Arrhythmia & Electrophysiology Review最新文献

{"title":"Impact of Right Ventricular Pacing Sites on Right Ventricular Function: Systematic Review and Meta-analysis.","authors":"Sean DeAngelo, Badri Aryal, Maryam Haghshomar, Parnian Shobeiri, Deepak Saluja, Angelo Biviano, Elaine Y Wan, Jose Dizon, Hasan Garan, Matthew F Yuyun, Hirad Yarmohammadi","doi":"10.15420/aer.2025.17","DOIUrl":"10.15420/aer.2025.17","url":null,"abstract":"<p><strong>Background: </strong>Conventional transvenous dual-chamber pacemakers may have deleterious effects on the left ventricle, such as pacing-induced cardiomyopathy for those with a high pacing burden. Although the effect of right ventricular (RV) pacing on left ventricular function has been well studied, its impact on RV remodelling and function is not well established.</p><p><strong>Methods: </strong>This systematic review and meta-analysis were constructed according to PRISMA guidelines. We searched Embase, PubMed and SCOPUS using MeSH terms, associated keywords and Boolean operators from inception to March 2024. Relevant studies reported on at least one component of RV function following RV pacing, including: change in RV ejection fraction (RVEF), pulmonary artery systolic pressure (sPAP), tricuspid annular plane systolic excursion (TAPSE), RV volume, tissue Doppler-derived tricuspid lateral annular systolic velocity (S'), 2D fractional area change (FAC), RV index of myocardial performance (RIMP) and tricuspid regurgitation.</p><p><strong>Results: </strong>In all, 18 studies, enrolling 1,220 patients, were examined to analyse the effect of RV pacing on RV echocardiographic parameters. The meta-analysis revealed that RV pacing influenced several echocardiographic parameters. RVEF showed a pooled mean difference of 2.28% (95% CI [-1.2818, 5.8385]; p=0.21), whereas TAPSE (-0.0444 cm; 95% CI [-0.1976, 0.1089]; p=0.57) and RIMP (-0.0714; 95% CI [-0.2888, 0.1459]; p=0.52) exhibited small, non-significant reductions in pooled mean difference. In contrast, S' pooled mean difference decreased significantly (-1.3522 cm/s; 95% CI [-2.3647, -0.3396]; p=0.0089), but there were no significant changes in FAC% (-0.1208 %; 95% CI [-3.6630, 3.4215]; p=0.95) or sPAP (3.7282 mmHg; 95% CI [-6.0651, 13.5216]; p=0.46) pooled mean difference. Heterogeneity was high across all RV function parameters examined, with I² values exceeding 89%. Length of treatment was not significantly associated with changes in RVEF (p=0.21), TAPSE (p=0.53), S' (p=0.22), or FAC% (p=0.68), but significantly influenced RIMP (p=0.01). Site of pacing significantly affected TAPSE (p=0.0198), S' (p=0.0124), FAC% (p=0.0014) and sPAP (p=0.0006). Apical pacing was consistently associated with the worst outcomes across parameters, including the greatest negative impact on TAPSE, S' and sPAP, whereas left bundle branch area pacing (LBBAP) generally showed better outcomes, including the least impact on sPAP.</p><p><strong>Conclusion: </strong>RV pacing is associated with significant reductions in S' and notable effects on other echocardiographic parameters, with heterogeneity largely driven by the site of pacing. Apical pacing had the most detrimental effects across multiple parameters, whereas LBBAP was generally associated with better outcomes. Further studies are needed to address residual heterogeneity and examine additional covariates.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"15 ","pages":"e02"},"PeriodicalIF":4.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324600","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":"Long-term Outcomes of Atrioventricular Node Ablation and Pacemaker Therapy for Rate Control in Atrial Fibrillation: Insights from a 10-year Nationwide Analysis.","authors":"Anette Caroline Kõre, Martin Serg, Tuljo Ööbik, Mart Kals, Rain Paju, Rein Kolk, Indrek Roose, Kaido Hanni, Jüri Voitk, Jaan Eha, Priit Kampus","doi":"10.15420/aer.2025.49","DOIUrl":"10.15420/aer.2025.49","url":null,"abstract":"<p><strong>Background: </strong>Atrioventricular node ablation (AVNA) is an effective rate-control strategy for patients with AF refractory to medical therapy. However, data on long-term survival outcomes and prognostic factors in this population remain limited. Thus, we aimed to evaluate long-term mortality in patients with refractory AF who underwent AVNA in a single country.</p><p><strong>Methods: </strong>We conducted a nationwide retrospective cohort study including all patients who underwent AVNA followed by permanent pacing (n=435) in Estonia from 2012 to 2022. The primary endpoint was all-cause mortality. Comparisons were made between CRT and right ventricular (RV) pacing, AVNA timing (≤6 months and later following device implantation) and by patient sex.</p><p><strong>Results: </strong>Acute success was achieved in 418 (96.1%); mean age was 73.2 ± 10.2 years and 56.5% were female. Median follow-up was 4.2 years (range 2 days to 12.9 years), with median survival of 7.8 years. No significant survival difference was observed between CRT and RV pacing overall nor in ad hoc AVNA and pacemaker implantation cases. Among CRT recipients, early AVNA (≤6 months post-implantation) significantly reduced mortality risk compared with later AVNA (HR 0.48; 95% CI [0.24-0.96]; p=0.038). In RV-paced patients, timing showed no survival impact, but renal function independently predicted mortality (p<0.001). Survival was similar between sexes.</p><p><strong>Conclusion: </strong>In this 10-year nationwide cohort, AVNA with permanent pacing resulted in survival comparable to local population norms. CRT provided no universal survival benefit over RV pacing, but early AVNA was associated with significantly improved outcomes in CRT recipients.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"15 ","pages":"e01"},"PeriodicalIF":4.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324625","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":"Idiopathic Ventricular Fibrillation: Substrates, Mechanisms and Treatment.","authors":"Marine Arnaud, Josselin Duchateau, Mélèze Hocini","doi":"10.15420/aer.2025.34","DOIUrl":"10.15420/aer.2025.34","url":null,"abstract":"<p><p>Idiopathic VF is a complex clinical entity that is characterised by an evolving scope over time. Arrhythmogenic cardiomyopathy and electrical diseases represent a significant proportion of diagnoses attributed during follow-up in patients with an initial diagnosis of idiopathic VF. Stepwise diagnostic workup and management are of paramount importance. We proposed that idiopathic VF can be split into two distinct phenotypes, with potential overlap in an individual patient. In patients with Purkinje-related idiopathic VF, short-coupled ventricular ectopy can be documented, and ablation of the culprit tissue is a reasonable strategy to avoid recurrence. In patients with microstructural idiopathic VF, localised myocardial alterations can be unveiled by thorough electro-anatomical mapping and are amenable to a substrate-elimination strategy. Idiopathic VF is also a dynamic and evolving field, with promising research, new diagnostic tools and ablation techniques being developed in the near future.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e35"},"PeriodicalIF":3.3,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950958","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":"Determining Good Candidates for Atrioventricular Junction Ablation and Device Therapy and Which Device to Implant.","authors":"Arnaud Bisson, Thibaut Lenormand, Mathieu Jacobs, Laurent Fauchier","doi":"10.15420/aer.2025.41","DOIUrl":"10.15420/aer.2025.41","url":null,"abstract":"<p><p>The 'ablate-and-pace' strategy, combining atrioventricular junction ablation with permanent pacing, has re-emerged as a valuable therapeutic option for patients with AF who are symptomatic, have poor rate control or develop AF-mediated cardiomyopathy. While historically considered a last-resort treatment, recent randomised trials and meta-analyses support its efficacy in improving functional status, reducing hospitalisations and potentially enhancing survival, particularly when paired with CRT or conduction system pacing. The success of this approach depends on careful patient selection and appropriate device choice. Candidates include patients with uncontrolled ventricular rates, tachycardia-bradycardia syndrome, symptomatic bradycardia or those with poor CRT response due to persistent AF. Right ventricular pacing should be avoided when possible, in favour of biventricular or conduction system pacing, which preserves synchrony and reduces pacing-induced cardiomyopathy. This review discusses clinical scenarios, prognostic considerations, and current device options - including leadless systems - offering a practical guide for tailoring atrioventricular junction ablation-based therapies to individual patient profiles.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e33"},"PeriodicalIF":3.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951611","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 Sympathetic Innervation and Ventricular Arrhythmias in Structural Heart Disease: Current Peripheral Neuromodulation Therapies and Emerging Therapeutic Targets.","authors":"Léa Benabou, Marmar Vaseghi","doi":"10.15420/aer.2025.24","DOIUrl":"10.15420/aer.2025.24","url":null,"abstract":"<p><p>Over the past several decades, substantial evidence has pointed to the role of the autonomic nervous system in the genesis and maintenance of ventricular arrhythmia. In particular, sympathetic activation has been shown to increase the risk of ventricular arrhythmia, particularly in the context of structural heart diseases, and is a key target of neuromodulatory therapies. Current peripheral sympathetic neuromodulatory approaches include temporary interventions, such as stellate ganglion block, proximal intercostal block, and thoracic epidural anaesthesia, as well as more definitive therapies, such as cardiac sympathetic denervation and renal denervation. Each of these approaches presents distinct strengths and limitations, as well as side effects that warrant careful consideration in clinical practice and highlight the need for more targeted strategies. Emerging interventions focusing on neuropeptide Y, sympathetic afferents ablation, high-frequency block of efferent nerves, and the restoration of sympathetic innervation after MI have shown promising potential. However, further research is needed to evaluate the feasibility and safety of these novel therapies prior to their implementation in patients with cardiovascular diseases.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e34"},"PeriodicalIF":3.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951596","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":"Feasibility of Echocardiography-guided Percutaneous Transapical Lead Implantation for Intraventricular Septal Pacing: Acute and 3-Month Evaluation.","authors":"Zhaohui Qiu, Xianhao Wu, Haiyan Chen, Ke Du, Jing Ni, Zheng Li, Yuhua Tang, Wei Hu, Zhongcheng Xu, Mingyue Sun","doi":"10.15420/aer.2025.14","DOIUrl":"10.15420/aer.2025.14","url":null,"abstract":"<p><strong>Background: </strong>Transvenous lead implantation often faces challenges regarding venous access and lead-related complications. This study evaluated the feasibility and safety of a novel echocardiography-guided percutaneous transapical intraventricular septum (PTAIVS) pacing approach in an animal model.</p><p><strong>Methods: </strong>Twelve adult dogs underwent PTAIVS lead implantation guided by transthoracic and transoesophageal echocardiography. Leads were introduced percutaneously through the apex and fixed in the mid-to-basal septum. The first six dogs were implanted with a pacing set with a coaxial introducer needle (CareFusion) and a Model 3830 lead (Medtronic), whereas an improved pacing set with an extended helix lead was used in the next six dogs. The first three dogs were used for evaluation of acute gross pathology, with the remaining nine followed up over a period of 4-12 weeks. Pathological examinations were performed at the end of the follow-up period.</p><p><strong>Results: </strong>Successful lead placement without procedural complications was achieved in all dogs, with a mean (± SD) procedural time of 28.8 ± 4.8 min. At implantation, the median (interquartile range) capture threshold was 1.7 (0.85-2.50) V, the R-wave amplitude was 6.80 (6.13-13.00) mV and impedance was 536 (510-922) Ω. In the initial six dogs in which the unmodified pacing system was used, lead dislodgement occurred at the 1-month follow-up. Modifications to the system eliminated dislodgement at 1 month, but varying degrees of displacement were observed by 3 months.</p><p><strong>Conclusion: </strong>This study demonstrates the initial technical feasibility of echocardiography-guided PTAIVS pacing, offering a potential alternative to traditional transvenous methods. However, further refinements are essential to improve long-term lead stability.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e32"},"PeriodicalIF":3.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951574","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":"Long-term Survival and Stroke after Cardiac Surgery with Concomitant Surgical Ablation for Atrial Fibrillation.","authors":"Mark A Sammut, Justin Lee, Sxe Chang Cheong, Chai Jin Lim, Manwi Singh, Robert F Storey, Peter C Braidley, Norman P Briffa, Neil Cartwright, Govind Chetty, Stefano Forlani, Renata Greco, Syed Sadeque, Steven Hunter","doi":"10.15420/aer.2025.27","DOIUrl":"10.15420/aer.2025.27","url":null,"abstract":"<p><strong>Background: </strong>Concomitant surgical ablation (SA) is recommended at the time of cardiac surgery in patients with AF but it remains widely underperformed. We sought to report on the safety and long-term efficacy of concomitant SA and the associated incidence of stroke and survival.</p><p><strong>Methods: </strong>A retrospective observational study was performed on patients with AF undergoing cardiac surgery between April 2011 and March 2022 with grouping based on whether or not they received concomitant SA. Thirty-day complications and long-term atrial tachyarrhythmia recurrence, stroke and mortality were compared between groups after propensity score matching.</p><p><strong>Results: </strong>A total of 1,205 patients were included; two groups were obtained after matching (n=326 each). Post-operative length of stay was slightly longer in matched patients receiving concomitant SA (median 10 versus 9 days; p=0.048) but length of stay on intensive care and complication rates were similar in both groups. Freedom from atrial tachyarrhythmia in the SA group was 74% at 1 year and 58% at 3 years compared with 10% and 8%, respectively, for the no-SA group. Ten-year survival was increased for matched patients in the SA group compared with patients in the no-SA group (adjusted HR 0.61; 95% CI [0.45-0.82]; p=0.001) but the incidence of ischaemic stroke was similar (subdistribution HR 1.11; 95% CI [0.53-2.30]; p=0.790).</p><p><strong>Conclusion: </strong>In patients with AF undergoing cardiac surgery, concomitant SA was associated with improved long-term survival without increasing complications. Concomitant SA was not associated with an independent reduction in the long-term incidence of ischaemic stroke.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e31"},"PeriodicalIF":3.3,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145826854","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":"Polymorphic Ventricular Tachycardia After Cardioversion for AF with Tachycardia-induced Cardiomyopathy.","authors":"Eiad Habib, Mahmoud Abdelnabi, Ramzi Ibrahim, Sean Smith, Hoang Nhat Pham, Abdul Hakim Almakadma, Abdulrhman Eldeib, Mayank Sardana, Dan Sorajja","doi":"10.15420/aer.2025.38","DOIUrl":"10.15420/aer.2025.38","url":null,"abstract":"<p><p>Ventricular arrhythmias after electrical cardioversion for AF are rare. Most of these arrhythmias are related to QT prolongation, resulting from marked and sudden slowing of heart rates, treatment with Class III antiarrhythmic drugs or other QT-prolonging medications, and the ventricular repolarisation remodelling effect of electrical cardioversion. A case of polymorphic ventricular tachycardia post-cardioversion of rapid AF in a patient with tachycardia-induced cardiomyopathy and the use of amiodarone is reported.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e29"},"PeriodicalIF":3.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676382","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":"Chronic Effects of Vein of Marshall Ethanol Infusion on Pulmonary Vein and Mitral Isthmus Reconnection.","authors":"Ling-Cong Kong, Tian Shuang, Yu-Min Sun, Jian-Feng Huang, Wei-Feng Jiang, Xin-Hua Wang","doi":"10.15420/aer.2025.47","DOIUrl":"10.15420/aer.2025.47","url":null,"abstract":"<p><strong>Background: </strong>While combined vein of Marshall ethanol infusion (EIVOM) and radiofrequency ablation improves acute left pulmonary vein (LPV) isolation and posterior mitral isthmus block in nonparoxysmal AF (non-PAF) ablation, its long-term efficacy remains unclear. This multicentre cohort study aimed to evaluate the chronic effect of EIVOM on LPV and mitral isthmus conduction recovery beyond 3 months post-initial ablation.</p><p><strong>Methods: </strong>We retrospectively analysed consecutive non-PAF patients undergoing reablation across three tertiary centres, categorised by EIVOM use during initial ablation: the EIVOM cohort (n=41) versus the non-EIVOM cohort (n=50). Primary endpoints included the prevalence and anatomical distribution of conduction gaps at the LPV antrum and posterior mitral isthmus lines. Results: LPV reconnection rates were comparable (39% in the EIVOM cohort versus 28% in non-EIVOM cohort; p=0.27), with the EIVOM cohort showing more frequent conduction gaps at the inferior antrum of the LPV. Mitral isthmus conduction recovery was significantly reduced in the EIVOM cohort versus the non-EIVOM cohort (46.3% versus 80.8%; p=0.002). Absence of EIVOM use (OR 3.611; 95% CI [1.377-9.465]; p=0.009) and AF duration (OR 1.012; 95% CI [1.002-1.023]; p=0.021) were significant predictors for mitral isthmus conduction recovery. Mitral isthmus conduction gaps were commonly localised at the lateral ridge in both cohorts; endocardial mitral annulus conduction gaps were more frequent in the EIVOM cohort and epicardial vein of Marshall-related epicardial conduction gaps were predominant in the non-EIVOM cohort.</p><p><strong>Conclusion: </strong>The combined EIVOM-radiofrequency ablation strategy significantly improved chronic mitral isthmus block durability but did not enhance long-term durability of LPV isolation compared with radiofrequency ablation alone. Distinct anatomical patterns of LPV and mitral isthmus conduction recovery provide useful clues for refining ablation strategies in non-PAF ablation.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e30"},"PeriodicalIF":3.3,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676387","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":"The Global Impact of Atrial Fibrillation.","authors":"Maham F Karatela, Hugh Calkins","doi":"10.15420/aer.2025.33","DOIUrl":"10.15420/aer.2025.33","url":null,"abstract":"<p><p>AF is a common yet multifaceted cardiac arrhythmia with a far-reaching impact. The global burden of AF has been growing rapidly over the last few decades, partly related to the increasing overall burden of chronic illnesses in the setting of an ageing world population. Not only is AF common, but it also has significant implications for patients' health. There exist regional variations in the incidence, prevalence, morbidity and mortality of AF. Moreover, treatment strategies differ appreciably by global regions in a pattern influenced by regional differences in access to medications, the development of large-volume centres and the presence of clinical research. This review explores how AF epidemiology has evolved over time with distinct geographic heterogeneity, and it aims to provide an updated context for the global impact of AF.</p>","PeriodicalId":8412,"journal":{"name":"Arrhythmia & Electrophysiology Review","volume":"14 ","pages":"e28"},"PeriodicalIF":3.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676458","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}