Publications by authors named "Jacopo Francesco Imberti"
Aims: Prolonged right ventricular pacing (RVP) increases the risk of cardiomyopathy, atrial fibrillation, heart failure (HF), and mortality. This registry-based trial compared left bundle branch area pacing (LBBAP) with RVP in patients younger than 65 years.
Methods And Results: Using the ConTempoRary Cardiac Stimulation in Clinical practicE: lEft, BivEntriculAr, Right, and conDuction System Pacing (TREEBEARD) registry (NCT06324682), patients were randomized 1:1 to LBBAP or RVP.
Introduction And Objectives: Increased physical activity may improve outcomes in patients with atrial fibrillation (AF), but available data are limited. This study aimed to analyze the association between physical activity and major adverse outcomes in a large European AF cohort.
Methods: We used data from a prospective, observational, large-scale multicenter study of AF in European patients, involving 27 countries and 250 centers.
Atrial fibrillation and female sex: use of oral anticoagulants in a large European cohort and residual risk of thromboembolism and stroke.
Eur Heart J Qual Care Clin Outcomes
August 2025
Background: The role of female sex in stroke risk and oral anticoagulant (OAC) use in atrial fibrillation (AF) remains controversial. This study evaluates sex-specific differences in OAC prescription, residual risk of stroke/TIA and thromboembolism (STE), and the predictive performance of CHA₂DS₂-VASc vs. CHA₂DS₂-VA scores.
View Article and Find Full Text PDFAtrial fibrillation (AF) is the most prevalent cardiac arrhythmia, and it is associated with substantial morbidity, mortality, and economic burden. Effective management of AF remains a critical focus in contemporary medicine, given its complex and multifaceted nature. In the present paper, we provide the essential updates for everyday clinical practice from the 2024 European Society of Cardiology (ESC) guidelines for AF management.
View Article and Find Full Text PDFBackground: Electrophysiology (EP) procedures, including cardiac implantable electronic devices (CIEDs) and ablations, are widely used to manage arrhythmias and heart failure. These interventions, though effective, require substantial resources, prompting the need for systematic economic evaluations to inform healthcare decision-making.
Methods: A systematic review of studies from 2007 to 2024 was conducted in two phases.
Background: Chronic kidney disease (CKD) and atrial fibrillation (AF) often coexist, making accurate renal function estimation crucial, typically through equations calculating estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl).
Objective: To compare the concordance and predictive performance of different renal function estimation equations in a European cohort of AF patients.
Methods: We analyzed data from AF patients enrolled in a prospective observational European registry.
Optimal Medical Therapy for Heart Failure and Integrated Care in Patients With Atrial Fibrillation: A Report From the ESC-EHRA EORP Atrial Fibrillation Long-Term General Registry.
J Am Heart Assoc
January 2025
Background: Heart failure (HF) often occurs in patients with atrial fibrillation (AF), with a major impact on prognosis. Few data are available on the effect of integrated treatment strategies to improve prognosis in patients with AF. We aimed to evaluate the association between HF (according to left ventricular ejection fraction [LVEF]), HF optimal medical therapy and adherence to the Atrial Fibrillation Better Care pathway, and major outcomes in patients with AF.
View Article and Find Full Text PDFPeripheral artery disease, antithrombotic treatment and outcomes in European and Asian patients with atrial fibrillation: analysis from two prospective observational registries.
BMC Med
December 2024
Background: In patients with atrial fibrillation (AF), the impact of peripheral artery disease (PAD) on oral anticoagulant (OAC) therapy use and the risk of outcomes remains unclear.
Objective: To analyse the epidemiology of PAD in a large cohort of European and Asian AF patients, and the impact on treatment patterns and risks of adverse outcomes.
Methods: We analysed AF patients from two large prospective observational registries.
Article Synopsis
- The study investigates if using algorithms for right ventricular pacing modulation (RVPm) can lower negative health outcomes compared to traditional dual-chamber pacing (DDD) in patients needing anti-bradycardia treatments.
- The analysis, which included eight studies and over 7,200 patients, revealed that RVPm was associated with a reduced risk of persistent atrial fibrillation and cardiovascular hospitalizations, but no significant impact on overall mortality or adverse symptoms was found.
- Overall, RVPm algorithms appear beneficial in minimizing certain health risks, without increasing unwanted side effects, even for patients with higher levels of atrioventricular block.
Performance of HAS-BLED and DOAC scores to predict major bleeding events in atrial fibrillation patients treated with direct oral anticoagulants: A report from a prospective European observational registry.
Eur J Intern Med
October 2024
Article Synopsis
- The study aimed to assess the effectiveness of two bleeding risk assessment scores—HAS-BLED and DOAC score—among patients with atrial fibrillation who are on direct oral anticoagulants (DOAC).
- Analysis included 2834 patients, revealing that the DOAC score identified a significantly higher proportion of very low-risk patients compared to the HAS-BLED score.
- However, both scoring systems showed only modest predictive abilities for major bleeding events, indicating no strong preference for using the DOAC score over HAS-BLED in this context.
Article Synopsis
- Cardiac resynchronization therapy (CRT) emerged in the 2000s as an important treatment for heart failure patients with poor ejection fraction and wide QRS, but around one-third of patients do not respond well to it.
- The review emphasizes that determining whether a patient is a CRT nonresponder is complex and should consider multiple factors rather than a single criterion.
- New pacing techniques like His-bundle and left bundle branch area pacing offer promising alternatives to CRT, but more comprehensive studies are necessary to validate their effectiveness in treating heart failure with electromechanical dyssynchrony.
The epidemiology and mortality of patients with atrial fibrillation: a complex landscape.
J Cardiovasc Med (Hagerstown)
November 2023
Article Synopsis
- The study aimed to assess the current pharmacological management of atrial fibrillation in Italy, highlighting the need for personalized treatment according to ESC guidelines.
- Data were gathered through an in-person survey of 106 physicians across 72 hospitals in Italy, revealing significant variability in how atrial fibrillation is managed, particularly in areas with less clear literature support.
- The findings indicate that there is a lack of consistency among Italian cardiologists in their approaches to managing atrial fibrillation, suggesting that more research is needed to determine if these differences affect patient outcomes.
Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide. The presence of AF is associated with increased risk of systemic thromboembolism, but with the uptake of oral anticoagulant (OAC) and implementation of a holistic and integrated care management, this risk is substantially reduced. The diagnosis of AF requires a 30-s-long electrocardiographic (ECG) trace, irrespective of the presence of symptoms, which may represent the main indication for an ECG tracing.
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- * Out of 838 enrolled patients, 5 (0.6%) developed infections related to CIEDs, while 212 (25.5%) died over a median follow-up period of 42.3 months.
- * The study found that chronic kidney disease requiring dialysis and corticosteroid therapy significantly increased infection risk, while older age, chronic kidney disease, and a history of atrial fibrillation were associated with higher all-cause mortality.
The medical approach to atrial fibrillation (AF) underwent a paradigm shift over time, evolving from considering AF as a simple arrhythmic phenomenon to a complex nosological entity [...
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