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Objective: Although imaging modalities, such as transesophageal and intracardiac echocardiography, have helped to improve the safety of atrial transseptal puncture (TSP), fluoroscopy is still traditionally and widely used in TSP. The aim of the present study was to evaluate an individual knack for TSP during cryoballoon ablation of atrial fibrillation (AF) under fluoroscopy. Methods: Through the prospective study of 72 cases of patients with paroxysmal or persistent AF admitted for cryoablation in our center, 46 cases using a puncture site toward the bifurcation of the left main bronchus (LMB group) and 26 cases using an anterior-inferior puncture site (AI group) were included in the study. The acute pulmonary vein (PV) isolation success rate, single-procedure success rate, and time-to-effect (TTE) between the two groups were analyzed. Results: All PVs were identified and successfully isolated, and there are no differences in the two groups. However, the mean TTE was shorter in the LMB group than in the AI group. Moreover, a higher single-procedure success rate was observed in the LMB group. Conclusion: The bifurcation of the LMB can be clearly evaluated in each patient under fluoroscopy and is an anatomical landmark for the location of the left PV. TSP guided by the LMB is a new practical method for choosing individualized transseptal sites for catheter ablation of AF, which can help to shorten TTE and procedure time. [ABSTRACT FROM AUTHOR]

Objective: To investigate the expression profile of circular RNAs (circRNAs) and proposed circRNA--microRNA (miRNA) regulatory network in atrial fibrillation (AF). Methods: Atrial tissues from patients with persistent AF with rheumatic heart disease and non-AF myocardium with normal hearts were collected for circRNA differential expression analyses by high-throughput sequencing. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to predict the potential functions of the differentially expressed genes and AF-related pathways. Co-expression networks of circRNA--miRNA were constructed based on the correlation analyses between the differentially expressed RNAs. Quantitative reverse transcription polymerase chain reaction (PCR) was performed to validate the results. Results: A total of 108 circRNAs were found to be differentially expressed in AF. Among them, 51 were up-regulated, and 57 were down-regulated. Dysregulated circRNAs were validated by quantitative real-time PCR. The GO and KEGG pathway enrichment analyses were executed to determine the principal functions of the significantly deregulated genes. Furthermore, we constructed correlated expression networks between circRNAs and miRNAs. circRNA19591, circRNA19596, and circRNA16175 interacted with 36, 28, and 18 miRNAs, respectively; miR-29b-1-5p and miR-29b-2-5p were related to 12 down-regulated circRNAs, respectively. Conclusion: Our findings provide a novel perspective on circRNAs involved in AF due to rheumatic heart disease and establish the foundation for future research of the potential roles of circRNAs in AF. [ABSTRACT FROM AUTHOR]