Atrial fibrillation is a highly prevalent arrhythmia and a major risk factor for stroke, heart failure and death1. We conducted a genome-wide association study (GWAS) in individuals of European ancestry, including 6,707 with and 52,426 without atrial fibrillation. Six new atrial fibrillation susceptibility loci were identified and replicated in an additional sample of individuals of European ancestry, including 5,381 subjects with and 1 0,030 subjects without atrial fibrillation (P < 5 × 10−8). Four of the loci identified in Europeans were further replicated in silico in a GWAS of Japanese individuals, including 843 individuals with and 3,350 individuals without atrial fibrillation. The identified loci implicate candidate genes that encode transcription factors related to cardiopulmonary development, cardiac-expressed ion channels and cell signaling molecules.

VT ablation required epicardial ablation in 121 of 913 procedures (13%), with a risk of 5% and 2% of acute and delayed major complications related to epicardial access.

Background The impact of catheter ablation of ventricular tachycardia (VT) on all-cause mortality remains unknown. Objective To examine the association between VT recurrence after ablation and survival in patients with scar-related VT. Methods Analysis of 2,061 patients with structural heart disease referred for catheter ablation of scar-related VT from 12 international centers was performed. Data on clinical and procedural variables, VT recurrence, and mortality were analyzed. Kaplan-Meier analysis was used to estimate freedom from recurrent VT, transplant, and death. Cox proportional hazards frailty models were used to analyze the effect of risk factors on VT recurrence and mortality. Results One-year freedom from VT recurrence was 70% (72% in ischemic and 68% in non-ischemic cardiomyopathy). 57 (3%) patients underwent cardiac transplantation and 216 (10%) died during follow-up. At one year, the estimated rate of transplant and/or mortality was 15% (same for ischemic and non-ischemic cardiomyopathy). Transplant-free survival was significantly higher in patients without VT recurrence compared to those with recurrence (90% vs. 71%, p<0.001). In multivariable analysis, recurrence of VT after ablation showed the highest risk for transplant and/or mortality (HR 6.9 (5.3-9.0); p<0.001). In patients with EF<30% and across all NYHA classes, improved transplant-free survival was seen in those without VT recurrence. Conclusions Catheter ablation of VT in patients with structural heart disease results in 70% freedom from VT recurrence, with an overall transplant and/or mortality rate of 15% at 1 year. Freedom from VT recurrence is associated with improved transplant-free survival, independent of heart failure severity.

Objectives To characterize the relationship between changes in body mass index (BMI) and incident atrial fibrillation (AF) in a large cohort of women. Background Obesity and AF are increasing public health problems. The importance of dynamic obesity-associated AF risk is uncertain, and mediators are not well characterized. Methods Cases of AF were confirmed by medical record review in 34,309 participants in the Women’s Health Study. Baseline and updated measures of BMI were obtained from periodic questionnaires. Results Over 12.9 +/− 1.9 years of follow-up, 834 AF events were confirmed. BMI was linearly associated with AF risk, with a 4.7% (95% CI 3.4, 6.1, p<0.0001) increase in risk with each kg/m2. Adjustment for inflammatory markers minimally attenuated this risk. When updated measures of BMI were utilized to estimate dynamic risk, overweight (HR 1.22 95%CI 1.02, 1.45, p=0.03) and obesity (HR 1.65 95%CI 1.36, 2.00, p<0.0001) were associated with adjusted short term elevations in AF risk. Participants becoming obese during the first 60 months had a 41% adjusted increase in risk of developing AF (p=0.02) compared to those maintaining BMI <30 kg/m2. The prevalence of overweight and obesity increased over time. The adjusted proportion of incident AF attributable to short term elevations in BMI was substantial (18.3%). Conclusions In this population of apparently healthy women, BMI was associated with short and long term elevations in AF risk, accounting for a large proportion of incident AF independent of traditional risk factors. A strategy of weight control may reduce the increasing incidence of AF.

Catheter ablation of frequent PVCs is a low-risk and often effective treatment strategy to eliminate PVCs and associated symptoms. In patients with PVC-induced cardiomyopathy, cardiac function is frequently restored after successful ablation.

Context The risks associated with new-onset AF among middle-aged women and populations with a low co-morbidity burden are poorly defined. Objective To examine the association between incident AF and mortality in initially healthy women, and to evaluate the influence of associated cardiovascular co-morbidities on risk. Design, Setting and Participants Between 1993 and March 16, 2010, 34722 women participating in the Women's Health Study underwent prospective follow-up. Participants (95% white) were >45 years (median (interquartile range) 53 (49–59) years) and free of AF and cardiovascular disease at baseline. Cox proportional-hazards models with time-varying covariates were utilized to determine the risk of events among women with incident AF. Secondary analyses were performed among women with paroxysmal AF. Main outcome measure Primary outcomes included total, cardiovascular, and non-cardiovascular mortality. Secondary outcomes included stroke, congestive heart failure and myocardial infarction. Results During a median (interquartile range) follow-up of 15.4 (14.7–15.8) years, 1011 women developed AF. Incidence rates (95% confidence intervals (CIs)) per 1000 person-years among women with and without AF were 10.8 (8.1–13.5) and 3.1 (2.9–3.2) for all-cause, 4.3 (2.6–6.0) and 0.57 (0.5–0.6) for cardiovascular and 6.5 (4.4–8.6) and 2.5 (2.4–2.6) for non-cardiovascular mortality, respectively. In multivariable models, hazard ratios (HRs) (95% CIs) of new-onset AF for all-cause, cardiovascular and non-cardiovascular mortality were 2.14 (1.64–2.77), 4.18 (2.69–6.51) and 1.66 (1.19–2.30), respectively. Adjustment for non-fatal cardiovascular events potentially on the causal pathway to death attenuated these risks, but incident AF remained associated with all mortality components (HR 1.70 (1.30–2.22)), 2.57 (1.63–4.07) and 1.42 (1.02–1.98)). Among women with paroxysmal AF (n=656), the increase in mortality risk was limited to cardiovascular causes (HR 2.94 (1.55–5.59)). Conclusion Among a group of healthy women, new-onset AF was independently associated with cardiovascular, non-cardiovascular and all-cause mortality, with some of the risk potentially explained by non-fatal cardiovascular events.

LMNA-related heart disease was associated with a high incidence of phenotypic progression and adverse arrhythmic and nonarrhythmic events over long-term follow-up. The index cardiac phenotype did not predict adverse events. Genetic diagnosis and subsequent follow-up, including anticipatory planning for therapies to prevent sudden death and manage HF, is warranted.

Background-The influence of systolic and diastolic blood pressure (BP) on incident atrial fibrillation (AF) is not well studied among initially healthy, middle-aged women. Methods and Results-A total of 34 221 women participating in the Women's Health Study were prospectively followed up for incident AF.