Ion Channel Remodelling in Atrial Fibrillation

2011 ◽  
Vol 7 (2) ◽  
pp. 97 ◽  
Author(s):  
Niels Voigt ◽  
Dobromir Dobrev ◽  
◽  
Keyword(s):  
Atrial Fibrillation ◽  
Ion Channel ◽  
Antiarrhythmic Drugs ◽  
Current Knowledge ◽  
Bleeding Complications ◽  
Large Size ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
Life Threatening ◽  
Underlying Mechanisms

Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.

scholarly journals Atrial Cardiomyopathy and Atrial Fibrillation in Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mengdi Ren ◽  
Yu Yao ◽  
Xin Yue ◽  
Yuye Ning ◽  
Yan Yang
Keyword(s):  
Atrial Fibrillation ◽  
Current Literature ◽  
Atrial Remodeling ◽  
Number Of Patients ◽  
Anticancer Treatment ◽  
Underlying Mechanisms

The number of patients with oncologic and cardiologic comorbidities is increasing. A growing number of evidence shows an inextricable link between cancer, atrial fibrillation, and atrial cardiomyopathy. Cancer itself and resultant inflammation, anticancer treatment, and other comorbidities lead to atrial remodeling and fibrosis, which increases the tendency to develop atrial cardiomyopathy and atrial fibrillation. The scarcity of current literature and ambiguous results make its relationship difficult to fully understand. In this review, we will summarize existing evidence of the relationships and interactions among cancer, atrial cardiomyopathy, and atrial fibrillation and discuss the underlying mechanisms, and provide better information for the management of these patients.

scholarly journals Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation

2019 ◽  
Vol 12 (12) ◽  
Author(s):  
Jakub Gumprecht ◽  
Mariola Szulik ◽  
Magdalena Domek ◽  
Michał Mazurek ◽  
Alena Shantsila ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Current Knowledge ◽  
Tissue Doppler ◽  
Atrial Size ◽  
Number Of Patients ◽  
Echocardiographic Parameters ◽  
Doppler Techniques ◽  
Diagnosis Accuracy ◽  
Atrial Strain ◽  
Left Atrial Dysfunction

Abstract Purpose of Review Atrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management of AF patients. Recent Findings Novel echocardiographic biomarkers and their clinical application related to the management of AF have been taken into consideration. Both standard parameters such as atrial size and volume but also novels like atrial strain and tissue Doppler techniques have been analyzed. Summary A number of novel echocardiographic parameters have been proven to enable early detection of left atrial dysfunction along with increased diagnosis accuracy. This concerns particularly experienced echocardiographers. Hence, these techniques might improve the prediction of stroke and thromboembolic events among AF patients and need to be further developed and disseminated. Nonetheless, even the standard imaging parameters could be of significant value and should not be discontinued in everyday clinical practice.

A Comprehensive Review of Risk Factor, Mechanism, and Management of Left Ventricular Assist Device–Associated Stroke

2021 ◽  
Author(s):  
Sung-Min Cho ◽  
Pouya Tahsili-Fahadan ◽  
Ahmet Kilic ◽  
Chun Woo Choi ◽  
Randall C. Starling ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Number Of Patients ◽  
Left Ventricular Assist ◽  
Underlying Mechanisms

AbstractThe use of left ventricular assist devices (LVADs) has been increasing in the last decade, along with the number of patients with advanced heart failure refractory to medical therapy. Ischemic stroke and intracranial hemorrhage remain the leading causes of morbidity and mortality in LVAD patients. Despite the common occurrence and the significant outcome impact, underlying mechanisms and management strategies of stroke in LVAD patients are controversial. In this article, we review our current knowledge on pathophysiology and risk factors of LVAD-associated stroke, outline the diagnostic approach, and discuss treatment strategies.

scholarly journals Perioperative coronary artery spasms in patients undergoing catheter ablation of atrial fibrillation

2021 ◽  
Author(s):  
Masato Hachisuka ◽  
Yuhi Fujimoto ◽  
Eiichiro Oka ◽  
Hiroshi Hayashi ◽  
Teppei Yamamoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Catheter Ablation ◽  
Case Reports ◽  
Rare Complication ◽  
Smoking Habit ◽  
Ablation Procedure ◽  
Af Ablation ◽  
Number Of Patients ◽  
Life Threatening

Abstract Purpose Catheter ablation (CA) is an established treatment for atrial fibrillation (AF). Although coronary artery spasms (CAS) during or after ablation procedures have been described as a rare complication in some case reports, the incidence and characteristics of this complication have not been fully elucidated. The present observational study aimed to clarify the CAS in a large number of patients experiencing AF ablation. Methods A total of 2913 consecutive patients (male: 78%, mean 66 ± 10 years) who underwent catheter ablation of AF were enrolled. Results Nine patients (0.31%, mean 66 ± 10 years, 7 males) had transient ST-T elevation (STE). Eight out of the 9 patients had STE in the inferior leads. STE occurred after the transseptal puncture in 7 patients, after the sheath was pulled out of the left atrium in 1, and 2 h after the ablation procedure in 1. Six patients had definite angiographic CAS without any sign of an air embolization on the emergent coronary angiography. In the3 other patients, the STE improved either directly after an infusion of nitroglycerin or spontaneously before the CAG. The patients with CAS had a higher frequency of a smoking habit (89% vs. 53%; P = .04), smaller left atrial diameter (36 ± 6 vs. 40 ± 7; P = .07), and lower CHADS2 score (0.6 ± 0.5 vs. 1.3 ± 1.1; P = .004) than those without. Conclusions Although the incidence was rare (0.31%), CAS should be kept in mind as a potentially life-threatening complication throughout an AF ablation procedure especially performed under conscious sedation.

scholarly journals Voltage-Dependent Sarcolemmal Ion Channel Abnormalities in the Dystrophin-Deficient Heart

2018 ◽  
Vol 19 (11) ◽  
pp. 3296 ◽  
Author(s):  
Xaver Koenig ◽  
Janine Ebner ◽  
Karlheinz Hilber
Keyword(s):  
Ion Channel ◽  
Current Knowledge ◽  
Intracellular Protein ◽  
Gene Encoding ◽  
Skeletal Muscle Weakness ◽  
Ion Channel Properties ◽  
Voltage Dependent ◽  
Dystrophin Deficiency ◽  
Underlying Mechanisms ◽  
Channel Properties

Mutations in the gene encoding for the intracellular protein dystrophin cause severe forms of muscular dystrophy. These so-called dystrophinopathies are characterized by skeletal muscle weakness and degeneration. Dystrophin deficiency also gives rise to considerable complications in the heart, including cardiomyopathy development and arrhythmias. The current understanding of the pathomechanisms in the dystrophic heart is limited, but there is growing evidence that dysfunctional voltage-dependent ion channels in dystrophin-deficient cardiomyocytes play a significant role. Herein, we summarize the current knowledge about abnormalities in voltage-dependent sarcolemmal ion channel properties in the dystrophic heart, and discuss the potentially underlying mechanisms, as well as their pathophysiological relevance.

scholarly journals Atrial Arrhythmias in Obstructive Sleep Apnea: Underlying Mechanisms and Implications in the Clinical Setting

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
David Filgueiras-Rama ◽  
Miguel A. Arias ◽  
Ángel Iniesta ◽  
Eduardo Armada ◽  
José L. Merino ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Current Knowledge ◽  
Upper Airway ◽  
Atrial Arrhythmias ◽  
Therapeutic Implications ◽  
Obstructive Sleep ◽  
Cardiovascular Morbidity And Mortality ◽  
Young Subjects ◽  
Underlying Mechanisms

Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive interruption of ventilation during sleep caused by recurrent upper airway collapse, which leads to intermittent hypoxia. The disorder is commonly undiagnosed despite its relationship with substantial cardiovascular morbidity and mortality. Moreover, the effects of the disorder appear to be particularly dangerous in young subjects. In the last decade, substantial clinical evidence has identified OSA as independent risk factor for both bradyarrhythmias and tachyarrhythmias. To date the mechanisms leading to such arrhythmias have not been completely understood. However, recent data from animal models and new molecular analyses have increased our knowledge of the field, which might lead to future improvement in current therapeutic strategies mainly based on continuous positive airway pressure. This paper aims at providing readers a brief and specific revision of current knowledge about the mechanisms underlying atrial arrhythmias in OSA and their clinical and therapeutic implications.

Pathophysiology of atrial fibrillation and chronic kidney disease

2020 ◽  
Author(s):  
Wern Yew Ding ◽  
Dhiraj Gupta ◽  
Christopher F Wong ◽  
Gregory Y H Lip
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Oral Anticoagulation ◽  
Stroke Prevention ◽  
Bleeding Complications ◽  
Stroke Management ◽  
Underlying Mechanisms ◽  
Shared Risk

Abstract Atrial fibrillation (AF) and chronic kidney disease (CKD) are closely related conditions with shared risk factors. The growing prevalence of both AF and CKD indicates that more patients will suffer from concurrent conditions. There are various complex interlinking mechanisms with important implications for the management of these patients. Furthermore, there is uncertainty regarding the use of oral anticoagulation (OAC) in AF and CKD that is reflected by a lack of consensus between international guidelines. Therefore, the importance of understanding the implications of co-existing AF and CKD should not be underestimated. In this review, we discuss the pathophysiology and association between AF and CKD, including the underlying mechanisms, risk of thrombo-embolic and bleeding complications, influence on stroke management, and evidence surrounding the use of OAC for stroke prevention.

P3772Risk factors for future development of atrial fibrillation are not evident among apparently healthy individuals with paroxysmal atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Koshiyama ◽  
K Tamaki ◽  
M Ohsawa
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Future Development ◽  
Repeated Measurements ◽  
Prevalence Rates ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
Electrocardiogram Ecg ◽  
Near Future ◽  
Apparently Healthy

Abstract Background Atrial fibrillation (AF) is one of the important factors of cardiovascular morbidity and mortality and to find not only patients with persistent AF but also individuals with paroxysmal AF among apparently healthy people is a crucial strategy for decreasing number of patients with serious cardio-embolic stroke. However, screening ability using previously known risk factors for future development of AF has not been examined in individuals with paroxysmal AF. Methods A total of 59730 male individuals, aged 40 years or older who underwent multiple comprehensive physical check-ups including 12 lead electrocardiogram (ECG) from 2012 to 2015 were enrolled. Persistent AF was defined a case that consecutively manifested AF till the last checkup. Paroxysmal AF was defined as a case who transiently manifested AF in each of the checkup and subsequently manifested sinus rhythm at the last checkup. Non-AF was defined as a case that never manifested AF in any of checkup. Age-adjusted prevalence rates and their 95% confidence intervals of known-risk factors in the first survey were estimated by logistic regression analysis separately by the three groups (non-AF (n=58602), paroxysmal AF (n=392) and persistent AF (736)). Results Age-adjusted prevalence rates (95% confidence interval) of risks factors for AF are shown in the table. Already known risk factors were evidently manifested in persistent AF group, however, prevalence rates of these factors in paroxysmal AF group were not different from the rates in non-AF group. Conclusion The repeated measurements of ECG study indicated that individuals who would develop paroxysmal AF in the near future did not have typical risk factors for AF and a screening test using risk factors for AF have no chance to find a high-risk individual for paroxysmal AF.

scholarly journals Antiarrhythmic therapy in the treatment of atrial fibrillation: yesterday, today, tomorrow

2019 ◽  
Vol 18 (3) ◽  
pp. 81-87 ◽  
Author(s):  
V. I. Podzolkov ◽  
A. I. Tarzimanova
Keyword(s):  
Atrial Fibrillation ◽  
Antiarrhythmic Drug ◽  
Antiarrhythmic Drugs ◽  
Effective Interaction ◽  
Heart Rhythm ◽  
Interventional Treatment ◽  
Surgical Ablation ◽  
Number Of Patients ◽  
Control And Prevention ◽  
High Level

Atrial fibrillation (AF) is the most common heart rhythm disorder encountered in clinical practice. Each year, the number of patients with AF significantly increases. It is associated with an increase of life expectancy and frequency of cardiovascular pathologies. Treatment of AF remains one of the most difficult tasks of modern cardiology. Currently, only a few antiarrhythmic drugs are available for use in Russia. More and more new attempts are being made to create a universal antiarrhythmic drug with a high level of anti-relapsing efficacy and adverse effects. The accumulated information suggests that the tactics of management of patients with arrhythmias will be intended to improving the new surgical and interventional treatment methods with use of anticoagulants and antiarrhythmic drugs. The multidisciplinary team of specialists on AF treatment should include an expert (cardiologist) in antiarrhythmic drug therapy, an interventional electrophysiologist, and a cardiac surgeon — master the technology of interventional or surgical ablation. Effective interaction of specialists of various levels will improve the results of rhythm control and prevention of complications in patients with AF.

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