsis in US Hospitals.

Background: Little is known about the frequency, hospital-level variation, predictors, and clinical outcomes of antibiotic de-escalation in suspected sepsis.

Methods: We retrospectively analyzed all adults admitted to 236 US hospitals between 2017-2021 with suspected sepsis (defined by a blood culture draw, lactate measurement, and intravenous antibiotic administration) who were initially treated with ≥2 days of anti-MRSA and anti-pseudomonal antibiotics but had no resistant organisms requiring these agents identified through hospital day 4. De-escalation was defined as stopping anti-MRSA and anti-pseudomonal antibiotics or switching to narrower antibiotics by day 4.

Efficacy and Safety of Dupilumab in Children With Peanut Allergy: A Multicenter, Open-Label, Phase II Study.

Background: Peanut allergy is a potentially life-threatening food allergy in children. This study explored whether dupilumab, a human monoclonal immunoglobulin (Ig)G4 antibody that blocks the activity of interleukin (IL)-4/IL-13, improved safety and desensitization to peanut exposure in children with peanut allergy.

Methods: A Phase II, 24-week, multicenter, single-arm, open-label, proof-of-concept study was conducted in the USA and Canada (NCT03793608).

Moderate Aortic Stenosis With Cardiac Damage: A New Type of Severe Aortic Stenosis.

The clinical implications of severe aortic stenosis have been well established. Understanding of moderate aortic stenosis, however, continues to evolve. Athough moderate aortic stenosis may be less clinically impactful in patients with normal ventricular function, it may carry prognostic significance in those patients with a ventricle exhibiting signs of cardiac damage.

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.

In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.

Clinical Outcomes in Atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices.

Background: Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in aortic stenosis patients. However, the factors associated with poorer outcomes among AF patients in contemporary transcatheter aortic valve replacement (TAVR) practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.

Methods: In this multicenter study we assessed consecutive patients with a history of AF and evaluated the clinical outcomes, predictors of mortality, and HF-related hospitalization rates of those who underwent TAVR with newer generation devices using either balloon- or self-expandable valves.

Evaluating the performance of the BOADICEA model in predicting 10-year breast cancer risks in UK Biobank.

Background: The BOADICEA model predicts breast cancer risk using cancer family history, epidemiological and genetic data. We evaluated its validity in a large prospective cohort.

Methods: We assessed model calibration, discrimination and risk classification ability in 217,885 women (6,838 incident breast cancers) aged 40-70 years old of self-reported White ethnicity with no previous cancer from the UK Biobank.

Can the Present Canadian Health Care System Provide Evidence-Based Pharmaceutical Care? Consideration of Two Important Cardiovascular Clinical Contexts.

Background: Canada is the only country with universal health care lacking universal pharmaceutical care (pharmacare). Currently, a minority portion of the population has drug coverage. Furthermore, there may be discordance between provincial plans of medications that are covered.