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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

Am Heart J 2021 May 3. Epub 2021 May 3.

Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Background: New-onset atrial fibrillation (NEW-AF) following ST-segment elevation myocardial infarction (STEMI) is a common complication, but the long-term mortality and morbidity remains unknown the true prognostic impact of NEW-AF is unknown. Additionally, the optimal treatment of NEW-AF among patients with STEMI is warranted.

Methods: A large cohort of consecutive patients with STEMI treated with percutaneous coronary intervention were identified using the Eastern Danish Heart Registry from 1999-2016. Read More

Heart Rhythm 2021 Apr 1. Epub 2021 Apr 1.

Grandview Medical Center, Birmingham, Alabama.

Background: Watchman 2.5 (Boston Scientific Inc, Marlborough, MA) implant success approaches 95% in registries, yet many patients are not attempted because of complex left atrial appendage (LAA) anatomy. Watchman FLX can expand the range of ostium width (14-31. Read More

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

Division of Cardiovascular Medicine, University of Utah, Salt Lake City, UT, USA.

The shape of the left atrium (LA) and left atrial appendage (LAA) have been shown to predict stroke in patients with atrial fibrillation (AF). Prior studies rely on qualitative assessment of shape, which limits reproducibility and clinical utility. Statistical shape analysis (SSA) allows for quantitative assessment of shape. Read More

J Interv Card Electrophysiol 2021 May 6. Epub 2021 May 6.

Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.

Purpose: Clinical significance of reduced vagal activity following pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unclear. Periesophageal vagal nerve injury following PVI may be a powerful contributing factor of decreased vagal tone.

Methods: Drug-refractory 51 AF patients (31 males, 64 ± 11 years), who underwent successful PVI, were enrolled. Read More

J Cardiovasc Electrophysiol 2021 May 5. Epub 2021 May 5.

Cardiovascular Institute, Stanford University, Stanford, CA, USA.

The mapping and ablation of Atrial Tachycardias (AT) can be challenging, particularly in patients with prior ablation or structural atrial disease. This article is protected by copyright. All rights reserved. Read More

J Cardiovasc Electrophysiol 2021 May 5. Epub 2021 May 5.

Universitäres Herz- und Gefäßzentrum Hamburg-Eppendorf, Department of Cardiology, Hamburg, Germany.

Background: The impact of basic atrial rhythm (sinus rhythm (SR) vs atrial fibrillation (AF)) during AF ablation on efficacy and safety is unknown.

Methods: 3375 patients from the German Ablation Registry undergoing first-time AF ablation were divided according to the type of AF and the basic atrial rhythm during the ablation procedure: paroxysmal AF (PAF) and SR [group Ia], PAF and AF [group Ib]), persistent AF and SR (IIa) and persistent AF and AF (IIb).

Results: Patients in SR (n=2312 (67%)) underwent cryoballoon ablation more often (Ia vs Ib p=0. Read More

Clin Interv Aging 2021 29;16:739-745. Epub 2021 Apr 29.

Department of Cardiology, Hospital Universitari de Sant Joan.

Background: The European Heart Rhythm Association (EHRA) score is a proven and validated tool for assessing the symptoms of atrial fibrillation (AF). Little is known about the variables related to this score and how it changes after cardioversion.

Methods: We analyzed 744 patients undergoing elective cardioversion in whom AF-related symptoms were assessed at baseline and after 6 months of follow-up using the EHRA score. Read More

Clin Interv Aging 2021 28;16:707-719. Epub 2021 Apr 28.

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

Purpose: We aimed to compare the rate of clinical outcomes among three age groups (<65, 65-74, and ≥75 years) of adult patients with non-valvular atrial fibrillation (NVAF).

Patients And Methods: We prospectively enrolled NVAF patients from 27 Thailand medical centers. The following were collected at baseline: demographic data, risk factors, comorbid conditions, laboratory data, and medications. Read More

Heart 2021 May 5. Epub 2021 May 5.

Department of Cardiology, AZ Sint-Jan AV, Bruges, WVL, Belgium.

Objective: Pulmonary vein isolation (PVI) guided by a standardised CLOSE (contiguous optimised lesions) protocol has been shown to increase clinical success after catheter ablation for paroxysmal atrial fibrillation (PAF). This study analysed healthcare utilisation and quality of life (QOL) outcomes from a large multicentre prospective study, measured association between QOL and atrial fibrillation (AF) burden and identified factors associated with lack of QOL improvement.

Methods: CLOSE-guided ablation was performed in 329 consecutive patients (age 61. Read More

Eur J Intern Med 2021 May 2. Epub 2021 May 2.

Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. Electronic address:

J Thorac Cardiovasc Surg 2021 Apr 1. Epub 2021 Apr 1.

Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany. Electronic address:

Objective: New-onset postoperative atrial fibrillation (POAF) after cardiac surgery is common, with rates up to 60%. POAF has been associated with early and late stroke, but its association with other cardiovascular outcomes is less known. The objective was to perform a meta-analysis of the studies reporting the association of POAF with perioperative and long-term outcomes in patients with cardiac surgery. Read More

BMC Cardiovasc Disord 2021 May 5;21(1):231. Epub 2021 May 5.

Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, No.389, Xincun Rd, putuo District, Shanghai, 200065, China.

Introduction: The prognosis of new-onset atrial fibrillation (AF) compared with that of preexisting and non-AF remains controversial. The purpose of this study was to evaluate the effect of new-onset AF compared with preexisting and non-AF on hospital and 90-day mortality.

Methods: A retrospective cohort study was performed using data obtained from the Medical Information Mart for Intensive Care III database. Read More

J Cardiovasc Pharmacol 2021 May;77(5):549-556

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.

Abstract: Checkpoint kinase 1 (CHK1) plays a broad role in regulating the cell cycle process and is involved in the pathogenesis of various malignant tumors. Preclinical and animal studies have shown that CHK1 inhibitors can enhance the cytotoxic effects of radiotherapy and chemotherapy. Currently, CHK1 inhibitors are actively tested in clinical trials. Read More

Am J Nephrol 2021 May 5:1-8. Epub 2021 May 5.

Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Introduction: Atrial fibrillation (AF) is common in patients with chronic kidney disease (CKD) and is associated with higher rates of hospitalization compared to those without AF. Whether routine electrocardiographic parameters are predictive of future hospitalizations with AF is not clear.

Methods: The present study is an analysis of a prospective cohort of 2,759 patients without baseline AF from the Chronic Renal Insufficiency Cohort, a large prospective multicenter study of patients with nondialysis-dependent CKD. Read More

J Electrocardiol 2021 Apr 23;66:131-135. Epub 2021 Apr 23.

Center for Arrhythmia Care, Heart & Vascular Center, Pritzker School of Medicine of the University of Chicago, Chicago, IL, USA.

The SCN5A gene, located on chromosome 3p21, has 28 exons and is a member of the human voltage-gated sodium channel gene family. Genetic variation in SCN5A is associated with a diverse range of phenotypes. Due to incomplete penetrance, delayed expression, inherent low signal-to-noise ratio, and marked phenotypic heterogeneity, rare novel variants in SCN5A could be misinterpreted. Read More

Comput Biol Med 2021 Apr 15;133:104404. Epub 2021 Apr 15.

Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of Technology, Delft, the Netherlands.

Aims: Automated detection of atrial fibrillation (AF) in continuous rhythm registrations is essential in order to prevent complications and optimize treatment of AF. Many algorithms have been developed to detect AF in surface electrocardiograms (ECGs) during the past few years. The aim of this systematic review is to gain more insight into these available classification methods by discussing previously used digital biomarkers and algorithms and make recommendations for future research. Read More

Rom J Intern Med 2021 May 5. Epub 2021 May 5.

University of Medicine and Pharmacy Gr. T. Popa Iași, Strada Universității 16, Iași 700115, Romania.

Atrial fibrillation (AF) is considered the most common sustained arrhythmia. Major cardiovascular risk factors that have been identified to initiate and perpetuate AF include age, sex, arterial hypertension, heart failure, valvular heart disease and diabetes mellitus. In the literature, several studies aimed to formulate easily - applied and accurate risk stratification scores, based on antecedent cardiovascular events, comorbidities and biomarkers for the prediction of new-onset AF. Read More

J Clin Hypertens (Greenwich) 2021 May 5. Epub 2021 May 5.

Department of Innovative Technologies in Medicine & Dentistry, University "Gabriele d'Annunzio", Chieti-Pescara, Chieti, Italy.

The aim of this study was to perform a meta-analysis of studies evaluating the association of clinic and daytime, nighttime, and 24-h blood pressure with the occurrence of new-onset atrial fibrillation. We conducted a literature search through PubMed, Web of science, and Cochrane Library for articles evaluating the occurrence of new-onset atrial fibrillation in relation to the above-mentioned blood pressure parameters and reporting adjusted hazard ratio and 95% confidence interval. We identified five studies. Read More

Age Ageing 2021 May;50(3):772-779

Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.

Background: Atrial fibrillation (AF) is common in older people and is associated with increased stroke risk that may be reduced by oral anticoagulation (OAC). Frailty also increases with increasing age, yet the extent of OAC prescription in older people according to extent of frailty in people with AF is insufficiently described.

Methods: An electronic health records study of 536,955 patients aged ≥65 years from ResearchOne in England (384 General Practices), over 15. Read More

Age Ageing 2021 May;50(3):744-757

Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.

Background: anticoagulation is integral to stroke prevention for atrial fibrillation (AF), but there is evidence of under-treatment in older people in long-term care (LTC).

Objective: to synthesise evidence on the prevalence and outcomes (stroke, mortality or bleeding) of AF in LTC and the factors associated with the prescription of anticoagulation.

Methods: studies were identified from Medline, CINAHL, PsycINFO, Scopus and Web of Science from inception to 31 October 2019. Read More

Medicine (Baltimore) 2021 May;100(18):e25701

Department of Neurology, University of Missouri Health Care, Missouri.

Rationale: Myasthenia gravis (MG) patients are at increased risk of COVID-19 infection and its complications due to chronic immunosuppression. COVID-19 infection can also increase the risk of myasthenia exacerbation.

Patient Concerns: The patient presented with respiratory distress, fever and chills and was diagnosed with COVID-19 pneumonia. Read More

Medicine (Baltimore) 2021 May;100(18):e25559

Department of Cardiology, Xijing Hospital, The Air Force Military Medical University, Xi'an Shaanxi, China.

Abstract: Background: Atrial fibrillation (AF) is a type of arrhythmia that represents a severe health hazard. The current therapies for AF have achieved success in some conditions. However, because the mechanisms underlying the occurrence and development of this disease remain unclear, the current treatment for AF often does not achieve the desired outcomes. Read More

Int J Clin Pract 2021 May 5:e14313. Epub 2021 May 5.

Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Background: Atrial fibrillation. (AF) is the most common sustained arrhythmia globally and its prevalence is likely to increase in the next decades due to increasing age and co-morbidities. There are no data on demographic features, clinical characteristics, associated comorbidities, and practice patterns of AF in Iran. Read More

JAMA Cardiol 2021 May 5. Epub 2021 May 5.

Center for Genetic Medicine, Bluhm Cardiovascular Institute, Northwestern University School of Medicine, Chicago, Illinois.

JAMA Cardiol 2021 May 5. Epub 2021 May 5.

Department of Medicine, University of Illinois at Chicago.

Importance: Although rare variants in cardiac ion channels, transcription factors, and myocardial structural proteins are associated with early-onset atrial fibrillation (AF) in White individuals of European descent, it remains unclear whether genetic variation also contributes to the cause of AF in those of minority ethnicity.

Objectives: To assess the prevalence of rare and novel pathogenic variants in candidate genes in ethnic minority probands with early-onset AF and determine genotype-phenotype associations.

Design, Setting, And Participants: In this cohort, family-based study, probands of African and Hispanic descent with early-onset AF (defined as AF occurring in individuals aged ≤66 years) prospectively enrolled in a clinical and genetic biorepository underwent sequencing of 60 candidate genes. Read More