Artificial Intelligence in Atrial Fibrillation: From Early Detection to Precision Therapy

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(8), P. 2627 - 2627

Published: April 11, 2025

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, associated with significant morbidity, mortality, and healthcare burden. Despite advances in AF management, challenges persist early detection, risk stratification, treatment optimization, necessitating innovative solutions. Artificial intelligence (AI) has emerged as a transformative tool care, leveraging machine learning deep algorithms to enhance diagnostic accuracy, improve prediction, guide therapeutic interventions. AI-powered electrocardiographic screening demonstrated ability detect asymptomatic AF, while wearable photoplethysmography-based technologies have expanded real-time rhythm monitoring beyond clinical settings. AI-driven predictive models integrate electronic health records multimodal physiological data refine stroke anticoagulation decision making. In realm of treatment, AI revolutionizing individualized therapy optimizing management catheter ablation strategies. Notably, AI-enhanced electroanatomic mapping procedural guidance hold promise for improving success rates reducing recurrence. these advancements, integration remains an evolving field. Future research should focus on large-scale validation, model interpretability, regulatory frameworks ensure widespread adoption. This review explores current emerging applications highlighting its potential precision medicine patient outcomes.

Language: Английский

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Gut microbiota and atrial cardiomyopathy

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 4, 2025

Atrial cardiomyopathy is a multifaceted heart disease characterized by structural and functional abnormalities of the atria closely associated with atrial fibrillation its complications. Its etiology involves number factors, including genetic, infectious, immunologic, metabolic factors. Recent research has highlighted critical role gut microbiota in pathogenesis cardiomyopathy, this consistent gut–heart axis having major implications for cardiac health. The aim work to bridge knowledge gap regarding interactions between particular focus on elucidating mechanisms which dysbiosis may induce remodeling dysfunction. This article provides an overview changes composition effects metabolites. We also discuss how diet exercise affect influencing microbiota, as well possible future therapeutic approaches targeting axis. A healthy can prevent disease, but ecological lead variety symptoms, induction disease. pathophysiological aspects impact structure function, strategies exploring modulation treatment cardiomyopathy. Finally, we fecal transplantation oral probiotics or prebiotics. Our study highlights importance homeostasis cardiovascular health suggests that targeted interventions pave way innovative preventive

Language: Английский

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Extensive Atrial Fibrosis and Recalcitrant Atrial Fibrillation: A Case Report and Brief Literature Review

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 17, 2025

Atrial fibrillation is one of the most common supraventricular arrhythmias. It has multiple etiologies, some which include advanced age, hypertension, valvular heart disease, hyperthyroidism, sleep apnea, ischemic cardiomyopathy, and certain medications. Herein, we will discuss a case extensive atrial fibrosis in 57-year-old male with recalcitrant fibrillation, significant role plays recurrence brief pathophysiologic interplay between both pathologies based on current literature research, various imaging modalities treatment options utilized these cases. Likewise, also outline challenges faced or worth keeping mind when using pertaining to above subject matter.

Language: Английский

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Evaluating inflammatory status to predict atrial fibrillation recurrence following ablation: The role of systemic immune-inflammation index

World Journal of Cardiology, Journal Year: 2025, Volume and Issue: 17(3)

Published: March 21, 2025

Atrial fibrillation (AF) is the most common arrhythmia in humans, affecting more than 40 million people worldwide. Radiofrequency catheter ablation (RFCA) was first introduced as a treatment for AF by Haïssaguerre M late 1990s. This procedure quickly became of choice, especially symptomatic patients with refractory to medication. However, up 45% may experience recurrence within 12 months after RFCA. In this setting, likely multifactorial, including atrial remodeling, local fibrosis or incomplete due failure locating trigger. Additionally, obesity, sleep apnea, hypertension, diabetes are at an increased risk Inflammation increasingly recognized potential key factor and arise both from healing response heart tissue post-ablation chronic low-grade inflammation, observed many factors. Here, we present original study Wang et al , which investigated combination systemic immune-inflammation index—a marker developed assess overall inflammatory status—and APPLE score, designed predict following The found that using indicators together improved accuracy prediction. These findings underscore significant role inflammation cardiovascular disease demonstrated its impact on Further research warranted validate combined use these two scores clinical settings predicting ablation.

Language: Английский

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Beyond Pulmonary Vein Reconnection: Exploring the Dynamic Pathophysiology of Atrial Fibrillation Recurrence After Catheter Ablation

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(9), P. 2919 - 2919

Published: April 23, 2025

Atrial fibrillation (Afib) recurrence after catheter ablation (CA) remains a significant clinical challenge, driven by complex and dynamic interplay of structural, electrical, autonomic mechanisms. While pulmonary vein isolation (PVI) is the cornerstone CA, rates remain substantial, highlighting need to understand evolving pathophysiology beyond PV reconnection. Post-ablation changes, including inflammation, edema, oxidative stress, ischemia, create transient proarrhythmic state that may contribute early recurrence. Over time, atrial remodeling, fibrosis, residual activity further sustain arrhythmogenicity. Additionally, epicardial adipose tissue promotes myopathy, accelerating disease progression, particularly in patients with risk factors such as older age, female sex, obesity, hypertension, obstructive sleep apnea, heart failure. The multifactorial nature Afib underscores limitations “one-size-fits-all” strategy. Instead, patient-specific approach integrating advanced mapping techniques, multimodal imaging, computational modeling essential. Artificial intelligence (AI) digital twin models hold promise for predicting simulating individualized progression optimizing strategies. However, challenges regarding standardization validation these novel approaches. A deeper understanding interconnections between mechanisms driving crucial improving long-term CA outcomes. This review explores recurrence, emphasizing precision medicine accounts continuous interaction pathophysiological processes order refine patient selection, strategies, post-procedural management.

Language: Английский

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Thermal and Non-Thermal Energies for Atrial Fibrillation Ablation

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(6), P. 2071 - 2071

Published: March 18, 2025

The cornerstone of ablative therapy for atrial fibrillation (AF) is pulmonary vein isolation (PVI). Whether PVI should be added with additional lesions in persistent (PerAF) or any post-ablative recurrent AF a matter debate. Whatever the strategy, it must determine choice energy source to achieve most durable lesion sets least likelihood complications. Radiofrequency (RF) studied thermal ablation technique. It can combined high-density electroanatomic mapping and used both extrapulmonary ablation. Cryoenergy at as effective radiofrequency PVI; rapid, relatively safe, has steep learning curve. Therefore, been proposed first-line approach PVI-only procedures. More recently, non-thermal technique based on application pulsed direct current (Pulsed Field Ablation—PFA) introduced. PFA causes cell death by opening membrane pores (electroporation) without significant increase tissue temperature. fast does not alter extracellular matrix techniques do, although ends up causing long-lasting, transmural lesions. Most importantly, selective cardiac myocytes therefore potentially safer than techniques. Some systems systems. However, now, appears that these technologies considered complementary rather alternative number practical theoretical reasons.

Language: Английский

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Clonal Hematopoiesis of Indeterminate Potential and Atrial Fibrillation: Insights into Pathophysiology and Clinical Implications

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(6), P. 2739 - 2739

Published: March 18, 2025

Clonal hematopoiesis of indeterminate potential (CHIP) has emerged as a novel risk factor for cardiovascular diseases. CHIP is characterized by the expansion hematopoietic stem cell clones harboring somatic mutations in genes such TET2, DNMT3A, and ASXL1, which are implicated inflammation, atrial remodeling, hypercoagulability. These foster pro-inflammatory pro-thrombotic environment conducive to arrhythmogenesis, thereby linking development progression fibrillation (AF). Mechanistic insights indicate that contributes fibrosis, disrupts calcium signaling, exacerbates oxidative stress, all heighten susceptibility AF. Clinical studies, including epidemiological Mendelian randomization analyses, further support association between an increased both incident progressive AF, with specific TET2 ASXL1 identified significant contributors. Additionally, been linked adverse outcomes elevated rates heart failure, thromboembolism, mortality. Understanding CHIP’s role AF pathophysiology offers opportunities precision medicine approaches, providing avenues early intervention targeted treatment. This review synthesizes current mechanistic clinical evidence on emphasizes its biomarker stratification, explores emerging therapeutic strategies targeting CHIP-associated pathways.

Language: Английский

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Comparison of Cryoballoon and Ablation Index-Guided Radiofrequency Ablation in Paroxysmal Atrial Fibrillation

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(6), P. 2119 - 2119

Published: March 20, 2025

Background: Atrial fibrillation is the most common sustained arrhythmia worldwide. Pulmonary vein isolation (PVI) effective catheter ablation technique for treating paroxysmal atrial (pAF). Common methods include point-by-point radiofrequency (RF) and single-shot techniques such as cryoballoon (CB). This single-center, prospective study aimed to compare efficacy of index-guided RF (AI-RF) CB in patients with symptomatic, antiarrhythmic-resistant pAF. Methods: A total 154 undergoing initial PVI were divided into two groups (CB: 51, AI-RF: 103), based on operators’ decision. Procedural data (total procedure time, fluoroscopy radiation dose, complication rate) recurrence rates analyzed over a 12-month follow-up period. Results: The group had significantly shorter time compared AI-RF (64 [57; 74.8] minutes vs. 92 [76; 119] minutes; p < 0.001). However, experienced higher times (559 [395; 868] seconds 167 [126; 224] seconds; 0.001) greater dose (21.8 [11.7; 40.1] mGy 7.65 [5.21; 14.5] mGy; Recurrence similar during both blanking period (11.7% 10.7%; = 0.84) (22.7% 13.4%; 0.22). No major complications reported this study. Conclusions: In single-center study, there no significant differences long-term or between antiarrhythmic-refractory, symptomatic While benefited from it required longer time.

Language: Английский

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Correlation of electrocardiographic and echocardiographic parameters in assessing left atrial dysfunction

Journal of Electrocardiology, Journal Year: 2025, Volume and Issue: 91, P. 154017 - 154017

Published: May 6, 2025

Language: Английский

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