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The article discusses the research study conducted that examines the causes of Arrhythmias accompanied with acute coronary syndromes (ACSs) and how to manage and treat challenging cases of arrhythmias in patients. Topics discussed include how to determine patients at risk for arrhythmias, direct current cardioversion (DCC) and catheter ablation, and atrial fibrillation.

Up to 20% of patients with chronic kidney disease have atrial fibrillation, and 40%-50% of atrial fibrillation patients suffer from chronic kidney disease. The 2 diseases share several risk factors and frequently coincide with each other. Both entities are associated with a prothrombotic state, which contributes to increased thromboembolic risk. Atrial fibrillation patients with chronic kidney disease have elevated risk of stroke, major bleeding, and mortality. Clinical risk scores, including CHA2DS2-VASc score, HAS-BLED score, or ORBIT score have a limited value in adverse clinical outcome risk stratification in patients with severe chronic kidney disease. However, the inclusion of renal function in the R(2)-CHA2DS2-VASc score does not improve significantly thromboembolic risk prediction in atrial fibrillation. There is growing evidence suggesting that biomarkers, including N-terminal pro-B-type natriuretic peptide, high-sensitivity cardiac troponin, cystatin C, or growth differentiation factor-15, might be helpful in the assessment of thromboembolic, bleeding, and/or mortality risk in atrial fibrillation patients with chronic kidney disease. The first-choice anticoagulant therapy is based on direct oral anticoagulants in this subgroup. The highest risk of adverse events is observed in end-stage renal disease, and in Europe, in contrast to the USA, solely warfarin is recommended in such atrial fibrillation patients. Treatment of atrial fibrillation patients with chronic kidney disease should be closely monitored with the selection of right anticoagulant agents at the appropriate dose. The current review paper summarizes available evidence and the challenges of the management of atrial fibrillation patients with chronic kidney disease with practical implications. [ABSTRACT FROM AUTHOR]

The co-existence of atrial fibrillation (AF) and acute heart failure (AHF) is frequently reported and can exacerbate either or both of them. Their combination leads to increased morbidity and mortality. Although there has been a lack of studies on the prevalence and significance, as well as the treatment, of AF in patients with AHF, a position statement from the Acute Cardiovascular Care Association and European Heart Rhythm Association has recently reviewed the latest evidence on AF in the setting of AHF. The purpose of this paper is to briefly overview the crucial aspects of this consensus document. [ABSTRACT FROM AUTHOR]

Although various cardiac monitoring methods were developed to detect subclinical arrhythmias, guidelines do not address in detail the management of subclinical atrial fibrillation and tachyarrhythmias. The European Heart Rhythm Association recently published a consensus document that addresses the clinical importance, implications, and management of device-detected subclinical atrial tachyarrhythmias. This paper comprehensively reviews the diagnostic tools to detect subclinical atrial arrhythmias and discusses the pathophysiologic link between devicedetected subclinical atrial fibrillation and stroke. In this invited review, in the light of this paper and current scientific data, we aimed to summarize how to manage subclinical atrial arrhythmias. [ABSTRACT FROM AUTHOR]

In this paper, we reviewed the atrial fibrillation screening strategies in a stepwise manner and discussed the uncertainties in the assessment of the need for anticoagulation in light of the recently published European Heart Rhythm Association consensus document. We reviewed not only the methods and tools but also the role of health care professionals and patient organizations in addition to cost-effectiveness issues. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation is a common arrhythmia. Cryoablation is a treatment for atrial fibrillation, which has achieved remarkable results. But there are still many problems worthy of improvement and discussion. We aim to evaluate the scientific outputs of global cryoablation of atrial fibrillation research, providing new ideas and directions for further research. Methods: The data were retrieved from the Web of Science Core Collection on July 28, 2022. Bibliometrics tools—CiteSpace V, Microsoft Excel 2019, and the Online Analysis Platform of Literature Metrology—were used for bibliometric analysis of the published outputs. Results: A total of 1676 research articles were obtained from the Web of Science Core Collection published between 2002 and 2022, and the number of annual publications has gradually increased, with a slight decline in 2006-2008, 2011-2012, and 2021, reaching a peak in 2020. The institution with the highest number of research publications in this field was Asklepios Klin St. Georg, followed by Vrije Univ Brussel. The most productive researchers were Carlo De Asmundis, Gianbattista Chierchia, Pedro Brugada, Karlheinz Kuck, and Andreas Metzner. The most prolific journal has been the US publication Journal of Cardiovascular Electrophysiology, and Europace from England ranked second. The article “Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation” ranked first among all cited articles. Burst detection analysis of top keywords suggested that follow-up, task force, trial, phrenic nerve injury, and radiofrequency ablation were research hotspots. Conclusion: This study provides a comprehensive overview of cryoablation in atrial fibrillation research using bibliometric and visual methods, which will help researchers better understand the development status and trends in this field. [ABSTRACT FROM AUTHOR]

Background: Over the past few years, smartwatches have become increasingly popular in the monitoring of arrhythmias. Although the detection of atrial fibrillation with smartwatches has been the subject of various articles, there is no comprehensive research on the detection of arrhythmias other than atrial fibrillation. In this study, we included individual cases from the literature to identify the characteristics of patients with smartwatch-detected arrhythmias other than atrial fibrillation. Methods: PubMed, Embase, and SCOPUS were searched for case reports, case series, or cohort studies that reported individual participant-level data, until January 6, 2022. The following search string was used for each databases: ("Smart Watch" OR "Apple Watch" OR "Samsung Gear") AND ("Supraventricular Tachycardia" OR "Cardiac Arrhythmia" OR "Ventricular Tachycardia" OR "Atrioventricular Nodal Reentry Tachycardia" OR "Atrioventricular Reentrant Tachycardia" OR "Heart Block" OR "Atrial Flutter" OR "Ectopic Atrial Tachycardia" OR "Bradyarrhythmia"). Results: A total of 52 studies from PubMed, 20 studies from Embase, and 200 studies from SCOPUS were identified. After screening, 18 articles were included. A total of 22 patients were obtained from 14 case reports or case series. Four cohort studies evaluating various arrhythmias were included. Arrhythmias, including ventricular tachycardia, atrial fibrillation, atrial flutter, atrioventricular nodal reentry tachycardia, atrioventricular reentrant tachycardia, second- or third-degree atrioventricular block, and sinus bradycardia, were detected with smartwatches. Conclusions: Cardiac arrhythmias other than atrial fibrillation are also commonly detected with smartwatches. Smartwatches have an important potential besides traditional methods in the detection of arrhythmias and clinical practice. [ABSTRACT FROM AUTHOR]

Background: The optimal treatments for atrial fibrillation in heart failure patients are controversial. The present study compared the efficacy of catheter ablation and medical therapy in patients with atrial fibrillation and heart failure. Methods: Pubmed, Embase, Cochrane Library, and Web of Science were searched until January 15, 2022. Randomized controlled trials comparing catheter ablation for atrial fibrillation with medical therapy in patients with atrial fibrillation and heart failure were enrolled. Primary outcome was all-cause mortality. Secondary outcomes included the heart failure hospitalization and the change in left ventricular ejection fraction, 6-minute walk test distance, peak oxygen consumption, and Minnesota Living with Heart Failure questionnaire score. Results: Totally 8 randomized controlled trials involving 1693 patients were included. Compared with medical therapy, catheter ablation significantly reduced all-cause mortality (risk ratios = 0.60, 95% Cl: 0.45 to 0.80, P < .001) and hospitalization due to heart failure (risk ratios = 0.58, 95% Cl: 0.46 to 0.73, P < .001), improved left ventricular ejection fraction (mean difference = 5.25%, 95% CI: 2.78% to 7.71%, P < .001), improved the performance of 6-minute walk test (mean difference = 28.83 m, 95% CI: 8.61 to 49.05 m, P = .005), increased peak oxygen consumption (mean difference = 3.11 mL/kg/min, 95% CI: 1.04 to 5.18 mL/kg/min, P = .003), and reduced Minnesota Living with Heart Failure score (mean difference = -8.45, 95% CI: -16.28 to -0.62, P = .03). Conclusion: In heart failure patients with atrial fibrillation, catheter ablation provides more benefits over medical therapy in the important clinical outcomes, exercise capacity, and quality of life. [ABSTRACT FROM AUTHOR]

Considering the aging population, the increase in predisposing factors, and the improvement in healthcare with increased survival rates, atrial fibrillation has been the most common cardiac arrhythmia in adults with a rise in the estimated lifetime risk over recent years. While aging is a powerful risk factor for atrial fibrillation, the leading prevalent comorbidities are hypertension, heart failure, obesity, obstructive sleep apnea, diabetes mellitus, and chronic kidney disease. Atrial fibrillation is associated with substantial morbidity, impaired quality of life, and increased mortality and healthcare costs. As a significant proportion of the total atrial fibrillation population is asymptomatic or mildly symptomatic, early identification and initiation of appropriate treatment for atrial fibrillation may prevent potentially detrimental outcomes such as stroke and heart failure and decrease all-cause mortality. Although screening via evolving health technologies has recently been emerging, verification of the electrocardiogram track recording over at least 30 seconds by a physician with expertise is still required for a definite diagnosis. Based on the global and national data and the current healthcare environment in Turkey, this targeted review with cardiology, neurology, and family physicians' perspectives highlights the importance of early detection by implementing the advancing screening modalities as well as the need for raised awareness of both patients and healthcare professionals and establishment of a multidisciplinary clinical approach for a better outcome in atrial fibrillation management. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to examine the prognostic impact of decreased kidney function at admission on the occurrence of new-onset atrial fibrillation (AF) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods: The study enrolled 3,115 consecutive patients with STEMI. Kidney function was assessed by estimation of the glomerular filtration rate (eGFR) at admission. Patients with cardiogenic shock at admission, patients on hemodialysis, and patients with a medical history of previous AF (paroxysmal, persistent, or permanent) were excluded. The follow-up period was six years. Results: New-onset AF occurred in 215 (6.9%) patients, 75 (34.9%) patients presented with AF, and 140 (65.1%) patients developed AF after pPCI. The median time of AF occurrence in patients who did not present with AF was 4.5 (interquartile range 1-25) hours after pPCI. New-onset AF was associated with a higher short- and long-term mortality. In the multiple logistic regression analysis, all stages of reduced kidney function were independent predictors for the occurrence of new-onset AF, and negative prognostic impact increased with the deterioration of kidney function: eGFR <90 mL/min/m2, hazard ratio (HR) 1.96, 95% confidence interval (CI) 1.42-2.89, p=0.011; eGFR 60-89 mL/min/m2, HR 1.54, 95% CI 1.13-2.57, p=0.045; eGFR 45-59 mL/min/m2-, HR 2.09, 95% CI 1.24-2.85, p=0.023; eGFR 30-44 mL/min/m2-, HR 2.93, 95% CI 1.64-5.29, p<0.001; eGFR 15-29 mL/min/m2-, HR 5.51, 95% CI 2.67-11.39, p<0.001. Conclusion: Decreased kidney function was significantly associated with the occurrence of new-onset AF, and its impact increased with the deterioration in kidney function, starting with an eGFR value of 90 mL/min/m2. New-onset AF was an independent predictor of long-term allcause mortality in the analyzed patients. [ABSTRACT FROM AUTHOR]

Objective: The incidence of atrial fibrillation (AF) in patients with ST segment elevation myocardial infarction (STEMI) varies between 7% and 21%, and most of these studies were in the thrombolytic era. However, the frequency of new-onset AF during the primary percutaneous coronary intervention (PCI) period is still unclear. We aimed to investigate the frequency of new-onset AF and its effects on long-term clinical events in patients undergoing primary PCI. Methods: A total of 1,603 patients who were diagnosed with STEMI and underwent primary PCI were included in the study. All the patients were monitored for at least 48 hours after the procedure. The primary endpoint of the study was defined as new-onset AF during hospitalization. Results: The median follow-up period of our study was 44 months. New-onset AF developed in 85 (6.1%) patients. CHADs-VASc > 2, KILLIP > 2, and left atrial diameter were found to be independent predictors for the development of new-onset AF. In the AF (+) group, the all-cause and in-hospital mortality rates were found to be significantly higher. New-onset AF development in patients with STEMI was detected as an independent predictor of in-hospital mortality. Conclusion: In the era of primary percutaneous transluminal coronary angioplasty, new-onset AF rates were found to be lower than the literature data. In addition, new-onset AF was found to be a predictor of in-hospital mortality, and deaths occurred mostly in the early period. Therefore, close follow-up of these patients in the early period and re-evaluation in terms of AF burden when the patient becomes stable are important. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the acute effect of cryoballoon ablation (CB-A) on electrocardiographic parameters that have been suggested to reflect heterogeneity in atrial conduction and ventricular repolarization. Methods: A total of 67 patients (52.6±13.2 years, 43 men) without any exclusion criteria who had undergone CB-A for atrial fibrillation (AF) between January 01, 2015, and December 31, 2018, constituted our study population. Electrographic recordings obtained before and after the ablation procedure on the same day were retrospectively evaluated for the P-wave dispersion, QTc dispersion, Tp-Te interval, and Tp-Te/QT ratio. The pre- and post-ablation values were tested for significant differences. The association of the possible CB-A-related changes in these parameters with AF recurrence during follow-up was evaluated. Results: P dispersion (30.1±6.8 vs. 35.9±9.4 ms, p<0.001), QT dispersion (20.7±7.5 vs. 24.0±8.8 ms, p<0.001), Tp-Te duration (on V5 83.6±8.1 vs. 110.2±9.5 ms, p<0.001), and Tp-Te/QT ratio (on V5 0.22±0.03 vs. 0.28±0.02, p<0.001) were observed to increase significantly after CB-A. There was no association between the magnitudes of change in any parameter and AF recurrence. Conclusion: CB-A had significant effects on electrocardiographic parameters related to atrial conduction and ventricular repolarization in the acute phase after CB-A. Further prospective studies are required to examine the time-related course of these alterations and their impact on clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: Atrial fibrillation (AF) is the most common arrhythmia, which is also associated with mitral valve disease. Surgical ablation is still known to be an important procedure in restoring sinus rhythm (SR) concomitant with mitral valve surgery (MVS). In this study, we aimed to present our early- and mid-term result of AF cryoablation during robotic MVS. Methods: Between November 2014 and January 2020, total 34 patients who underwent robotic MVS with concomitant AF ablation were retrospectively analyzed. Ten patients had a <1 year AF history, 14 had 1-5 years, and 10 had >5 years. The primary end point of the study was postoperative AF recurrence. Results: Total 32 and 2 patients underwent mitral valve replacement and mitral valve repair, respectively. Mean aortic cross-clamp and cardiopulmonary bypass times were 141.8±32.1 min and 196±25.6 min, respectively. The SR was restored with the removal of cross-clamp and cardiac junctional rhythm was observed in 29 (85.3%) and 5 (14.7%) patients, respectively. Two in-hospital deaths secondary to low cardiac output and hepatorenal failure were recorded. Among the rest, 24 (75%) patients were in SR, 6 (18.75%) in AF, and 2 (6.25%) in paced rhythm at discharge. Conclusion: Robotic cryoablation of AF during MVS is a feasible method with favorable early- and mid-term results. [ABSTRACT FROM AUTHOR]

To the best of our knowledge, non-vitamin K antagonist oral anticoagulants (NOACs), or direct oral anticoagulants, have not been tested in randomized trials conducted in patients with atrial fibrillation (AF), affected by malignant disease. However, their use in patients with cancer is increasing, while real-life evidence for their effectiveness and safety in this vulnerable subset of patients is growing. The challenges of the use of NOACs in cancer patients with AF and current expert opinion on this subject have been summarized in this review article. [ABSTRACT FROM AUTHOR]

Objective: The corner stone of atrial fibrillation therapy includes the prevention of stroke with less adverse effects. The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) study provided data to compare treatment strategies in Turkey with other populations and every-day practice of stroke prevention management with complications. Methods: GARFIELD-AF is a large-scale registry that enrolled 52,014 patients in five sequential cohorts at >1.000 centers in 35 countries. This study was initiated to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF. A total of 756 patients from 17 enrolling sites in Turkey were in cohort 4 and 5. Treatment strategies at diagnosis initiated by CHA2DS2-VASc score, baseline characteristics of patients, treatment according to stroke and bleeding risk profiles, and INR values were analyzed in cohorts. Additionally, event rates during the first year follow up were evaluated. Results: AF patients in Turkey were mostly seen in young women. Stroke risk according to the CHADS2 score and CHA2DS2-VASc score compared with world data. The mean of risk score values, including HAS-BLED score were lower in Turkey than in the world data. The percentage of patients receiving FXa inhibitor with or without an antiplatelet usage was more than the other drug groups. All-cause mortality was higher in Turkey. Different form world data when HAS-BLED score was above 3, the therapy was mostly changed to antiplatelet drugs in Turkey. Conclusion: In addition to deficiencies in available treatment options, patient care and clinical outcomes of patients with AF, the data of GARFIELD- AF provide data from Turkey about therapeutic strategies and best practices. [ABSTRACT FROM AUTHOR]

Contact force (CF) monitoring can be useful in accomplishing circumferential pulmonary vein (PV) isolation for atrial fibrillation (AF). This metaanalysis aimed to assess the efficacy and safety of a CF-sensing catheter in treating AF. Randomized controlled trials or non-randomized observational studies comparing AF ablation using CF-sensing or standard non-CF (NCF)-sensing catheters were identified from PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (January 1, 1998-2016). A total of 19 studies were included. The primary efficacy endpoint was AF recurrence within 12 months, which significantly improved using CF-sensing catheters compared with using NCF-sensing catheters [31.1% vs. 40.5%; risk ratio (RR)=0.82; 95% confidence interval (CI), 0.73-0.93; p<0.05]. Further, the acute PV reconnection (10.1% vs. 24.2%; RR=0.45; 95% CI, 0.32-0.63; p<0.05) and incidence of major complications (1.8% vs. 3.1%; OR=0.59; 95% CI, 0.37-0.95; p<0.05) significantly improved using CF-sensing catheters compared with using NCF-sensing catheters. Procedure parameters such as procedure duration [mean difference (MD)=-28.35; 95% CI, -39.54 to -17.16; p<0.05], ablation time (MD=-3.8; 95% CI, -6.6 to -1.0; p<0.05), fluoroscopy duration (MD=-8.18; 95% CI, -14.11 to -2.24; p<0.05), and radiation dose (standard MD=-0.75; 95% CI, -1.32 to -0.18; p<0.05] significantly reduced using CF-sensing catheters. CF-sensing catheter ablation of AF can reduce the incidence of major complications and generate better outcomes compared with NCF-sensing catheters during the 12-month follow-up period. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, including ischemic stroke. Prolonged atrial electromechanical interval (EMI) is related to increased atrial fibrillation (AF) risk. The aim of the study is to evaluate atrial EMI and electrocar-diographic P-wave indices related to increased AF risk in patients with PCOS. Methods: Forty PCOS patients diagnosed on the basis of the Rotterdam criteria and 20 age-matched controls were prospectively included. patients with atrioventricular or intraventricular conduction abnormalities, dysrhythmia or taking antiarrhythmic drugs, atherosclerotic heart disease, cardiomyopathies, valvular lesions, pericardial disease, a history of pulmonary emboli or pulmonary hypertension, and abnormal thyroid function were excluded. Intra and interatrial EMI were measured by tissue Doppler imaging and P-wave dispersion (Pd) was calculated on 12-lead electrocardiography (ECG). The Isovolumetric relaxation time was the interval between the aortic valve closure artifact at the end of the LV outflow envelope and the mitral valve opening artifact at the beginning of the mitral E wave. Results: Patients with PCOS had significantly higher interatrial [38 (24-65) ms vs. 16 (9-19) ms p<0.001], left-sided intra-atrial (14.8±6.1 vs. 7±1.7 ms, p<0.001), and right-sided intra-atrial (22.3±8.1 vs. 8.6±3.6 ms, p<0.001) EMI compared with the control group. Pd was significantly greater in the PCOS group compared with control group [45 (27-60) ms vs. 30 (26-38) ms, p<0.001]. Echocardiographic parameters of atrial EMI were significantly correlated with body mass index, Pd, and isovolumetric relaxation time in patients with PCOS. Conclusion: PCOS is associated with prolonged inter- and intra-atrial conduction times, which are related to increased AF risk. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 68-year-old woman who was presented for preoperative evaluation in the outpatient clinic before total knee replacement. Topics mention including the electrocardiogram which shows atrial fibrillatiion with ST segment elevation, preoperative recommendations and coronary angiography.

Objective: In this study we assess the value of left atrial dyssynchrony time measured by tissue Doppler imaging (TDI) to predict recurrences after pulmonary vein isolation (PVI) in patients with paroxysmal and persistent atrial fibrillation (AF). Methods: One hundred sixty patients (57±7.5 years, 122 males) with symptomatic drug-refractory paroxysmal and persistent AF, undergoing PVI were enrolled in our study. PA peak time by tissue Doppler imaging (PApeak-TDI) is defined as the time measured from the start of P wave in lead II to the peak of A wave on the tissue Doppler tracing. Left atrial dyssynchrony was measured by subtracting the PApeak-TDI time measured at the mid-inter atrial septum from the PA peak-TDI time measured at the left atrial midlateral free wall, (LA dyssynchrony=PApeak TDI lateral-PApeak TDI septal). Results: During a mean follow-up of 12±3 months, recurrences occurred in 50 out of 160 patients. Patients with recurrence of atrial fibrillation had larger left atrial dyssynchrony time (26.5±2.4 ms vs. 23.5±2.3 ms, p<0.001). Left atrial dyssynchrony time of 25 ms has the best combined sensitivity and specificity (74% and 63% respectively) along with positive predictive value 53% and negative predictive value 85.5%. LA dyssynchrony time ≥25 ms was found to discriminate patients prone to AF recurrences over time. Multivariate regression analysis showed that left atrial dyssynchrony time (HR per ms: 1.69, p<0.001) was identified as independent predictor of AF recurrence. Conclusion: Left atrial dyssynchrony time is good clinical predictor of recurrence of AF after PVI in patients with paroxysmal and persistent AF. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was determine whether aortic knob width (AKW) is associated with the development of atrial fibrillation (AF) after isolated coronary artery bypass surgery (CABG). Methods: In this retrospective observational cohort study, we evaluated 135 patients without hemodynamically significant valvular problems. AKW was measured on chest X-ray by digital system. Multiple logistic regression analysis was used to find independent associates of postoperative AF (POAF). The diagnostic value of AKW was assessed using ROC analysis. Results: POAF occurred in 43 (31.8%) of all patients. The age, AKW, left atrial (LA) diameter and C-reactive protein (CRP) were significantly higher in patients with POAF than without POAF (67.2±8.6 vs 61.3±9.8 years, p=0.004; 45.6±5.8 vs 36.1±3.8 mm, p<0.001; 37.9±3.5 vs 35.8±3.1mm, p=0.002 and 10.6±8.5 vs 5.6±6.5 mg/L, p=0.001 respectively). Multiple logistic regression analysis demonstrated that AKW, LA diameter and CRP were independently associated with POAF (OR=4.527, 95% CI=1.315 -15.588, p=0.017; OR=2.834, 95% CI=1.091-7.360, p=0.032 and OR=1.300, 95% CI=1.038-1.628, p=0.022 respectively). ROC analysis has demonstrated that aortic knob of 36.5 mm constitutes the cut-off value for the occurrence of POAF with 84.4% sensitivity and 64.6% specificity (AUC=0.84, 95% CI=0.75-0.94, p<0.001). Conclusion: We have demonstrated a significant association between the AKW and AF development after isolated CABG. PA chest radiography is a cheap and readily available clinical tool and it can be examined easily by every cardiovascular surgeons. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: More than two decades of research work have shown that magnetocardiographic mapping (MCG) is reliable for non-invasive three-dimensional electroanatomical imaging (3D-EAI) of arrhythmogenic substrates. Magnetocardiographic mapping is now become appealing to interventional electrophysiologists after recent evidence that MCG-based dynamic imaging of atrial arrhythmias could be useful to classify patients with atrial fibrillation (AF) before ablation and to plan the most appropriate therapeutic approach. This article will review some key-points of 3D-EAI and discuss what is still missing to favor clinical applicability of MCG-based 3D-EAI. Methods: Magnetocardiographic mapping is performed with a 36-channel unshielded mapping system, based on DC-SQUID sensors coupled to second-order axial gradiometers (pick-up coil 19 mm and 55-70 mm baselines; sensitivity of 20 fT/√Hz in above 1 Hz), as part of the electrophysiologic investigation protocol, tailored to the diagnostic need of each arrhythmic patient. More than 500 arrhythmic patients have been investigated so far. Results: The MCG-based 3D-EAI has proven useful to localize well-confined arrhythmogenic substrates, such as focal ventricular tachycardia or preexcitation, to understand some causes for ablation failure, to study atrial electrophysiology including spectral analysis and localization of dominant frequency components of AF. However, MCG is still missing software tools for automatic and/or interactive 3D imaging, and multimodal data fusion equivalent to those provided with systems for invasive 3D electroanatomical mapping. Conclusion: Since there is an increasing trend to favor interventional treatment of arrhythmias, clinical application of MCG 3D-EAI is foreseen to improve preoperative selection of patients, to plan the appropriate interventional approach and to reduce ablation failure. [ABSTRACT FROM AUTHOR]

Objective: Atrial fibrillation (AF) is the most frequent cause of hospitalization for arrhythmias. The aim of our study was to evaluate the prevalence of thyroid dysfunction in patients with paroxysmal AF without any cardiomyopathy. Methods: Two hundred sixty eight patients (164 women and 104 men, mean age 64.9±16.9 years) affected by paroxysmal AF entered the present study. Patients underwent routine laboratory examinations with estimation of thyroid hormones levels, standard electrocardiogram (ECG) and transthoracic echocardiography. Results: Thyroid stimulating hormone (TSH) levels were low (<0.3 mU/L) in 168 patients (62.7%) and high (>5 mU/L) in 39 patients (14.9%); 76 patients (28.4%) had high free triiodothyronine (FT3) levels (>4.3 pg/ml) and 91 patients (34.3%) had high free thyroxine (FT4) levels (>1.7 ng/dl); 60 patients (22.4%) had low FT3 levels (<2 pg/ml) and 24 patients (9%) had low FT4 levels (<0.9 ng/dl). Overall, 76.2% of patients with hyperthyroidism were women. Hyperthyroidism was considered subclinical in 68 (40.5%) patients with low TSH concentrations. Conclusions: Thyroid dysfunctions have a high prevalence in AF patients and hyperthyroidism is the most common disorder. Hyperthyroidism in AF patients more often occurs in women than in men. Any minimal but persistent modification of circulating thyroid hormone levels can favor episodes of AF; it can be useful to thoroughly assess thyroid function in all patients suffering from AF. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 32-year-old female with a history of malaise, fatigue, atypical chest pain and palpitation. It informs that electrocardiography (ECG) showed atrial fibrillation with T-wave inversion in lateral precordial leads. It informs that the patient was treated with sodium 2, 3-dimercaptopropane-1-sulfonate (DMPS), a chelation therapy, and was prescribed with anticoagulation.

In this article, the author discusses the measurement of left atrial (LA) dyssynchrony time by tissue Doppler imaging for the prediction of atrial fibrillation (AF) recurrences after pulmonary vein isolation. Topics discussed include hypertension, echocardiographic parameters, cardioversion and catheter ablation, LA electromechanical delay, and radiofrequency ablation.