New Perspective in Atrial Fibrillation

Sagnard, Audrey; Hammache, Néfissa; Sellal, Jean‐Marc; Guenancia, Charles

doi:10.3390/jcm9113713

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Our project was “population-oriented” and not “device-oriented” so the performance of the MyDiagnostick device was not tested, also because the delay between testing with MyDiagnostick and 12-lead ECG (up to 24 h) represents a major limitation for an accurate estimate of device performance in terms of sensitivity. Finally, we did not consider the possibility of employing biomarkers for improving patient targeting [ 52 , 53 ], since this approach was not practicable in the setting that we considered.…”

Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

Boriani

Palmisano²,

Malavasi

et al. 2021

JCM

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Our aim was to assess the prevalence of unknown atrial fibrillation (AF) among adults during single-time point rhythm screening performed during meetings or social recreational activities organized by patient groups or volunteers. A total of 2814 subjects (median age 68 years) underwent AF screening by a handheld single-lead ECG device (MyDiagnostick). Overall, 56 subjects (2.0%) were diagnosed with AF, as a result of 12-lead ECG following a positive/suspected recording. Screening identified AF in 2.9% of the subjects ≥ 65 years. None of the 265 subjects aged below 50 years was found positive at AF screening. Risk stratification for unknown AF based on a CHA2DS2VASc > 0 in males and >1 in females (or CHA2DS2VA > 0) had a high sensitivity (98.2%) and a high negative predictive value (99.8%) for AF detection. A slightly lower sensitivity (96.4%) was achieved by using age ≥ 65 years as a risk stratifier. Conversely, raising the threshold at ≥75 years showed a low sensitivity. Within the subset of subjects aged ≥ 65 a CHA2DS2VASc > 1 in males and >2 in females, or a CHA2DS2VA > 1 had a high sensitivity (94.4%) and negative predictive value (99.3%), while age ≥ 75 was associated with a marked drop in sensitivity for AF detection.

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Section: Discussionmentioning

confidence: 99%

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

Boriani

Palmisano²,

Malavasi

et al. 2021

JCM

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“…Cardiac structural remodeling is characterized by atrial enlargement, a vital determinant of the persistence of AF-maintaining re-entry, and tissue fibrosis, characterized by the excessive accumulation of collagenous material in the extracellular space ( 12 , 20 , 26 ). Fibrotic atrial cardiomyopathy is a progressive disease with heterogeneous expressions, from mild to severe, and wide clinical variations, from asymptomatic to multiple arrhythmic manifestations ( 12 , 16 , 25 , 27 ).…”

Section: Pathophysiology Of Atrial Fibrillation In the Fibrotic Atria...mentioning

confidence: 99%

The Atrium in Atrial Fibrillation – A Clinical Review on How to Manage Atrial Fibrotic Substrates

Cunha

Laranjo

Heijman

et al. 2022

Front. Cardiovasc. Med.

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Atrial fibrillation (AF) is the most common sustained arrhythmia in the population and is associated with a significant clinical and economic burden. Rigorous assessment of the presence and degree of an atrial arrhythmic substrate is essential for determining treatment options, predicting long-term success after catheter ablation, and as a substrate critical in the pathophysiology of atrial thrombogenesis. Catheter ablation of AF has developed into an essential rhythm-control strategy. Nowadays is one of the most common cardiac ablation procedures performed worldwide, with its success inversely related to the extent of atrial structural disease. Although atrial substrate evaluation remains complex, several diagnostic resources allow for a more comprehensive assessment and quantification of the extent of left atrial structural remodeling and the presence of atrial fibrosis. In this review, we summarize the current knowledge on the pathophysiology, etiology, and electrophysiological aspects of atrial substrates promoting the development of AF. We also describe the risk factors for its development and how to diagnose its presence using imaging, electrocardiograms, and electroanatomic voltage mapping. Finally, we discuss recent data regarding fibrosis biomarkers that could help diagnose atrial fibrotic substrates.

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“…The pathophysiological mechanisms of AF are not well known [ 6 ]. Inflammation and substrate alterations (such as fibrosis) are complex and critical for the understanding of AF [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

The systemic-immune-inflammation index predicts the recurrence of atrial fibrillation after cryomaze concomitant with mitral valve surgery

Luo

Zhang

Liu

et al. 2022

BMC Cardiovasc Disord

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Background and aims Inflammation plays a key role in the initiation and progression of atrial fibrillation (AF). The systemic inflammation indexes are easily evaluated and predict AF development. However, it’s role in prediction of recurrence of AF is unknown. We aim to explore the association between the systemic inflammation indexes and recurrence of AF in patients underwent cryoablation (CryoMaze) concomitant with mitral valve surgery. Methods We examined systemic inflammation indexes during perioperative period in 122 patients between 2015 and 2018. Systemic inflammation indexes were developed by systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocytes to monocytes ratio. Univariate and multivariate analyses were performed to examine the association of each markers with recurrence of AF. Results Of the 122 patients included in this study, 22 patients (18%) experienced AF recurrence after CryoMaze concomitant with mitral valve surgery. There is no significant difference between each systemic inflammation indexes before surgery and recurrence of AF. In univariate analysis, MLR after surgery 3 days, PLR, MPLR, NLR, SII after surgery 7 days were able to predict recurrence of AF. In multivariate analyses, SII ≥ 1696 independently predicted recurrence (OR, 3.719; 95% CI, 1.417–9.760). Interestingly, baseline SII showed no significant in prediction of recurrence. It was sharply elevated after surgery and dropped slowly. In patients of recurrence, SII after 7 days of surgery increased again. Conclusions The raised SII again was associated with an increased risk of the postoperative recurrence of AF and independently predicted the late recurrence of AF after CryoMaze concomitant with mitral valve surgery.

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New Perspective in Atrial Fibrillation

Abstract: Despite a large number of publications on this subject, the pathophysiological mechanisms involved in atrial fibrillation (AF) onset and recurrence are uncertain [...]

Cited by 7 publications

References 25 publications

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

The Atrium in Atrial Fibrillation – A Clinical Review on How to Manage Atrial Fibrotic Substrates

The systemic-immune-inflammation index predicts the recurrence of atrial fibrillation after cryomaze concomitant with mitral valve surgery

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