Effect of remote ischemic preconditioning on left atrial remodeling and prothrombotic response after radiofrequency catheter ablation for atrial fibrillation

Han, Ruijuan; Liu, Xiaoqing; Zheng, Meimei; Zhao, Ruiping; Liu, Xiaoyan; Yin, Xiandong; Tian, Ying; Shi, Liang; Sun, Kai; Yang, Xinchun

doi:10.1111/pace.13271

Cited by 12 publications

(9 citation statements)

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“…observed that AF recurrence in the 3 months after the PAF ablation was signi cantly lower in the RIC group than in the control group. The RIPC group also showed a lower increase in atrial remodeling marker Matrix Metalloproteinase-9 and endothelial dysfunction marker von Willebrand-factor in blood samples compared with the control group 30 . Our study has shown that HRV was improved in heart failure patients by CRIC, which was a marker of autonomic nervous stress 19 .…”

Section: Discussionmentioning

confidence: 85%

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Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

Chen

Liu

Zhu

et al. 2020

Preprint

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Background: The burden of atrial fibrillation (AF) has been attractive recently and may be associated with stroke risk and mortality. Remote ischemic conditioning could reduce the incidence, inducibility and sustainability of AF. But the effects of chronic remote ischemic conditioning (CRIC) on atrial fibrillation burden in patients with pacemaker implanted are still unknown.Design: This was a single‑center, prospective, randomized, open-labeled clinical study.Methods: Sixty-six patients with permanent pacemakers were randomly divided into CRIC group and control group after 4 weeks screening. CRIC treatment was performed twice a day for 12 weeks. A remote ischemic conditioning protocol consisted of 4 × 5 min inflation/deflation of the blood pressure cuff applied in the upper arm to create intermittent arm ischemia. Pacemaker programming was performed for four times: before screening (-4-week), after screening and before randomization (0-week, baseline), 4-week and 12-week follow-up. Data including AF burden, longest duration of AF and cumulative numbers of atrial high-rate episodes (AHREs) were collected.Results: Sixty-one patients (31 patients in CRIC group and 30 patients in control group) completed the study. CRIC was well-tolerated by patients after 12 weeks treatment. The burden of AF in CRIC group was decreased significantly at 4-week compared with that at 0-week (14.7%±18.5% vs 17.0%±20.7%, p < 0.001), which further decreased at 12-week compared with that at 0-week (8.6%±10.2% vs 17.0%±20.7%, p < 0.001) and that at 4-week (8.6%±10.2% vs 14.7%±18.5%, p < 0.001), which was not observed in the control group. AF burden also reduced significantly after 12-week CRIC compared with that in control group (8.6%±10.2% vs 17.6%±19.5%, p = 0.013). Repeated measurement ANOVA showed that the changes of AF burden was associated with CRIC instead of time (p < 0.01). In addition, there were trends that longest duration of AF and cumulative numbers of AHREs were reduced after 12-week CRIC.Conclusions: This study suggests that a 12-week course of CRIC treatment could reduce AF burden in patients with permanent pacemakers, supporting widespread use of CRIC in the daily lives of these patients, which need to be verified in the future.Clinical Trial RegistrationRegistration name: Effects of remote ischemic conditioning on atrial fibrillation burden in patients with paroxysmal atrial fibrillationRegistration number: ChiCTR-IOR-17012666Registered 14 September 2017; URL: www.chictr.org.cn/showproj.aspx?proj=21591

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Section: Discussionmentioning

confidence: 85%

“…Kosiuk et al17 demonstrated that 3 sessions of RIC reduced the inducibility (23.3% vs 46.6%, p = 0.003) and sustainability (15.1% vs 32.9%, p = 0.01) of PAF signi cantly, which was possibly mediated by decrease in dispersion of atrial refractory periods (16.0 ± 14.0 ms vs 22.7 ± 19.0 ms, p = 0.21) and reduction in atrial conduction delay. Han et al30…”

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confidence: 99%

Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

Chen

Liu

Zhu

et al. 2020

Preprint

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“…Kosiuk,et al 17) demonstrated that three sessions of RIC significantly reduced the inducibility (23.3% versus 46.6%, P = 0.003) and sustainability (15.1% versus 32.9%, P = 0.01) of PAF, which was possibly mediated by a decrease in dispersion of atrial refractory periods (16.0 ± 14.0 millisecond versus 22.7 ± 19.0 millisecond, P = 0.21) and reduction in atrial conduction delay. Han, et al 30) observed that AF recurrence 3 months after the PAF ablation was significantly lower in the RIC group than in the control group. The RIPC group also showed a lower increase in atrial remodeling marker matrix metalloproteinase-9 and endothelial dysfunction marker von Willebrand factor in blood samples compared with the control group.…”

Section: Discussionmentioning

confidence: 98%

Effects of Chronic Remote Ischemic Conditioning on Atrial Fibrillation Burden in Patients with Permanent Pacemakers

et al. 2022

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This study aimed to evaluate the effects of chronic remote ischemic conditioning (CRIC) on atrial fibrillation burden in patients with an implanted pacemaker. Sixty-six patients with permanent pacemakers were randomly divided into the CRIC group and control group after 4 weeks of screening. CRIC treatment was performed twice daily for 12 weeks. The remote ischemic conditioning protocol consisted of 4 × 5 minutes inflation/deflation of the blood pressure cuff applied in the upper arm to create intermittent arm ischemia. Sixty-one patients (31 patients in the CRIC group and 30 patients in the control group) completed the study. CRIC was well tolerated by patients after 12 weeks of treatment. The burden of atrial fibrillation (AF) in the CRIC group decreased significantly at 4 weeks compared with that at 0 weeks (14.7% ± 18.5% versus 17.0% ± 20.7%, P < 0.001), which further decreased at 12 weeks compared with that at 0 weeks (8.6% ± 10.2% versus 17.0% ± 20.7%, P < 0.001) and that at 4 weeks (8.6% ± 10.2% versus 14.7% ± 18.5%, P < 0.001), which was not observed in the control group. AF burden also reduced significantly after 12-week CRIC compared with that in the control group (8.6% ± 10.2% versus 17.6% ± 19.5%, P = 0.013). Repeated measurement ANOVA showed that the changes in AF burden were associated with CRIC instead of time (P < 0.01). In addition, there were trends that the longest duration of AF and cumulative numbers of atrial high-rate episodes (AHREs) reduced after 12-week CRIC. This study suggests that a 12-week course of CRIC treatment could reduce AF burden in patients with permanent pacemakers, supporting the widespread use of CRIC in the daily lives of these patients, which needs to be verified in the future.

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“…e results obtained using these methods showed good detection performance. e classification accuracy, sensitivity, and specificity of the SVM and RBF have been found to be high, thus making it a good option for the diagnosis [75].…”

Section: Discussionmentioning

confidence: 99%

Detecting Congestive Heart Failure by Extracting Multimodal Features and Employing Machine Learning Techniques

Hussain

Awan

Aziz

et al. 2020

BioMed Research International

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The adaptability of heart to external and internal stimuli is reflected by the heart rate variability (HRV). Reduced HRV can be a predictor of negative cardiovascular outcomes. Based on the nonlinear, nonstationary, and highly complex dynamics of the controlling mechanism of the cardiovascular system, linear HRV measures have limited capability to accurately analyze the underlying dynamics. In this study, we propose an automated system to analyze HRV signals by extracting multimodal features to capture temporal, spectral, and complex dynamics. Robust machine learning techniques, such as support vector machine (SVM) with its kernel (linear, Gaussian, radial base function, and polynomial), decision tree (DT), k-nearest neighbor (KNN), and ensemble classifiers, were employed to evaluate the detection performance. Performance was evaluated in terms of specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). The highest performance was obtained using SVM linear kernel (TA = 93.1%, AUC = 0.97, 95% CI [lower bound = 0.04, upper bound = 0.89]), followed by ensemble subspace discriminant (TA = 91.4%, AUC = 0.96, 95% CI [lower bound 0.07, upper bound = 0.81]) and SVM medium Gaussian kernel (TA = 90.5%, AUC = 0.95, 95% CI [lower bound = 0.07, upper bound = 0.86]). The results reveal that the proposed approach can provide an effective and computationally efficient tool for automatic detection of congestive heart failure patients.

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Effect of remote ischemic preconditioning on left atrial remodeling and prothrombotic response after radiofrequency catheter ablation for atrial fibrillation

Abstract: RIPC before RFCA for paroxysmal AF significantly reduces the increase in markers of left atrial remodeling and endothelial damage associated with the procedure, and results in a lower ERAF.

Cited by 12 publications

References 41 publications

Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

Effects of Chronic Remote Ischemic Conditioning on Atrial Fibrillation Burden in Patients with Permanent Pacemakers

Detecting Congestive Heart Failure by Extracting Multimodal Features and Employing Machine Learning Techniques

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