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Arch Cardiovasc Dis 2021 Apr 9. Epub 2021 Apr 9.

Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France; Paediatric and Congenital Heart Disease Department, Necker Hospital, 75015 Paris, France.

Background: With the growing adult congenital heart disease (ACHD) population, the number of catheter ablation procedures is expected to dramatically increase. Data reporting experience and evolution of catheter ablation in patients with ACHD, over a significant period of time, remain scarce.

Aim: We aimed to describe temporal trends in volume and outcomes of catheter ablation in patients with ACHD. Read More

J Am Heart Assoc 2021 Apr 10:e019168. Epub 2021 Apr 10.

Population Health Research Institute McMaster University Hamilton Canada.

Background Hospitalization for heart failure (HF) is very common in patients with atrial fibrillation (AF). We hypothesized that biomarkers of inflammation can identify patients with AF at increased risk of this important complication. Methods and Results Patients with established AF were prospectively enrolled. Read More

Ann Transl Med 2021 Mar;9(5):393

Center for Basic Medical Research & Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Graduate School, Peking Union Medical College, Beijing, China.

Background: Mitral valve disease (MVD)-associated atrial fibrillation (AF) is one of the most common arrhythmias with an increased risk of thromboembolic events. This study aimed to identify the molecular mechanisms and possible biomarkers for chronic AF in MVD by using multi-omics methods.

Methods: This prospective study enrolled patients with MVD (n=100) undergoing mitral valve replacement surgery. Read More

Europace 2021 Apr;23(Supplement_2):ii4-ii8

Cardiovascular Disease Initiative, The Broad Institute of MIT and Harvard, Cambridge, MA, USA.

Atrial fibrillation (AF) management has significantly improved during the career of professor Crijns. Research was implemented into guidelines and clinical practice. However, despite advances in AF management, large differences between individual treatment responses still exist and the mechanisms underlying initiation and perpetuation of AF are not completely understood. Read More

Europace 2021 Apr;23(Supplement_2):ii9-ii13

Department of Medicine, Cardiovascular Research Institute, Case Western Reserve University/University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Determining the sequence of activation is a major source of information for understanding the electrophysiological mechanism(s) of atrial fibrillation (AF). However, the complex morphology of the electrograms hampers their analysis, and has stimulated generations of electrophysiologists to develop a large variety of technologies for recording, pre-processing, and analysis of fibrillation electrograms. This variability of approaches is mirrored by a large variability in the interpretation of fibrillation electrograms and, thereby, opinions regarding the basic electrophysiological mechanism(s) of AF vary widely. Read More

Front Cardiovasc Med 2021 23;8:630399. Epub 2021 Mar 23.

Department of Cardiology, The Second Affiliate Hospital of Xi'an Jiaotong University, Xi'an, China.

Cardiac pacing is an effective therapy for treating patients with bradycardia due to sinus node dysfunction or atrioventricular block. However, traditional right ventricular apical pacing (RVAP) causes electric and mechanical dyssynchrony, which is associated with increased risk for atrial arrhythmias and heart failure. Therefore, there is a need to develop a physiological pacing approach that activates the normal cardiac conduction and provides synchronized contraction of ventricles. Read More

Heart 2021 Apr 8. Epub 2021 Apr 8.

Department of Cardiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands

Objective: To investigate the prognostic value of left atrial volume index (LAVI) in patients with moderate to severe aortic regurgitation (AR) and bicuspid aortic valve (BAV).

Methods: 554 individuals (45 (IQR 33-57) years, 80% male) with BAV and moderate or severe AR were selected from an international, multicentre registry. The association between LAVI and the combined endpoint of all-cause mortality or aortic valve surgery was investigated with Cox proportional hazard regression analyses. Read More

Cardiovasc Drugs Ther 2021 Apr 8. Epub 2021 Apr 8.

Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan.

Purpose: Although direct oral anticoagulants are effective and safe in preventing stroke in atrial fibrillation (AF) patients with low body weight, data remain limited in AF patients with extremely low body weight (<50 kg). We aimed to investigate the association of this body weight category with clinical outcomes in elderly AF patients receiving apixaban.

Methods: The J-ELD AF Registry is a large-scale, multicenter prospective observational study of Japanese non-valvular AF patients aged ≥ 75 years taking on-label doses of apixaban. Read More

JACC Cardiovasc Interv 2021 Apr;14(7):768-780

Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts, USA.

Objectives: The aim of this study was to explore the early versus late benefits and risks of dabigatran dual therapy versus warfarin triple therapy in the RE-DUAL PCI (Randomized Evaluation of Dual Antithrombotic Therapy With Dabigatran Versus Triple Therapy With Warfarin in Patients With Nonvalvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention) trial.

Background: Patients with atrial fibrillation who undergo percutaneous coronary intervention are at increased risk for both bleeding and thrombotic events.

Methods: A total of 2,725 patients with atrial fibrillation underwent percutaneous coronary intervention and were randomized to receive dabigatran 110 mg, or dabigatran 150 mg plus a P2Y inhibitor (and no aspirin), or warfarin plus a P2Y inhibitor plus aspirin. Read More

Eur Heart J Qual Care Clin Outcomes 2021 Apr 2. Epub 2021 Apr 2.

Data Intelligence Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan.

Aims: To clarify the real-world clinical status and prognosis of elderly and very elderly non-valvular atrial fibrillation (NVAF) patients, more than 30 000 elderly patients with NVAF aged ≥75 years were enrolled in the ANAFIE Registry.

Methods And Results: This multicentre, prospective, observational study followed elderly NVAF patients in Japan for ∼2 years. Among 32 275 patients (mean age 81. Read More

BMC Med Inform Decis Mak 2021 Apr 3;21(1):112. Epub 2021 Apr 3.

Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.

Background: Many patients with atrial fibrillation (AF) remain undiagnosed despite availability of interventions to reduce stroke risk. Predictive models to date are limited by data requirements and theoretical usage. We aimed to develop a model for predicting the 2-year probability of AF diagnosis and implement it as proof-of-concept (POC) in a production electronic health record (EHR). Read More

Heart Rhythm 2021 Mar 31. Epub 2021 Mar 31.

Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, L'Institut de RYthmologie et modélisation Cardiaque (LIRYC), Université Bordeaux, France. Electronic address:

Background: Little is known about persistent atrial fibrillation (AF) ablation in patients with cardiac laminopathy (CLMNA).

Objective: We aimed to characterize atrial electrophysiological properties and to assess the long-term outcomes of persistent AF ablation in CLMNA patients.

Methods: All CLMNA patients referred in our center for persistent AF ablation were retrospectively included. Read More

Am J Med Genet A 2021 Apr 3. Epub 2021 Apr 3.

Rare Diseases Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Italy.

Smith-Magenis syndrome (SMS) is a genetic disorder characterized by multiple congenital anomalies, sleep disturbance, behavioral impairment, and intellectual disability. Its genetic cause has been defined as an alteration in the Retinoic Acid-Induced 1 gene. Cardiac anomalies have been reported since the first description of this condition in patients with 17p11. Read More

Heart Lung Circ 2021 Mar 30. Epub 2021 Mar 30.

Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York Presbyterian, New York, NY, USA.

Background: Redo coronary artery bypass grafting (CABG) can be performed with either the off-pump (OPCAB) or the on-pump (ONCAB) technique.

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), this meta-analysis compared the safety and efficacy of OPCAB versus ONCAB redo CABG.

Results: Twenty-three (23) eligible studies were included (OPCAB, n=2,085; ONCAB, n=3,245). Read More

Sensors (Basel) 2021 Mar 12;21(6). Epub 2021 Mar 12.

Thorax Center, Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands.

The large and growing burden of chronic heart failure (CHF) on healthcare systems and economies is mainly caused by a high hospital admission rate for acute decompensated heart failure (HF). Several remote monitoring techniques have been developed for early detection of worsening disease, potentially limiting the number of hospitalizations. Over the last years, the scope has been shifting towards the relatively novel invasive sensors capable of measuring intracardiac filling pressures, because it is believed that hemodynamic congestion precedes clinical congestion. Read More

Int J Mol Sci 2021 Mar 24;22(7). Epub 2021 Mar 24.

Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA.

The in vitro modeling of cardiac development and cardiomyopathies in human induced pluripotent stem cell (iPSC)-derived cardiomyocytes (CMs) provides opportunities to aid the discovery of genetic, molecular, and developmental changes that are causal to, or influence, cardiomyopathies and related diseases. To better understand the functional and disease modeling potential of iPSC-differentiated CMs and to provide a proof of principle for large, epidemiological-scale disease gene discovery approaches into cardiomyopathies, well-characterized CMs, generated from validated iPSCs of 12 individuals who belong to four sibships, and one of whom reported a major adverse cardiac event (MACE), were analyzed by genome-wide mRNA sequencing. The generated CMs expressed CM-specific genes and were highly concordant in their total expressed transcriptome across the 12 samples (correlation coefficient at 95% CI =0. Read More

J Clin Med 2021 Mar 1;10(5). Epub 2021 Mar 1.

Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA.

Background: SARS-CoV-2 infected patients are suggested to have a higher incidence of thrombotic events such as acute ischemic strokes (AIS). This study aimed at exploring vascular comorbidity patterns among SARS-CoV-2 infected patients with subsequent stroke. We also investigated whether the comorbidities and their frequencies under each subclass of TOAST criteria were similar to the AIS population studies prior to the pandemic. Read More

Medicina (Kaunas) 2021 Mar 18;57(3). Epub 2021 Mar 18.

Department of Cardiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

Restrictive cardiomyopathy (RCM) is one of the rarest cardiac disorders, with a very poor prognosis, and heart transplantation is the only long-term treatment of choice. We reported that a Korean family presented different cardiomyopathies, such as idiopathic RCM and hypertrophic cardiomyopathy (HCM), caused by the same mutation in different individuals. A 74-year-old male was admitted for the evaluation of exertional dyspnea, palpitations, and pitting edema in both legs for several months. Read More

Heart Surg Forum 2021 03 3;24(2):E215-E216. Epub 2021 Mar 3.

Department of Critical Care Medicine, Nantong Third People's Hospital, Nantong University, Nantong, China.

A 63-year-old man was admitted for acute left heart failure after doing farm work. He rapidly developed refractory cardiogenic shock due to a large left atrial myxoma which was found by bedside echocardiography. Venoarteriovenous extracorporeal membrane oxygenation (ECMO) was performed immediately, and the patient was transferred for further surgery with a good outcome. Read More

Kidney Res Clin Pract 2021 Mar 14;40(1):99-108. Epub 2021 Jan 14.

Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.

Background: The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. Read More

Ther Adv Neurol Disord 2021 11;14:1756286421999017. Epub 2021 Mar 11.

Department of Neurology, Inselspital, University Hospital and University of Bern, Freiburgstrasse, Bern, 3010, Switzerland.

Background And Aims: To investigate whether stroke aetiology affects outcome in patients with acute ischaemic stroke who undergo endovascular therapy.

Methods: We retrospectively analysed patients from the Bernese Stroke Centre Registry (January 2010-September 2018), with acute large vessel occlusion in the anterior circulation due to cardioembolism or large-artery atherosclerosis, treated with endovascular therapy (±intravenous thrombolysis).

Results: The study included 850 patients (median age 77. Read More

Stroke 2021 Mar 31:STROKEAHA120032453. Epub 2021 Mar 31.

Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland (D.S., G.S., S.N., P.M.).

Background And Purpose: The Risk of Paradoxical Embolism (RoPE) score stratifies patients with stroke according to the probability of having a patent foramen ovale (PFO), which (through Bayes theorem and simple assumptions) can be used to estimate the probability that a PFO is pathogenic in a given subgroup of patients with specific features (ie, a given RoPE score value): a higher PFO prevalence corresponds to a higher probability that a PFO is pathogenic. Among alternative mechanisms in embolic stroke of undetermined source (ESUS), the actual stroke cause may be covert atrial fibrillation. We aimed to validate the RoPE score in a large ESUS population and investigate the rate of stroke recurrence and new incident atrial fibrillation during follow-up according to PFO status and RoPE score. Read More

Sci Rep 2021 Mar 29;11(1):7127. Epub 2021 Mar 29.

Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.

The detection of underlying atrial fibrillation (AF) has become increasingly possible by insertable cardiac monitoring (ICM). During hospitalization for cryptogenic stroke, factors related to the early and late development of AF have not been studied. CHALLENGE ESUS/CS is a multicenter registry of cryptogenic stroke patients undergoing transesophageal echocardiography. Read More

CJC Open 2021 Mar 1;3(3):367-371. Epub 2020 Nov 1.

Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.

Background: A recent feasibility assessment of quality indicators for nonvalvular atrial fibrillation/atrial flutter (NVAF/AFL) identified the Canadian Primary Care Sentinel Surveillance Network, a national outpatient electronic medical record (EMR) system, as a data source for measurement. As a first step, we adapted and validated an existing EMR case definition.

Methods: A diagnosis of NVAF/AFL was defined using International Classification of Disease, 9th Revision, Clinical Modification codes (427. Read More

CJC Open 2021 Mar 13;3(3):303-310. Epub 2020 Nov 13.

Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

Background: Intracardiac echocardiography and 3D mapping systems allow catheter ablation for atrial fibrillation (AF) to be conducted without fluoroscopy; however, the safety and effectiveness of fluoroless AF ablation are not well defined.

Methods: We examined consecutive radiofrequency AF catheter ablations at a large academic teaching hospital from November 2017 to July 2019. Outcomes for fluoroscopy-guided (N = 176) and fluoroless (N = 147) ablations were compared. Read More

Cerebrovasc Dis 2021 Mar 26:1-6. Epub 2021 Mar 26.

Liverpool Centre for Cardiovascular Science, University of Liverpool & Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.

Introduction: Increasing evidence suggests patients with coronavirus disease 2019 (COVID-19) may develop thrombosis and thrombosis-related complications. Some previous evidence has suggested COVID-19-associated strokes are more severe with worse outcomes for patients, but further studies are needed to confirm these findings. The aim of this study was to determine the association between COVID-19 and mortality for patients with ischaemic stroke in a large multicentre study. Read More

Brain Res 2021 Mar 26;1763:147451. Epub 2021 Mar 26.

Department of Veterinary Physiology, Faculty of Agriculture, Tottori University, Japan. Electronic address:

Neurons in the subfornical organ (SFO) sense both neurotransmitters and circulating humoral factors such as angiotensin II (AII) and atrial natriuretic peptide (ANP), and regulate multiple physiological functions including drinking behavior. We recently reported that AII at nanomolar concentrations induced a persistent [Ca] increase in acutely dissociated SFO neurons and that this effect of AII was reversibly inhibited by GABA. In the present study, we studied the inhibitory mechanism of GABA using Ca imaging and patch-clamp electrophysiology. Read More

J Card Surg 2021 Mar 26. Epub 2021 Mar 26.

Division of Cardiovascular Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Postoperative atrial fibrillation (POAF) often complicates cardiac surgery and is associated with increased mortality and risk of thromboembolism. However, the optimal oral anticoagulation (OAC) strategy is uncertain. We performed a systematic review to examine the OAC practice patterns and efficacy in these circumstances. Read More

J Neurol Sci 2021 Mar 20;424:117410. Epub 2021 Mar 20.

Neurology Department, Neuroscience Institute, Geisinger Health System, Danville, PA, USA. Electronic address:

Objective: This study aimed to investigate the prevalence and factors associated with oral anticoagulant undertreatment of atrial fibrillation (AF) among a cohort of rural patients with stroke outcomes and examine how undertreatment may influence a patient's one-year survival after stroke.

Methods: This retrospective cohort study examined ischemic stroke patients with pre-stroke AF diagnosis from September 2003 to May 2019 and divided them into proper treatment and undertreatment group. Analysis included chi-square test, variance analysis, Kruskal-Wallis test, logistic regression, Kaplan-Meier estimator, and Cox proportional-hazards model. Read More

Curr Opin Crit Care 2021 Mar 23. Epub 2021 Mar 23.

Department of Intensive Care, Aarhus University Hospital Department of Clinical Medicine, Aarhus University Prehospital Emergency Medical Services, Central Denmark Region Department of Forensic Medicine, Aarhus University Zoophysiology, Department of Biology, Aarhus University, Aarhus, Denmark University of Leicester, East Midlands Forensic Pathology Unit, Leicester Royal Infirmary, UK.

Purpose Of Review: The purpose of this narrative review is to provide an update on hemodynamics during cardiopulmonary resuscitation (CPR) and to describe emerging therapies to optimize perfusion.

Recent Findings: Cadaver studies have shown large inter-individual variations in blood distribution and anatomical placement of the heart during chest compressions. Using advanced CT techniques the studies have demonstrated atrial and slight right ventricular compression, but no direct compression of the left ventricle. Read More