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Association between the cumulative triglyceride-glucose index and the recurrence of atrial fibrillation after radiofrequency catheter ablation

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Journal of Geriatric Cardiology 2024年第2期21卷 200-210页

作者： Qing YAN Jia-Qi LIANG Yi-De YUAN Yuan LI Jia-Li FAN Wen-Huan WU Pan XU Jia-Hong XUE Department of Cardiovascular Medicine the Second Affiliated Hospital of Xi’an Jiaotong UniversityShaanxiChina Department of Cardiovascular Medicine Zichang People’s HospitalShaanxiChina Department of Ultrasound Xijing HospitalAir Force Military Medical UniversityShaanxiChina

BACKGROUND Triglyceride-glucose(TyG)index values are a new surrogate marker for insulin resistance.This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation(AF)recurrence after radiofrequency catheter ablation(RFCA).METHODS A total of 576 patients with AF who underwent RFCA at the Second Affiliated Hospital of Xi'an Jiaotong University were included in this study.The participants were grouped based on cumulative TyG index values tertiles within 3 months after ablation.Cox regression and restricted cubic spline analyses were used to determine the relationship between cumulative TyG index values and AF recurrence.The predictive value of all risk factors was assessed by receiver operating curve analysis.RESULTS There were 375 patients completed the study(age:63.23±10.73 years,64.27%male).The risk of AF recurrence increased with increasing cumulative TyG index values tertiles.After adjusting for potential confounders,patients in the medium cumulative TyG index group[hazard ratio(HR)=4.949,95%CI:1.778–13.778,P=0.002]and the high cumulative TyG index group(HR=8.716,95%CI:3.371–22.536,Patrial diameter,and lactate dehydrogenase levels as a comprehensive factor,the model could effectively predict AF recurrence after RFCA[area under the curve(AUC)=0.847,95%CI:0.797–0.897,P<0.001].CONCLUSIONS Cumulative TyG index values were a risk factor for AF recurrence after RFCA.Monitoring longitudinal TyG index values may assist with optimized for risk stratification and outcome prediction for AF recurrence.

关键词： atrial fibrillation index

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Unveiling sinus venosus atrial septal defect and partial anomalous pulmonary venous return in an elderly patient

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Journal of Geriatric Cardiology 2024年第4期21卷 462-464页

作者： Cristina M Font Anamarys Blanco Fernandez Dinesh Kadariya Department of Medicine Division of CardiologyUniversity of Florida College of MedicineJacksonvilleFloridaUSA

Sinus venosus defect(SVD) accounts for 4%–11% of all atrial septal defects(ASD) and may present with dyspnea, heart failure(HF), palpitations, or angina.^[1] The malformation typically involves an interatrial communication due to a deficiency in the common wall connecting the right pulmonary veins and the superior vena cava(SVC) and often accompanies anomalous pulmonary venous connection of some or all of the pulmonary veins.

关键词： atrial septal venous

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Thoracoscopic resection of giant left atrial appendage aneurysm: A case report

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第1期7卷 48-51页

作者： Jie Han Jiakan Weng Jiwen Li Department of Cardiac Surgery Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China

Left atrial appendage aneurysm(LAAA)was first reported in the 1960s.1 LAAA is a rare condition,with just over 100 congenital or acquired cases reported to date.2 LAAA is frequently diagnosed incidentally during echocardiography or computed tomography(CT)scans.Most patients with LAAA are asymptomatic,while a few exhibit nonspecific symptoms,such as dyspnea,palpitation,and chest tightness.Patients with LAAA frequently present with atrial arrhythmias and systemic thromboembolism,such as stroke or multiorgan infarctions,due to the formation of a left atrial appendage thrombus.3 The lesion may be cured using aneurysm resection.Considering it as the potential cause of atrial arrhythmias and thromboembolism,the lesion must be identified on time and cured using a suitable treatment approach.

关键词： atrial aneurysm frequent

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Prolonged asystole following adenosine. Was it necessary?

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Journal of Geriatric Cardiology 2024年第6期21卷 686-688页

作者： Yuval Avidan Amir Aker Vsevolod Tabachnikov Department of Cardiology Lady Davis Carmel Medical CenterHaifaIsrael

A77-year-old woman presented with interchangeable episodes of both fast and slow heart rate.Past history was notable for paroxysmal atrial fibrillation treated with eliquis and tambocor and atrial septal defect closure 35 years ago.Except for mild tachycardia,vitals and physical examination were unremarkable.The 12-lead electrocardiogram(Figure 1)showed narrow complex tachycardia at 106 beats/min without obvious P-waves.

关键词： tachycardia septal atrial

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Cryoballoon ablation of persistent atrial fibrillation for de novo pulmonary vein isolation:a single-center follow-up study

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Journal of Geriatric Cardiology 2022年第10期19卷 725-733页

作者： Zhong-Jing CAO Xiao-Gang GUO Qi SUN Yan-Qiao CHEN Hai-Yang XIE Jian-Du YANG Hui-Qiang WEI Jia-Hui LI Jian MA Department of Cardiology Sichuan Academy of Medical Sciences&Sichuan Provincial People’s HospitalSchool of Medicine UESTCChengduChina State Key Laboratory of Cardiovascular Disease Arrhythmia CenterFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Guangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical ScienceGuangzhouChina

BACKGROUND Pulmonary vein isolation(PVI)alone for persistent atrial fibrillation(PersAF)remains controversial.The characteristics of cryoballoon ablation(CBA)to treat PersAF and the blanking period recurrence are underreported.METHODS This study retrospectively analyzed patients with PersAF undergoing second-generation CBA for de novo PVI.The post-procedural efficacy and survival analysis were compared between patients with different PersAF durations.The multivariate Cox regression analysis was used to detect the risk factors for recurrence.Early and long-term recurrence were analyzed relative to each other.RESULTS A total of 329 patients were enrolled,with a median PersAF duration of 4.0 months(interquartile range:2.0–12.0 months);257 patients(78.1%)were male.Kaplan-Meier analysis of freedom from atrial fibrillation recurrence at 12,24,and 30 months showed 71.0%,58.5%,and 54.9%,respectively.Early PersAF had a relatively favorable survival rate and a narrow P-wave duration of restoring sinus rhythm compared with that of PersAF lasting more than three months(Patrial anteroposterior diameter≥42 mm were the risk factors for atrial fibrillation recurrence after CBA[hazard ratio(HR)=1.89,95%CI:1.01–1.4,P=0.042;HR=3.6,95%CI:2.4–5.4,Patrial size were risk factors for atrial fibrillation recurrence after CBA.Blanking period recurrence was associated with long-term recurrence.

关键词： balloon fibrillation atrial

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Iatrogenic atrial septal defects after transseptal puncture for percutaneous left atrial appendage occlusion and their hemodynamic effects

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Journal of Geriatric Cardiology 2022年第9期19卷 675-684页

作者： Ioannis Drosos Roberta De Rosa Philipp C.Seppelt Sebastian Cremer Silvia Mas-Peiro Katrin Hemmann Jana Oppermann Recha Blessing Mariuca Vasa-Nicotera Andreas M.Zeiher Zisis Dimitriadis Division of Cardiology Department of Medicine IIIUniversity Hospital FrankfurtGoethe University Frankfurt am MainFrankfurtGermany German Center for Cardiovascular Research(DZHK) BerlinGermany Cardiopulmonary Institute(CPI) FrankfurtGermany Center of Cardiology University Medical Center MainzMainzGermany Di-vision of Cardiology and Intensive Care Department of Internal MedicineSt.Ansgar HospitalHöxterGermany

Background Percutaneous left atrial appendage occlusion(LAAO)requires puncture of the interatrial septum.The immediate hemodynamic effects of iatrogenic atrial septal defects(iASD)after LAAO have not been examined so far.We aimed at evaluat-ing these effects through invasive measurements of pressure and oxygen saturation.Moreover,we assessed the incidence of per-sistent iASD at three months.METHODS Forty-eight patients scheduled for percutaneous LAAO were prospectively included in the study.Pressure and oxygen saturation were measured(1)in the right atrium(RA)before transseptal puncture,(2)in the left atrium(LA)through the transseptal sheath after transseptal puncture,(3)in the LA after removal of introducer sheath,and(4)in the RA after removal of introducer sheath.Transesophageal echocardiography was performed at three months to detect iASD.RESULTS Pressure in the RA increased significantly after removing the introducer sheath(P=0.034),whereas no difference was found in oxygen saturation in the RA(P=0.623).Pressure measurement in the LA showed no significant difference after re-moving the introducer sheath(P=0.718).Oxygen saturation in the LA also showed no significant difference(P=0.129).Follow-up transesophageal echocardiogram at 3 months revealed a persistent iASD in 4 patients(8.5%).CONCLUSIONS Our study suggests that iASD after percutaneous LAAO does not result in significant shunts directly after the procedure,although a significant increase of mean right atrial pressure can be observed.Persistent iASDs after percutaneous LAAO seem to be relatively rare at three months.

关键词： atrial septal puncture

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Circulating circRNA expression profile and its potential role in late recurrence of paroxysmal atrial fibrillation post catheter ablation

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Journal of Geriatric Cardiology 2023年第11期20卷 788-800页

作者： Shan-Shan LIU Hong-Yang GUO Jian ZHU Jin-Ling MA Sai-Zhe LIU Kun-Lun HE Su-Yan BIAN Department of Cardiology the Second Medical CenterNational Clinical Research Center of Geriatric DiseaseBeijing Key Laboratory of Chronic Heart Failure Precision MedicineChinese PLA General HospitalBeijingChina Department of Cardiology the Six Medical CenterChinese PLA General HospitalBeijingChina Medical Big Data Research Center Medical Innovation Research DepartmentBeijing Key Laboratory of Chronic Heart Failure Precision MedicineChinese PLA General HospitalBeijingChina

BACKGROUND Catheter-based pulmonary vein isolation(PVI) is an effective and well-established intervention for symptomatic paroxysmal atrial fibrillation(PAF). Nevertheless, late recurrences of atrial fibrillation(LRAF) occurring during 3 to 12months are common, and the underlying mechanisms remain elusive. Circular RNAs(circ RNAs) in atrial tissue have been linked to the pathophysiological mechanisms and progression of PAF in a few studies. However, their expression patterns in peripheral blood and regulatory function in LRAF are not clear.METHODS In the present study, the expression profile of circulating circ RNAs in three paired nonvalvular PAF patients with or without LRAF was investigated by high-throughput sequencing and validated by quantitative real-time polymerase chain reaction(q RT-PCR). Bioinformatics analyses, including Gene Ontology(GO), Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis, and circ RNA/mi RNA regulatory network, were performed to predict the functions and potential regulatory roles of differentially expressed(DE) circ RNAs.RESULTS A total of 12,834 circ RNAs, comprising 5,491 down-regulated and 7,343 up-regulated circ RNAs, were found to be DE in blood smaples from the two groups in peripheral blood between LRAF and non-recurrence control individuals. The most enriched GO categories in terms of molecular function, biological process, and cellular component features were catalytic activity,cellular metabolic process, and intracellular part, respectively. The KEGG enrichment study revealed that the most important metabolic process controlled by DE circ RNAs is endocytosis. In the circ RNA/micro RNAs interaction network, four up-regulated circ RNAs(hsa_circ_0002665, hsa_circ_0001953, hsa_circ_0003831, and hsa_circ_0040533) and one down-regulated circ RNA(hsa_circ_0041103) were predicted to play potential regulatory roles in the pathogenesis of LRAF.CONCLUSIONS This investigation discovered the expression pattern of circulating circ RNAs that is indicative of PAF late recurren

关键词： atrial fibrillation paroxysmal

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Rotor hypothesis in the time chain of atrial fibrillation

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Journal of Geriatric Cardiology 2022年第4期19卷 251-253页

作者： Chang-Hao XU Xu LIU Department of Cardiology Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiChina

atrial fibrillation(AF)is the most preval-ent arrhythmia in the aging population,with people over 75 years accounting for 70%of the AF population.[1]Over the past twe-nty years,despite tremendous progress has been made in catheter ablation for rhythm control of AF,we still cannot establish a reliable ablative target for non-paroxysmal AF.Part of the reason is an incomplete understanding of the mechanism underlying the pro-gressive nature of AF.In the time chain of AF,AF bur-den increases,and the success rate of catheter abla-tion decreases as AF progresses from paroxysmal AF(PAF)to persistent AF(PerAF)and long-stand-ing persistent AF(LS-PerAF)form.Recently,with the advance in mapping technologies combined with biophysical insight,a new concept of AF mainten-ance has been introduced--the rotor(spiral waves).Meanwhile,the concept of complete electrical left atr-ial(LA)isolation has been introduced for AF with ext-ensive atrial fibrosis.These innovative ideas en-riched our armamentarium to combat different AF subtypes.This article proposes a rotor hypothesis to illustrate the mechanism underlying AF progress and discuss the application of new strategies in dif-ferent AF subtypes.

关键词： fibrillation atrial hypothesis

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An incessant atrial tachycardia originating from epicardial left atrial appendage in a 12-year-old girl:ablation or excision?

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Chinese Medical Journal 2022年第9期135卷 1111-1113页

作者： Xiangfei Feng Qunshan Wang Jian Sun Pengpai Zhang YiYu Yigang Li Department of Cardiology Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200092China

To the Editor: Left atrial appendage (LAA) is one of the major sources of atrial arrhythmias in children.[1] But atrial tachycardia (AT) with an epicardial LAA origin is uncommon and usually arises from the base.[2] Catheter ablation (CA) may be an important strategy for patients with atrial arrhythmia,[3] especially due to the LAA firing trigger.[4] Due to a large number of trabeculations and true epicardial location, endocardial CA in LAA may fail or even cause fatal tamponade.[2,5] The epicardial CA may be an alternative approach.[6] Because the LAA has a very thin wall and may be prone to perforation, caution should be taken when LAA ablation is performed,[4] even during an epicardial ablation. There may be recurrence of AT, and surgical left atrial appendectomy (SAE) may be required.

关键词： atrial tachycardia ablation

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Catheter ablation of atrial fibrillation via retrograde aortic approach in a patient with interrupted inferior vena cava:a case report

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Journal of Geriatric Cardiology 2023年第12期20卷 877-879页

作者： Hao-Tien Liu Po-Cheng Chang Hui-Ling Lee Chung-Chuan Chou Division of Cardiology Department of Internal MedicineChang Gung Memorial HospitalTaoyuan BranchTaiwanChina Division of Cardiology Department of Internal MedicineChang Gung Memorial HospitalLinkou BranchTaiwanChina School of Medicine Chang Gung University College of MedicineTaoyuanTaiwanChina Department of Anesthesia Chang Gung Memorial HospitalTaipei BranchTaiwanChina

Radiofrequency catheter ablation(RFCA)is a cornerstone treatment of atrial fibrillation(AF).Transfemoral venous approach with transseptal puncture to assess left atrium(LA)is a mainstream method for AF ablation.Interrupted inferior vena cava(IVC)is a rare congenital vascular anomaly which complicates electrophysiologic procedures and makes conventional approach not feasible.

关键词： fibrillation atrial vena

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