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  • 1
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    Effect of family history of atrial fibrillation on recurrence after atrial fibrillation ablation: A report from the Chinese Atrial Fibrillation Registry Study
    Wiley ; 2021
    In:  Journal of Cardiovascular Electrophysiology Vol. 32, No. 3 ( 2021-03), p. 678-685
    Details
    In: Journal of Cardiovascular Electrophysiology, Wiley, Vol. 32, No. 3 ( 2021-03), p. 678-685
    Abstract: To evaluate the impact of family history of atrial fibrillation (FAF) on postablation atrial tachyarrhythmia (AT) recurrence. Methods All the 8198 patients undergoing initial AF ablation registered in the Chinese Atrial Fibrillation Registry study were analyzed. FAF was defined as having first‐degree relatives diagnosed as AF at age 65 years or younger, and before the time the case in this study was diagnosed. Cox proportional hazards models were used to evaluate the impact of FAF on postablation AT recurrence. Age, sex, body mass index, AF type, history of congestive heart failure, hypertension, diabetes mellitus, prior stroke/transient ischemic attack/systemic embolism, vascular diseases, use of contact force‐sensing catheter, and completion of high school were adjusted. The definition of AT recurrence was any documented AF, atrial flutter, or AT lasting more than or equal to 30 s after 3 months blanking period. Results After a mean follow‐up of 26.2 ± 19.6 months, 318 out of the 645 patients (49.3%) with FAF and 3339 out of the 7553 patients (44.2%) without FAF experienced AT recurrence, corresponding to annual recurrence rates of 22.8% and 20.2%, respectively. Patients with FAF had a significant higher risk of AT recurrence (adjusted hazard ratio 1.129, 95% confidence interval 1.005–1.267) in multivariable analysis. Moreover, FAF had a significant higher impact on AT recurrence in the subgroup of patients diagnosed with AF at age 50 years or younger ( p for interaction = .036). Conclusion FAF is a risk factor for postablation AT recurrence. This is especially true in those with AF diagnosed at 50 years or younger.
    Type of Medium: Online Resource
    ISSN: 1045-3873 , 1540-8167
    URL: Issue
    URL: Article
    DOI: 10.1111/jce.v32.3
    DOI: 10.1111/jce.14919
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2037519-0
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  • 2
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    Diastolic Blood Pressure and Intensive Blood Pressure Control on Cognitive Outcomes: Insights From the SPRINT MIND Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hypertension Vol. 80, No. 3 ( 2023-03), p. 580-589
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    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 3 ( 2023-03), p. 580-589
    Abstract: The potential benefits or harms of intensive systolic blood pressure (BP) control on cognitive function and cerebral blood flow in individuals with low diastolic blood pressure (DBP) remain unclear. Methods: We conducted a post hoc analysis of the SPRINT MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension) that randomly assigned hypertensive participants to an intensive ( 〈 120 mm Hg; n=4278) or standard ( 〈 140 mm Hg; n=4385) systolic blood pressure target. We evaluated the effects of BP intervention on cognitive outcomes and cerebral blood flow across baseline DBP quartiles. Results: Participants in the intensive group had a lower incidence rate of probable dementia or mild cognitive impairment than those in the standard group, regardless of DBP quartiles. The hazard ratio of intensive versus standard target for probable dementia or mild cognitive impairment was 0.91 (95% CI, 0.73–1.12) in the lowest DBP quartile and 0.70 (95% CI, 0.48–1.02) in the highest DBP quartile, respectively, with an interaction P value of 0.24. Similar results were found for probable dementia (interaction P =0.06) and mild cognitive impairment (interaction P =0.80). The effect of intensive treatment on cerebral blood flow was not modified by baseline DBP either (interaction P =0.25). Even among participants within the lowest DBP quartile, intensive versus standard BP treatment resulted in an increasing trend of annualized change in cerebral blood flow (+0.26 [95% CI, −0.72 to 1.24] mL/[100 g·min] ). Conclusions: Intensive BP control did not appear to have a detrimental effect on cognitive outcomes and cerebral perfusion in patients with low baseline DBP. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01206062
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.122.20112
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2094210-2
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  • 3
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    Effectiveness of ethanol infusion into the vein of Marshall combined with a fixed anatomical ablation strategy (the “upgraded 2C3L” approach) for catheter ablation of persistent atrial fibrillation
    Wiley ; 2021
    In:  Journal of Cardiovascular Electrophysiology Vol. 32, No. 7 ( 2021-07), p. 1849-1856
    Details
    In: Journal of Cardiovascular Electrophysiology, Wiley, Vol. 32, No. 7 ( 2021-07), p. 1849-1856
    Abstract: Linear ablation in addition to pulmonary vein antrum isolation (PVAI) has failed to improve the success rate for persistent atrial fibrillation (PeAF), due to incomplete block of ablation lines, especially in the mitral isthmus (MI). Methods and Results The study enrolled 191 patients (66 in group 1 and 125 in group 2). In group 1, ethanol infusion into the vein of Marshall was first performed, followed by radiofrequency (RF) applications targeting bilateral PVAI and bidirectional block in the roofline, cavotricuspid isthmus, and MI. In group 2, PVAI and the three linear ablations were completed using only RF energy. MI block was achieved in 63 (95.5%) and 101 (80.8%) patients in groups 1 and 2, respectively ( p  = .006). Patients in group 1 had shorter ablation time for left pulmonary vein antrum (8.15 vs. 12.59 min, p   〈  .001) and MI (7.0 vs. 11.8 min, p   〈  .001) and required less cardioversion (50 [78.5%] vs. 113 [90.4%] , p  = .007). During the 12‐month follow‐up, 58 (87.9%) patients were free from atrial fibrillation/atrial tachycardia in group 1 compared with 81 (64.8%) in group 2 ( p   〈  .001). In multivariate cox regression, the “upgraded 2C3L” procedure is associated with a lower recurrence rate (hazard ratio = 0.27, 95% confidence interval = 0.12–0.59). Conclusion Compared with the conventional “2C3L” approach, the “upgraded 2C3L” approach has higher effectiveness for ablation of PeAF.
    Type of Medium: Online Resource
    ISSN: 1045-3873 , 1540-8167
    URL: Issue
    URL: Article
    DOI: 10.1111/jce.v32.7
    DOI: 10.1111/jce.15108
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2037519-0
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  • 4
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    Mild Renal Dysfunction and Risk of Thromboembolism and Bleeding in Patients with Atrial Fibrillation: The Chinese Atrial Fibrillation Registry Study
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Cardiology Discovery Vol. 1, No. 1 ( 2021-03), p. 29-36
    Details
    In: Cardiology Discovery, Ovid Technologies (Wolters Kluwer Health), Vol. 1, No. 1 ( 2021-03), p. 29-36
    Abstract: Previous studies indicated that patients with atrial fibrillation (AF) and moderate-to-severe chronic kidney disease (CKD) are at a higher risk of thromboembolism and bleeding during anticoagulation. Whether mild CKD is associated with an increased risk of thromboembolism and bleeding in AF patients remains unknown. This study aimed to evaluate the impact of mild CKD on thromboembolism and major bleeding among patients with AF. Methods: Baseline serum creatinine was available in 17,559 of 25,512 patients enrolled in the China-AF study between August 2011 and December 2018. After excluding those who underwent AF ablation or with moderate-to-severe CKD, 7191 non-valvular AF patients (2059 with mild CKD and 5132 with normal renal function) with regular follow-up for at least 6 months were included. Primary outcomes were the time to the first occurrence of thromboembolic and major bleeding events. Results: Over a mean follow-up of (44.4 ± 23.4) months, 639 thromboembolism and 231 major bleeding events occurred. The crude incidence rates of thromboembolism were higher in the mild CKD group than that of the normal renal function group (3.0/100 person-years vs . 2.2/100 person-years, P   〈  0.0001), while the crude incidence rates of major bleeding were comparable between the two groups (1.0/100 person-years vs . 0.8/100 person-years, P  = 0.076). After multivariate analyses, mild CKD was not associated with an increased risk of thromboembolism (HR = 1.05, 95% CI: 0.89–1.25, P  = 0.547) or major bleeding (HR = 1.11, 95% CI: 0.84–1.47, P  = 0.476). Conclusions: Mild CKD was not an independent risk factor of thromboembolism or major bleeding in patients with AF.
    Type of Medium: Online Resource
    ISSN: 2693-8499
    URL: Article
    DOI: 10.1097/CD9.0000000000000013
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 3133801-X
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  • 5
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    Effect of SGLT2 inhibitors on cardiovascular events in patients with atrial fibrillation: A systematic review and meta‐analysis of randomized controlled trials
    Wiley ; 2023
    In:  Pacing and Clinical Electrophysiology
    Details
    In: Pacing and Clinical Electrophysiology, Wiley
    Abstract: Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) is reported to reduce incident atrial fibrillation (AF) in patients with or without diabetes; however, its cardiovascular (CV) benefit for AF patients remains unclear.SS Aims To investigate the effect of SGLT2i on the incidence of CV events in patients with AF. Methods Six randomized controlled trials (RCTs) assessing the effects of SGLT2i on CV outcomes in patients with or without AF were included (PROSPERO: CRD 42023431535). The primary endpoint was the composite outcome of heart failure (HF) hospitalization and CV death. Additionally, we assessed the effects of treatment in prespecified subgroups on HF hospitalization, CV death, and all‐cause mortality. Results Among 38,529 participants from all trials, 5018 patients with AF were treated with SGLT2i. The follow‐up period of these trials ranged from 2.3 to 3.3 years. SGLT2i treatment was significantly associated with the risk reduction of primary endpoint in patients with AF (risk ratio [RR] 0.81, 95% confidence interval [CI] 0.74–0.88; p   〈  0.001), consistent with the finding in the general population ( p for interaction  = 0.76). SGLT2i was also associated with a consistent reduction in the risk of HF hospitalization in patients with AF (RR 0.76, 95% CI 0.69–0.84; p   〈  0.001) or not (RR 0.72, 95% CI 0.64–0.80; p   〈  0.0001), with no statistical difference between them ( p for interaction  = 0.41). Meta‐regression further revealed no significant association between the prevalence of HF with reduced ejection fraction or diabetes and the effect size of SGLT2i. Conclusions The treatment effects of SGLT2i were associated with a lower incidence of CV events, especially HF hospitalization, in patients with AF.
    Type of Medium: Online Resource
    ISSN: 0147-8389 , 1540-8159
    URL: Article
    DOI: 10.1111/pace.14880
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2037547-5
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  • 6
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    Effects of intensive blood pressure control on cardiovascular and cognitive outcomes in patients with atrial fibrillation: insights from the SPRINT trial
    Oxford University Press (OUP) ; 2022
    In:  EP Europace Vol. 24, No. 10 ( 2022-10-13), p. 1560-1568
    Details
    In: EP Europace, Oxford University Press (OUP), Vol. 24, No. 10 ( 2022-10-13), p. 1560-1568
    Abstract: Patients with atrial fibrillation (AF) have an increased risk of cardiovascular events and dementia, even if anticoagulated. Hypertension is highly prevalent in AF population; however, the optimal blood pressure (BP) target for AF patients remains unknown. Methods and results We conducted subgroup analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) to examine whether AF modified the treatment effects of intensive BP control on cardiovascular and cognitive outcomes using Cox proportional hazards regression and likelihood ratio tests. Among 9361 randomized participants, 778 (8.3%) had baseline AF, and 695 (89.3%) completed at least one follow-up cognitive assessment. Intensive BP control reduced the similar relative risk of cardiovascular events irrespective of the presence of AF, with all interaction P-values  & gt; 0.05. Patients with AF experienced a greater absolute risk reduction in the composite primary cardiovascular outcome (12.3 vs. 5.6 events per 1000 person-years) with intensive treatment, compared with those without AF. However, intensive BP control increased the risk of probable dementia in patients with AF [hazard ratio (HR), 2.22; 95% confidence interval (CI), 1.03–4.80], while reducing the dementia risk in patients without AF (HR, 0.75; 95% CI, 0.60–0.95; P = 0.009 for interaction). There were no significant interactions between the presence of AF and intensive BP treatment for mild cognitive impairment. Conclusion Patients with AF experienced greater absolute cardiovascular benefits with intensive BP treatment, but may need to be cautious of an increased risk of dementia. This post hoc analysis should be considered as hypothesis generating and merit further study. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT01206062.
    Type of Medium: Online Resource
    ISSN: 1099-5129 , 1532-2092
    URL: Article
    DOI: 10.1093/europace/euac059
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2002579-8
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  • 7
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    Effectiveness and safety of atrial fibrillation ablation in females
    Wiley ; 2020
    In:  Pacing and Clinical Electrophysiology Vol. 43, No. 6 ( 2020-06), p. 583-592
    Details
    In: Pacing and Clinical Electrophysiology, Wiley, Vol. 43, No. 6 ( 2020-06), p. 583-592
    Abstract: Existing data on the effectiveness and safety of atrial fibrillation (AF) ablation in females are limited to studies of small sample size, lacking longer term follow‐up or adjustment for potential confounders. Methods A total of 6421 patients (2072 females) undergoing a first AF ablation procedure after enrollment in the Chinese Atrial Fibrillation Registry (China‐AF) study between August 2011 and December 2017 were analyzed. We evaluated the effectiveness (recurrence of documented [symptomatic or not] atrial tachyarrhythmia (AT)) and the safety (incidence of procedure‐related complications) of AF ablation in female patients compared to male patients. Sensitivity analyses based on routine data were also utilized to avoid potential sex differences in reporting of AF symptoms. Results Females were about 5 years older than males at the time of ablation (mean age 63.4 ± 9.5 vs 58.3 ± 10.8, P   〈  .0001). A higher proportion of female patients had paroxysmal AF (74.3% vs 56.7%, P   〈  .0001), hypertension (69.7% vs 61.3%, P  〈  .0001), and hyperlipidemia (57.2% vs 52.9%, P  = .001). Female sex was found to be an independent risk factor of AT recurrence in multivariate analyses (HR = 1.26, 95% CI 1.15‐1.38, P   〈  .0001). These findings were confirmed in sensitivity analyses using only Holter data. Female sex was also associated with a higher risk of periprocedural complications after adjustment for baseline variables (OR = 1.41, 95% CI 1.03‐1.94, P  = .03). Conclusions Female sex is an independent risk factor of AT recurrence and periprocedural complications after AF ablation.
    Type of Medium: Online Resource
    ISSN: 0147-8389 , 1540-8159
    URL: Issue
    URL: Article
    DOI: 10.1111/pace.v43.6
    DOI: 10.1111/pace.13921
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2037547-5
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  • 8
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    Epicardial connections and bi‐atrial tachycardias: From anatomy to clinical practice
    Wiley ; 2023
    In:  Pacing and Clinical Electrophysiology Vol. 46, No. 8 ( 2023-08), p. 895-903
    Details
    In: Pacing and Clinical Electrophysiology, Wiley, Vol. 46, No. 8 ( 2023-08), p. 895-903
    Abstract: Bi‐atrial tachycardia (BiAT) is not rare after extensive atrial ablation or cardiac surgery. The complexity of bi‐atrial reentrant circuits poses a great challenge for clinical practice. With recent advances in mapping technologies, we are now able to characterize atrial activation in detail. However, given the involvement of both atria and multiple epicardial conductions, endocardial mapping for BiATs is not easy to understand. Knowledge of the atrial myocardial architecture is the foundation for the clinical management of BiATs; as it is required to understand the possible mechanism of the tachycardia and identify the optimal target of ablation. In this review we summarize current knowledge about the anatomy of interatrial connections as well as other epicardial fibers and discuss the interpretation of electrophysiological findings and ablation strategies for BiATs.
    Type of Medium: Online Resource
    ISSN: 0147-8389 , 1540-8159
    URL: Issue
    URL: Article
    DOI: 10.1111/pace.v46.8
    DOI: 10.1111/pace.14778
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2037547-5
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  • 9
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    Research on Normal Contact Stiffness of Rough Joint Surfaces Machined by Turning and Grinding
    MDPI AG ; 2022
    In:  Metals Vol. 12, No. 4 ( 2022-04-14), p. 669-
    Details
    In: Metals, MDPI AG, Vol. 12, No. 4 ( 2022-04-14), p. 669-
    Abstract: In order to accurately obtain the contact stiffness of rough joint surfaces machined by turning and grinding, a research simulation is carried out by using the finite element method. Based on the surface modeling method under the combined machining mode, the three-dimensional (3D) solid model is constructed. Then, the finite element results of the normal contact stiffness were obtained through contact analysis. The comparative analysis was carried out with the analytical results of the KE model and the experimental results. The comparison results show that three results have the same trend of change. However, the maximum relative error of the finite element results is 6.03%, while that of the analytical results for the KE model is 60.07%. After that, the finite element results under different machining parameters are compared. The normal contact stiffness increases with the increase in the turning tool arc radius, grinding depth, and fractal dimension, but decreases with the increase in the turning feed rate and scale coefficient. The rationality of the results is explained by the distribution of the asperities and the contact deformation law of the asperities on the rough surface.
    Type of Medium: Online Resource
    ISSN: 2075-4701
    URL: Article
    DOI: 10.3390/met12040669
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662252-X
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  • 10
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    Data_Sheet_1.docx
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-9-6)
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    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-9-6)
    Abstract: Multimorbidity, polypharmacy and inappropriate prescribing is common in elderly patients worldwide. We aimed to explore the current status of multimorbidity, polypharmacy and the appropriateness of pharmacological therapy among elderly patients with atrial fibrillation (AF) in China. Materials and methods We randomly selected 500 patients aged 65 years or older from the China AF Registry study. Multimorbidity was defined as ≥2 comorbidities and polypharmacy was defined as ≥5 long-term prescribed drugs. Appropriateness of prescribing was evaluated using the Screening Tool of Older People’s Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) criteria version 2. Patients’ attitudes toward polypharmacy were evaluated by the Patients’ Attitudes Towards Deprescribing (PATD) questionnaire. Results Among the 500 patients included (mean age 75.2 ± 6.7 years, 49.0% male), 98.0% had multimorbidity and 49.4% had polypharmacy. The prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) was 43.6% ( n = 218) and 71.6% ( n = 358), respectively. Traditional Chinese medicine attributed largely to PIMs. Anticoagulants were the most common PPOs. Many clinical factors increased the risk of PIMs and PPOs. However, polypharmacy increased the risk of PIMs (OR 2.70, 95%CI 1.78–4.11; p & lt; 0.0001), but not PPOs. In addition, 73.7% patients with polypharmacy were willing to have one or more of their medications prescribed if advised by their doctor. Conclusion Multimorbidity and polypharmacy were highly prevalent in elderly patients with AF in China. A high prevalence of inappropriate prescribing was also observed. Therefore, much more attention should be paid to the serious health problem in the elderly population.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2022.988799
    DOI: 10.3389/fcvm.2022.988799.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2781496-8
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