Recent-onset atrial fibrillation: challenges and opportunities.

Atrial fibrillation (AF) is increasingly diagnosed early, close to its first occurrence due to: (i) increased public awareness with self-screening; (ii) health care initiatives including population screening and opportunistic case finding; and (iii) increased use and surveillance of implantable cardiac devices. At its onset, AF is often low burden, and cardiovascular co-morbidities may be absent or at an early stage. Thus, the management of recent-onset AF has become an issue of growing importance.

Short-Term Anticoagulation After Cardioversion in New-Onset Atrial Fibrillation and Low Thromboembolic Risk: A Real-World International Investigation.

: International guidelines differ on short-term (4-week) oral anticoagulation (OAC) indication after acute cardioversion for recent-onset atrial fibrillation (AF < 12-48 h) in low-risk patients (CHADS-VA = 0). While Canadian and Chinese guidelines recommend OAC for all, European, Australian and New Zealand, and American guidelines state that such treatment is optional due to the absence of high-quality evidence supporting its indication in this specific scenario. This study aimed to assess physicians' management of a simple clinical case at an international level, focusing on how they balance ischemic and bleeding risks in a setting lacking any strong evidence-based recommendations.

Artificial intelligence and the electrocardiogram: A modern renaissance.

Integrating Artificial Intelligence (AI) with electrocardiograms (ECG) represents a transformative shift in cardiovascular medicine, marking a modern renaissance of this traditional diagnostic technique. This article explores recent advancements in AI-enhanced ECG technologies, highlighting their potential to improve diagnostic accuracy, predict cardiovascular events, and enable personalized patient care. AI-driven ECG interpretation has demonstrated groundbreaking capabilities in the field of both structural and electrical heart diseases.

PULSE survey: Population Survey on Knowledge, Gaps and Perception of Heart Rhythm disorders-an initiative of the Scientific Initiatives Committee of the European Heart Rhythm Association.

Aims: Despite increasing prevalence, the general population lacks knowledge regarding diagnosis, implications, and management of cardiac arrhythmias (CA). This study aims to assess public perception of CA and identify knowledge gaps.

Methods And Results: The 36-item PULSE survey was disseminated via social media to the general population and conducted under the auspices of the European Heart Rhythm Association Scientific Initiatives Committee (EHRA SIC) with EHRA patient committee support.

Leadless pacemaker implantation in real-world clinical practice: An Italian survey promoted by the AIAC (Italian Association of Arrhythmology and Cardiac Pacing).

Backgrounds: After a decade since the introduction of leadless pacemaker (L-PM), its use is still limited. The aim of this survey is to evaluate how this technology is perceived by electrophysiologist members of a National scientific society in clinical practice.

Methods: A questionnaire with 22 questions was posted in the reserved area of the society website.

Cardioneuroablation: a new treatment for vasovagal syncope.

Cardioneuroablation (CNA) is emerging as an appealing therapeutic option for patients with vasovagal reflex syncope. This review examines key aspects of CNA, including patient selection, procedural aspects and mid-term effects. We critically evaluate procedural results from recent studies and address ongoing challenges, such as the need for standardized procedural protocols and harmonized postprocedural data collection.

Different Approaches to Atrial Fibrillation Ablation in Heart Failure Patients: Temporal Trends and Clinical Outcomes.

Background: Catheter ablation of atrial fibrillation has been proven beneficial in patients with heart failure and reduced ejection fraction (HFrEF). On top of pulmonary vein isolation (PVI), additional ablation strategies such as empirical lines/posterior box/low voltage ablation (PVI+L/LVA) are often used. Whether PVI+L/LVA provides additional benefits in this population has never been systematically investigated.

Ultra High-Density Mapping and Ablation of Localized Micro-Reentrant Tachycardias: Insight From the CHARISMA Registry.

Background: Recent advancements in ultra-high-density mapping (UHDM) featuring automated functionalities have enhanced our understanding of micro-reentrant atrial tachycardias (mAT) circuits and the precise localization of the origin.

Purpose: To evaluate the diagnostic support provided by an automated UHDM algorithm in guiding the ablation of mATs.

Methods: Consecutive patients eligible for AT ablation in 22 Italian centers were prospectively enrolled.

Which Brugada patient deserves continuous ECG monitoring through implantable loop recorder? An evidence update.

Brugada syndrome (BrS) is a genetic condition that increases the risk of life-threatening arrhythmias, which can result in sudden cardiac death (SCD). Implantable loop recorders (ILRs) have become a key tool in managing patients with unexplained syncope, and guidelines advise their use in individuals with recurrent, unexplained syncope or palpitations. However, the role of ILRs in inherited arrhythmic conditions like BrS remains a topic of debate.

Atrial High-Rate Episodes and Subclinical Atrial Fibrillation: State of the Art and Clinical Questions with Complex Solutions.

Atrial high-rate episodes (AHREs) and subclinical atrial fibrillation (AF) are frequently registered in asymptomatic patients with cardiac implantable electronic devices (CIEDs) and insertable cardiac monitors (ICMs). While an increased risk of thromboembolic events (e.g.

Contact-force local impedance algorithm to guide effective pulmonary vein isolation in AF patients: 1-year outcome from an international multicenter clinical setting.

Background: The combination of highly localized impedance (LI) and contact force (CF) may improve tissue characterization and lesion prediction during radiofrequency (RF) pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF).

Objective: We report the outcomes of our acute and long-term clinical evaluation of CF-LI-guided PVI in consecutive AF ablation cases from an international multicenter clinical setting.

Methods: Three hundred twenty-four consecutive patients from 20 European centers undergoing RF catheter ablation with the Stablepoint™ catheter were enrolled in the CHARISMA registry.

Selection of candidates for cardiac resynchronization therapy and implantation management: an Italian survey promoted by the Italian Association of Arrhythmology and Cardiac Pacing.

Background: Cardiac resynchronization therapy (CRT) represents an effective heart failure treatment, associated with reduction in mortality and heart failure hospitalizations. This Italian survey aimed to address relevant CRT issues.

Methods: An online survey was administered to AIAC members.

Pulsed field vs very high-power short-duration radiofrequency ablation for atrial fibrillation: Results of a multicenter, real-world experience.

Background: Pulsed field ablation (PFA) and very high-power short-duration (vHPSD) radiofrequency ablation are the most recently introduced technologies for atrial fibrillation (AF) ablation. The procedural performance, safety, and effectiveness of PFA vs vHPSD are currently unknown.

Objective: The study aimed to compare PFA with vHPSD for the treatment of paroxysmal or persistent AF.

Epicardial Atrial Fat at Cardiac Magnetic Resonance Imaging and AF Recurrence after Transcatheter Ablation.

The relationship between epicardial adipose tissue (EAT) and atrial fibrillation (AF) has gained interest in recent years. The previous literature on the topic presents great heterogeneity, focusing especially on computed tomography imaging. The aim of the present study is to determine whether an increased volume of left atrial (LA) EAT evaluated at routine pre-procedural cardiac magnetic resonance imaging (MRI) relates to AF recurrences after catheter ablation.

INFLA-score: A new diagnostic paradigm to identify pericarditis.

Background: Diagnosis of pericarditis may be challenging because not all patients meet the conventional criteria. An overlooked diagnosis implies a longer course of symptoms and an increased risk of recurrences. C-reactive protein (CRP), widely used as an inflammation marker, has some limitations.

Convolutional neural network (CNN)-enabled electrocardiogram (ECG) analysis: a comparison between standard twelve-lead and single-lead setups.

Background: Artificial intelligence (AI) has shown promise in the early detection of various cardiac conditions from a standard 12-lead electrocardiogram (ECG). However, the ability of AI to identify abnormalities from single-lead recordings across a range of pathological conditions remains to be systematically investigated. This study aims to assess the performance of a convolutional neural network (CNN) using a single-lead (D1) rather than a standard 12-lead setup for accurate identification of ECG abnormalities.