Arrhythmia & Electrophysiology Review最新文献

{"title":"Gut Microbiota and Atrial Fibrillation: Pathogenesis, Mechanisms and Therapies.","authors":"Ahmed M Al-Kaisey,&nbsp;William Figgett,&nbsp;Joshua Hawson,&nbsp;Fabienne Mackay,&nbsp;Stephen A Joseph,&nbsp;Jonathan M Kalman","doi":"10.15420/aer.2022.33","DOIUrl":"https://doi.org/10.15420/aer.2022.33","url":null,"abstract":"<p><p>Over the past decade there has been an interest in understanding the role of gut microbiota in the pathogenesis of AF. A number of studies have linked the gut microbiota to the occurrence of traditional AF risk factors such as hypertension and obesity. However, it remains unclear whether gut dysbiosis has a direct effect on arrhythmogenesis in AF. This article describes the current understanding of the effect of gut dysbiosis and associated metabolites on AF. In addition, current therapeutic strategies and future directions are discussed.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e14"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/5c/aer-12-e14.PMC10326663.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Medicine: Neither Intelligent nor Artificial?","authors":"Demosthenes G Katritsis","doi":"10.15420/aer.2023.01","DOIUrl":"https://doi.org/10.15420/aer.2023.01","url":null,"abstract":"","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e13"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/20/aer-12-e13.PMC10326659.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Pill-in-the-pocket' Oral Anticoagulation Guided by Daily Rhythm Monitoring for Stroke Prevention in Patients with AF: A Systematic Review and Meta-analysis.","authors":"Andre Briosa E Gala,&nbsp;Michael Timothy Brian Pope,&nbsp;Milena Leo,&nbsp;Alexander James Sharp,&nbsp;Victor Tsoi,&nbsp;John Paisey,&nbsp;Nick Curzen,&nbsp;Timothy Rider Betts","doi":"10.15420/aer.2022.22","DOIUrl":"https://doi.org/10.15420/aer.2022.22","url":null,"abstract":"<p><strong>Aims: </strong>In patients with a low AF burden and long periods of sinus rhythm, 'pill-in-the-pocket' oral anticoagulation (OAC) may, taken as needed in response to AF episodes, offer the same thromboembolic protection as continuous, life-long OAC, while reducing bleeding complications at the same time. The purpose of this study is to systematically summarise available evidence pertaining to the feasibility, safety and efficacy of pill-in-the-pocket OAC.</p><p><strong>Methods: </strong>Medline and Embase were searched from inception to July 2022 for studies adopting a pill-in-the-pocket OAC strategy in AF patients guided by daily rhythm monitoring (PROSPERO/CRD42020209564). Outcomes of interest were extracted and event rates per patient-years of follow-up were calculated. A random effects model was used for pooled estimates.</p><p><strong>Results: </strong>Eight studies were included (711 patients). Daily rhythm monitoring was continuous in six studies and intermittent in two (pulse checks or smartphone single-lead electrocardiograms were used). Anticoagulation criteria varied across studies, reflecting the uncertainty regarding the AF burden that warrants anticoagulation. The mean time from AF meeting OAC criteria to its initiation was not reported. Adopting pill-in-the-pocket OAC led to 390 (54.7%) patients stopping OAC, 85 (12.0%) patients taking pill-in-the-pocket OAC and 237 (33.3%) patients remaining on or returning to continuous OAC. Overall, annualised ischaemic stroke and major bleeding rates per patient-year of follow-up were low at 0.005 (95% CI [0.002-0.012]) and 0.024 (95% CI [0.013-0.043]), respectively.</p><p><strong>Conclusion: </strong>Current evidence, although encouraging, is insufficient to inform practice. Additional studies are required to improve our understanding of the relationships between AF burden and thromboembolic risk to help define anticoagulation criteria and appropriate monitoring strategies.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e05"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/03/aer-12-e05.PMC10433111.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10049408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence for the Detection and Treatment of Atrial Fibrillation.","authors":"David M Harmon,&nbsp;Ojasav Sehrawat,&nbsp;Maren Maanja,&nbsp;John Wight,&nbsp;Peter A Noseworthy","doi":"10.15420/aer.2022.31","DOIUrl":"https://doi.org/10.15420/aer.2022.31","url":null,"abstract":"<p><p>AF is the most common clinically relevant cardiac arrhythmia associated with multiple comorbidities, cardiovascular complications (e.g. stroke) and increased mortality. As artificial intelligence (AI) continues to transform the practice of medicine, this review article highlights specific applications of AI for the screening, diagnosis and treatment of AF. Routinely used digital devices and diagnostic technology have been significantly enhanced by these AI algorithms, increasing the potential for large-scale population-based screening and improved diagnostic assessments. These technologies have similarly impacted the treatment pathway of AF, identifying patients who may benefit from specific therapeutic interventions. While the application of AI to the diagnostic and therapeutic pathway of AF has been tremendously successful, the pitfalls and limitations of these algorithms must be thoroughly considered. Overall, the multifaceted applications of AI for AF are a hallmark of this emerging era of medicine.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e12"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/c0/aer-12-e12.PMC10326669.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Ventricular Arrhythmias and Sudden Death.","authors":"Lauri Holmström,&nbsp;Frank Zijun Zhang,&nbsp;David Ouyang,&nbsp;Damini Dey,&nbsp;Piotr J Slomka,&nbsp;Sumeet S Chugh","doi":"10.15420/aer.2022.42","DOIUrl":"https://doi.org/10.15420/aer.2022.42","url":null,"abstract":"<p><p>Sudden cardiac arrest due to lethal ventricular arrhythmias is a major cause of mortality worldwide and results in more years of potential life lost than any individual cancer. Most of these sudden cardiac arrest events occur unexpectedly in individuals who have not been identified as high-risk due to the inadequacy of current risk stratification tools. Artificial intelligence tools are increasingly being used to solve complex problems and are poised to help with this major unmet need in the field of clinical electrophysiology. By leveraging large and detailed datasets, artificial intelligence-based prediction models have the potential to enhance the risk stratification of lethal ventricular arrhythmias. This review presents a synthesis of the published literature and a discussion of future directions in this field.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e17"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/89/aer-12-e17.PMC10345967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Electro-energetics of Biventricular, Septal and Conduction System Pacing.","authors":"Frits W Prinzen,&nbsp;Joost Lumens,&nbsp;Jürgen Duchenne,&nbsp;Kevin Vernooy","doi":"10.15420/aer.2023.12.er1","DOIUrl":"https://doi.org/10.15420/aer.2023.12.er1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.15420/aer.2021.30.].</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e19"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/05/aer-12-e19.PMC10345947.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Resynchronisation with Conduction System Pacing.","authors":"Fatima M Ezzeddine,&nbsp;Isaac G Leon,&nbsp;Yong-Mei Cha","doi":"10.15420/aer.2023.03","DOIUrl":"https://doi.org/10.15420/aer.2023.03","url":null,"abstract":"<p><p>To date, biventricular pacing (BiVP) has been the standard pacing modality for cardiac resynchronisation therapy. However, it is non-physiological, with the activation spreading between the left ventricular epicardium and right ventricular endocardium. Up to one-third of patients with heart failure who are eligible for cardiac resynchronisation therapy do not derive benefit from BiVP. Conduction system pacing (CSP), which includes His bundle pacing and left bundle branch area pacing, has emerged as an alternative to BiVP for cardiac resynchronisation. There is mounting evidence supporting the benefits of CSP in achieving synchronous ventricular activation and repolarisation. The aim of this review is to summarise the current options and outcomes of CSP when used for cardiac resynchronisation in patients with heart failure.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e22"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/2d/aer-12-e22.PMC10466271.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10134662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed Field Ablation for Atrial Fibrillation.","authors":"David Schaack,&nbsp;Boris Schmidt,&nbsp;Shota Tohoku,&nbsp;Stefano Bordignon,&nbsp;Lukas Urbanek,&nbsp;Ramin Ebrahimi,&nbsp;Jun Hirokami,&nbsp;Tolga Han Efe,&nbsp;Shaojie Chen,&nbsp;Kr Julian Chun","doi":"10.15420/aer.2022.45","DOIUrl":"https://doi.org/10.15420/aer.2022.45","url":null,"abstract":"<p><p>Catheter ablation is a widely used, effective and safe treatment for AF. Pulsed field ablation (PFA), as a novel energy source for cardiac ablation, has been shown to be tissue selective and is expected to decrease damage to non-cardiac tissue while providing high efficacy in pulmonary vein isolation. The FARAPULSE ablation system (Boston Scientific) follows the idea of single-shot ablation and is the first device approved for clinical use in Europe. Since its approval, multiple high-volume centres have performed increasing numbers of PFA procedures in patients with AF and have published their experiences. This review summarises the current clinical experience regarding the use of PFA for AF using the FARAPULSE system. It provides an overview of its efficacy and safety.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e11"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/d0/aer-12-e11.PMC10326665.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural Adaptations to Avoid Haemodynamic Instability During Catheter Ablation of Scar-related Ventricular Tachycardia.","authors":"Benjamin L Freedman,&nbsp;Timothy R Maher,&nbsp;Madison Tracey,&nbsp;Pasquale Santangeli,&nbsp;Andre d'Avila","doi":"10.15420/aer.2022.24","DOIUrl":"https://doi.org/10.15420/aer.2022.24","url":null,"abstract":"<p><p>Classically, catheter ablation for scar-related ventricular tachycardia (VT) relied upon activation and entrainment mapping of induced VT. Advances in post-MI therapies have led to VTs that are faster and haemodynamically less stable, because of more heterogeneous myocardial fibrosis patterns. The PAINESD score is one means of identifying patients at highest risk for haemodynamic decompensation during attempted VT induction, who may, therefore, benefit from alternative ablation strategies. One strategy is to use temporary mechanical circulatory support, although this warrants formal assessment of cost-effectiveness. A second strategy is to minimise or avoid VT induction altogether by employing a family of 'substrate'-based approaches aimed at identifying VT isthmuses during sinus or paced rhythm. Substrate mapping techniques are diverse, and focus on the timing, morphology and amplitude of local ventricular electrograms - sometimes aided by advanced non-invasive cardiac imaging modalities. In this review, the evolution of VT ablation over time is discussed, with an emphasis on procedural adaptations to the challenge of haemodynamic instability.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e20"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/75/aer-12-e20.PMC10350657.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular Arrhythmia in Cancer Patients: Mechanisms, Treatment Strategies and Future Avenues.","authors":"Manyoo A Agarwal,&nbsp;Aadhavi Sridharan,&nbsp;Rhea C Pimentel,&nbsp;Steven M Markowitz,&nbsp;Lynda E Rosenfeld,&nbsp;Michael G Fradley,&nbsp;Eric H Yang","doi":"10.15420/aer.2023.04","DOIUrl":"https://doi.org/10.15420/aer.2023.04","url":null,"abstract":"<p><p>Cardiovascular disease and cancer are the leading causes of morbidity and mortality in the US. Despite the significant progress made in cancer treatment leading to improved prognosis and survival, ventricular arrhythmias (VA) remain a known cardiovascular complication either exacerbated or induced by the direct and indirect effects of both traditional and novel cancer treatments. Although interruption of cancer treatment because of VA is rarely required, knowledge surrounding this issue is essential for optimising the overall care of patients with cancer. The mechanisms of cancer-therapeutic-induced VA are poorly understood. This review will discuss the ventricular conduction (QRS) and repolarisation abnormalities (QTc prolongation), and VAs associated with cancer therapies, as well as existing strategies for the identification, prevention and management of cancer-treatment-induced VAs.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"12 ","pages":"e16"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/89/aer-12-e16.PMC10345968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}