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Thromb Haemost 2021 May 7. Epub 2021 May 7.

Department of Medicine, Campus Bio-Medico University, Roma, Italy.

Introduction: Atrial fibrillation (AF), the most frequent arrhythmia of older patients, associates with serious thrombo-embolic complications and high mortality. COVID-19 severely affects aged subjects, determining an important prothrombotic status. Aim of this study was to evaluate mortality-related factors in older AF patients with COVID-19. Read More

Can J Cardiol 2021 May 4. Epub 2021 May 4.

Department of Cardiology, Herlev and Gentofte University Hospital, Denmark; Department of Nursing and Nutrision, University College Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

PLoS One 2021 7;16(5):e0251260. Epub 2021 May 7.

Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany.

Introduction: Work-life conflicts (WLC) may impact health, but few studies prospectively consider the impact of WLC on objective outcomes such as cardiovascular disease. Using data from the Gutenberg Health Study (GHS), we examined if WLC at baseline was associated with an increased five-year incidence of cardiovascular events (myocardial infarct, stroke, atrial fibrillation, peripheral artery disease, coronary artery disease, chronic heart failure, sudden cardiac death). We also considered if WLC was associated with incident hypertension and arterial stiffness and if the effects of WLC on cardiovascular health differ for men and women. Read More

Clin Res Cardiol 2021 May 7. Epub 2021 May 7.

Department of Cardiology II-Electrophysiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.

Introduction: Supraventricular tachycardias (SVT) are often difficult to document due to their intermittent, short-lasting nature. Smartphone-based one-lead ECG monitors (sECG) were initially developed for the diagnosis of atrial fibrillation. No data have been published regarding their potential role in differentiating inappropiate sinus tachycardia (IST) from regular SVT. Read More

Europace 2021 May 7. Epub 2021 May 7.

IHU LIRYC-CHU Bordeaux, Univ. Bordeaux, Inserm U1045, Avenue du Haut Lévêque, 33604 Pessac, France.

Aims: Extra-atrial injury can cause complications after catheter ablation for atrial fibrillation (AF). Pulsed field ablation (PFA) has generated preclinical data suggesting that it selectively targets the myocardium. We sought to characterize extra-atrial injuries after pulmonary vein isolation (PVI) between PFA and thermal ablation methods. Read More

Eur Heart J 2021 May 7. Epub 2021 May 7.

GenesisCare, 3/140 Mounts Bay Rd, Perth, Western Australia, Australia.

Colchicine is a unique, sophisticated anti-inflammatory agent that has been used for decades for the prevention of acute inflammatory flares in gout and familial Mediterranean fever. In recent years, clinical trials have demonstrated its potential in a range of cardiovascular (CV) conditions. Colchicine is avidly taken up by leucocytes, and its ability to bind to tubulin and interfere with microtubular function affects the expression of cytokines and interleukins, and the ability of neutrophils to marginate, ingress, aggregate, express superoxide, release neutrophil extracellular traps, and interact with platelets. Read More

G Ital Cardiol (Rome) 2021 May;22(5):341-351

U.O.C. Cardiologia, Ospedale G.B. Grassi, Ostia (RM).

During the last 50 years a continuous improvement was observed in the field of cardiac pacing and electrophysiology as for as both technological and clinical aspects were concerned. We moved from the first recording of the His bundle electrogram to the identification of the various mechanisms and sites of supraventricular and ventricular tachyarrhythmias, to three-dimensional mapping and ablation of different reentry circuits and eventually to pulmonary vein isolation for the treatment of atrial fibrillation. As far as cardiac pacing is concerned, we moved from single chamber to dual chamber pacing, to ventricular pacing and implantable automatic defibrillators provided by sophisticated diagnostic and therapeutic algorithms and by remote control. Read More

Anatol J Cardiol 2021 May;25(5):338-345

First Department of Internal Medicine, Medical University Varna; Varna-Bulgaria.

Objective: Atrial fibrillation (AF) is a progressive disease, associated with increased risk of mortality, stroke, heart failure, and worsens quality of life. There is a high incidence of AF recurrence despite the treatment. The aim of the study was to assess the time to recurrence of AF after sinus rhythm restoration with electrical or pharmacological cardioversion and to identify the risk factors. Read More

ESC Heart Fail 2021 May 6. Epub 2021 May 6.

Cardiovascular Center, Division of Cardiology, Seoul National University Bundang Hospital, Gumiro 166, Bundang, Seongnam, Republic of Korea.

Aims: Tachycardia is a reversible event that may cause hemodynamic decompensation but may not necessarily cause direct damages to the myocardium. To evaluate the clinical outcomes of patients with heart failure (HF) and atrial fibrillation (AF), whose acute decompensation was tachycardia mediated.

Methods And Results: The Korean Acute Heart Failure registry was a prospective registry that consecutively enrolled 5625 patients with acute HF. Read More

Pacing Clin Electrophysiol 2021 May 6. Epub 2021 May 6.

Cardiac Electrophysiology, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA.

Purpose: Non-white patients are underrepresented in left atrial appendage occlusion (LAAO) trials, and racial disparities in LAAO periprocedural management are unknown.

Methods: We assessed sociodemographics and comorbidities of consecutive patients at our institution undergoing LAAO between 2015 - 2020, then in adjusted analyses, compared procedural wait time, procedural complications, and post-procedure oral anticoagulation (OAC) use in whites versus non-whites.

Results: Among 109 patients undergoing LAAO (45% white), whites had lower CHA2DS VASc scores, on average, than non-whites (4. Read More

Pacing Clin Electrophysiol 2021 May 7. Epub 2021 May 7.

Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, Hasselt, 3500, Belgium.

Introduction: Obstructive sleep apnea is often underdiagnosed in atrial fibrillation (AF) patients although it is an important risk factor. A systematic review and meta-analysis was performed to assess which techniques cardiac implantable electronic devices (CIED) and Holter monitors use to screen for sleep apnea (SA), and to evaluate if these are suitable for AF patients from a diagnostic accuracy perspective.

Methods: The search was conducted in accordance with the PRISMA-guidelines. Read More

CJEM 2021 May 6;23(3):267-268. Epub 2021 May 6.

Division of Emergency Medicine and Department of Medicine, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada.

CJEM 2021 May 20;23(3):325-329. Epub 2021 Jan 20.

Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.

Background: Atrial fibrillation increases the risk of stroke, which can be mitigated by anticoagulant prescription. We evaluated local emergency physician anticoagulation practice for patients discharged from the emergency department with atrial fibrillation, along with 90-day incidence of stroke and major bleeding.

Methods: This was a health record review of patients diagnosed with new onset atrial fibrillation in two emergency departments between 2014 and 2017. Read More

CJEM 2021 May 18;23(3):314-324. Epub 2021 Jan 18.

Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.

Background: Acute atrial flutter has one-tenth the prevalence of acute atrial fibrillation in the emergency department (ED) but shares many management strategies. Our aim was to compare conversion from acute atrial flutter to sinus rhythm between pharmacological cardioversion followed by electrical cardioversion (Drug-Shock), and electrical cardioversion alone (Shock-Only).

Methods: We conducted a randomized, blinded, placebo-controlled comparison of attempted pharmacological cardioversion with IV procainamide followed by electrical cardioversion if necessary, and placebo infusion followed by electrical cardioversion. Read More

Int J Cardiovasc Imaging 2021 May 6. Epub 2021 May 6.

Image Cardiology Section, Cardiology Service, University Hospital of Badajoz, Badajoz, Spain.

An 85-year-old patient with permanent atrial fibrillation with a DDD pacemaker, and with indication for left atrial appendage occlusion (LAAO). Sent for LAAO due to recurrent gastrointestinal bleedings even on apixaban and with a CHA 2 DS 2 VASc and HAS-BLED scores of 4 and 3 respectively. Read More

Eur Heart J Case Rep 2021 Apr 30;5(4):ytab158. Epub 2021 Apr 30.

University Hospital of Patras, Rio, Patras, 26504, Greece.

Background: SCN5A mutations may present with different clinical phenotypes such as Brugada syndrome, long QT3 syndrome, sick sinus syndrome, atrial fibrillation, dilated cardiomyopathy, and the least known multifocal ectopic Purkinje-related premature contractions syndrome.

Case Summary: We report a case of a 29-year-old woman with palpitations due to multifocal premature ventricular complexes (PVCs) and a family history of sudden death. The previous electrophysiological study had shown that PVCs arose from Purkinje fibres but catheter ablation was unsuccessful. Read More

Front Pharmacol 2021 20;12:667254. Epub 2021 Apr 20.

Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy.

The renin-angiotensin-aldosterone system (RAAS) firstly considered as a cardiovascular circulating hormonal system, it is now accepted as a local tissue system that works synergistically or independently with the circulating one. Evidence states that tissue RAAS locally generates mediators with regulatory homeostatic functions, thus contributing, at some extent, to organ dysfunction or disease. Specifically, RAAS can be divided into the traditional RAAS pathway (or classic RAAS) mediated by angiotensin II (AII), and the non-classic RAAS pathway mediated by angiotensin 1-7. Read More

Crit Pathw Cardiol 2021 Apr 22. Epub 2021 Apr 22.

Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK School of Medicine, Keele University, Stoke-on-Trent, UK Department of Cardiology, Royal Devon and Exeter NHS Trust, Exeter, UK.

Chest pain is one of the most common reasons for patients to present to healthcare professionals. One of the main challenges with the management of chest pain is the wide differential diagnosis, ranging from minor chest trauma to potentially life threatening acute myocardial infarction. In a patient-centered health service pathway, the aim is to assess, investigate, diagnose and treat patients in the safest and most accurate, time and cost-efficient manner. Read More

BMJ Open 2021 May 6;11(5):e043862. Epub 2021 May 6.

Division of Cardiology, Department of Medicine, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.

Objective: To determine the effect of gender on clinical outcomes of Asian non-valvular atrial fibrillation patients.

Design: This is a cohort study.

Setting: 27 university and regional hospitals in Thailand. Read More

Heart Lung Circ 2021 May 3. Epub 2021 May 3.

Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia; South Australian Health and Medical Research Institute, Adelaide, SA, Australia; Lyell McEwin Hospital, Adelaide, SA, Australia. Electronic address:

Introduction: Successful pulmonary vein isolation (PVI) for atrial fibrillation (AF) depends on the formation of durable transmural lesions. Recently, novel indices have emerged to guide lesion delivery. The aim of the systematic review of literature was to determine AF recurrence following ablation guided by indices incorporating force, power and time, and compare acute procedural outcomes and 12-month AF recurrence with ablation guided by contact force (CF) guided only. Read More

J Thorac Cardiovasc Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Cardiac Surgery, Sheba Medical Center, Tel-Hashomer, Israel. Electronic address:

Mayo Clin Proc 2021 May;96(5):1175-1183

Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ. Electronic address:

Objective: To evaluate the relationship between peripheral arterial disease (PAD) and incident atrial fibrillation (AF) and its clinical and pathophysiologic implications on ischemic stroke and all-cause mortality.

Patients And Methods: We identified all adult patients in the Mayo Clinic Health System without a previous diagnosis of AF undergoing ankle-brachial index (ABI) testing for any indication from January 1, 1996, to June 30, 2018. Retrospective extraction of ABI data and baseline echocardiographic data was performed. Read More

BMC Health Serv Res 2021 May 6;21(1):435. Epub 2021 May 6.

Sunnybrook Health Sciences Centre, University of Toronto, 890 Sheppard Avenue West, Ontario, M4N 3M5, Toronto, Canada.

Background/purpose: Interventional cardiac electrophysiology (EP) is a rapidly evolving field in Canada; a nationwide registry was established in 2011 to conduct a periodic review of resource allocation.

Methods: The registry collects annual data on EP lab infrastructure, imaging, tools, human resources, procedural volumes, success rates, and wait times. Leading physicians from each EP lab were contacted electronically; participation was voluntary. Read More

BMC Med 2021 May 7;19(1):111. Epub 2021 May 7.

Department of Surgical Sciences, Unit of Medical Epidemiology, The EpiHub, Uppsala University, Dag Hammarskjölds väg 14 B, 75185, Uppsala, Sweden.

Background: Cigarette smoking is a well-known risk factor for cardiovascular disease (CVD), but whether smokeless tobacco such as snuff is associated with the risk of CVD is still unclear. We investigated the association of the use of Swedish oral moist snuff (snus) with a broad range of CVDs and CVD mortality.

Methods: We used data from a population-based cohort of 41,162 Swedish adults with a mean baseline age of 70 (56-94) years who completed questionnaires regarding snus use and other lifestyle habits and health characteristics. Read More

BMC Med Imaging 2021 May 6;21(1):76. Epub 2021 May 6.

Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel.

Background: Evidence of diastolic dysfunction (DD) required for the diagnosis of heart failure with preserved ejection fraction (HFpEF) is elusive in atrial fibrillation (AF). Left ventricular (LV) and left atrial (LA) speckle-tracking echocardiography (STE) may provide rhythm independent indications of DD. We aimed to find common LV/LA myocardial mechanics parameters to demonstrate DD, using STE in patients with AF. Read More

Dtsch Med Wochenschr 2021 May 6;146(S 01):S2-S16. Epub 2021 May 6.

Kardiologie, Universitäts-Herzzentrum Freiburg.

Stroke prophylaxis with non-vitamin K-dependent oral anticoagulants (NOAKs) in patients with non-valvular atrial fibrillation (nvVHF) is now firmly established in routine clinical practice. The definition of nvVHF includes the absence of a mechanical heart valve and AF not associated with moderate- or high-grade mitral valve stenosis. The management of oral anticoagulation (OAC) requires a high degree of interdisciplinarity. Read More

Dtsch Med Wochenschr 2021 May 6;146(S 01):S1. Epub 2021 May 6.

Comput Biol Med 2021 Apr 24;133:104423. Epub 2021 Apr 24.

Sección de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario de Badajoz, Avda. de Elvas S/n, 06006, Badajoz, Spain.

Background: Recently, advances in medical imaging, segmentation techniques, and high-performance computing have supported the use of patient-specific computational fluid dynamics (CFD) simulations. At present, CFD-compatible atrium geometries can be easily reconstructed from atrium images, providing important insight into the atrial fibrillation (AF) phenomenon, and assistance during therapy selection and surgical procedures. However, the hypothesis assumed for such CFD models should be adequately validated. Read More

J Am Coll Cardiol 2021 Apr 19. Epub 2021 Apr 19.

Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address:

Int J Cardiol 2021 May 3. Epub 2021 May 3.

Cardiology Research Unit, University Hospital Geelong, Barwon Health, Geelong, Australia.

Background The COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial showed that rivaroxaban plus aspirin reduced major adverse cardiovascular events (MACE) in patients with chronic coronary artery disease (CAD) and/or peripheral artery disease (PAD). We explored whether CHADS-VASc or CHADS scores, well-validated tools for assessing risk of thromboembolic events in atrial fibrillation, can identify vascular patients at highest risk of recurrent events who may derive greatest benefits of treatment. Methods Predictive accuracies of the CHADS-VASc and CHADS scores for MACE, were assessed in this analysis of the COMPASS trial. Read More