Social Determinants of Health and Disparities in Diagnosis-to-Ablation Time for Atrial Fibrillation.

Background: Social determinants of health (SDOH) significantly influence health care access and outcomes, but their impact on atrial fibrillation (AF) diagnosis-to-ablation time (DAT) and anticoagulation prescription rates is unknown.

Objective: The goal of this study was to assess the associations between SDOH, measured by using the Area Deprivation Index (ADI), and DAT and anticoagulation prescription rates in patients undergoing AF ablation.

Methods: Data from the Hopkins AF Ablation Registry (2014-2023) were analyzed retrospectively.

Patient Centered mobile Health TECHnology Enabled Atrial Fibrillation Management (mTECH Afib): A Pilot Randomized Controlled Trial.

Background: Digital health technologies provide a scalable, efficient approach to implementing guideline-recommended risk factor modification in the care of patients with atrial fibrillation (AF).

Objectives: This study aimed to evaluate the feasibility of a 12-week, multicomponent, virtual AF management program using a smartphone application, connected devices, and virtual coaching calls for risk factor modification.

Methods: Patients with AF were enrolled from outpatient clinics.

Harnessing Wearables and Digital Technologies to Decode the Cardiovascular Exposome.

The cardiovascular exposome encompasses the array of external and internal factors affecting cardiovascular health throughout life, inviting comprehensive monitoring and analysis to enhance prevention, diagnosis, and treatment strategies. Wearable and digital technologies have emerged as promising tools in this domain, offering longitudinal, real-time data on physiological parameters such as heart rate, heart rhythm, physical activity, and sleep patterns. This review explores the advancements in wearable sensor technology, the methodologies for data collection and analysis, and the integration of these technologies into clinical practice and research.

Effects of Glucagon-Like Peptide-1 Receptor Agonists on Atrial Fibrillation Recurrence After Catheter Ablation.

Background: Relationship between glucagon-like peptide-1 receptor agonist (GLP-1 RA) use prior to atrial fibrillation (AF) ablation and subsequent AF recurrence is not well-understood.

Objectives: This study investigated the effects of GLP-1 RA use within 1 year before ablation and its association with AF recurrence and associated outcomes.

Methods: The TriNetX research database was used to identify patients aged ≥18 years undergoing AF ablation (2014-2023).

Comprehensive atrial fibrillation burden and symptom reduction post-ablation: insights from DECAAF II.

Aims: Traditional atrial fibrillation (AF) recurrence after catheter ablation is reported as a binary outcome. However, a paradigm shift towards a more granular definition, considering arrhythmic or symptomatic burden, is emerging. We hypothesize that ablation reduces AF burden independently of conventional recurrence status in patients with persistent AF, correlating with symptom burden reduction.

Rationale and Design of the mTECH-Rehab Randomized Controlled Trial: Impact of a Mobile Technology Enabled Corrie Cardiac Rehabilitation Program on Functional Status and Cardiovascular Health.

Background: Cardiac rehabilitation (CR) is an evidence-based, guideline-recommended intervention for patients recovering from a cardiac event, surgery or procedure that improves morbidity, mortality, and functional status. CR is traditionally provided in-center, which limits access and engagement, most notably among underrepresented racial and ethnic groups due to barriers including cost, scheduling, and transportation access. This study is designed to evaluate the Corrie Hybrid CR, a technology-based, multicomponent health equity-focused intervention as an alternative to traditional in-center CR among patients recovering from a cardiac event, surgery, or procedure compared with usual care alone.

Use of Human-Centered Design Methodology to Develop a Digital Toolkit to Optimize Heart Failure Guideline-Directed Medical Therapy.

Background: Guideline-directed medical therapies (GDMTs) improve quality of life and health outcomes for patients with heart failure (HF). However, GDMT utilization is suboptimal among patients with HF.

Objective: The aims of this study were to engage key stakeholders in semistructured, virtual human-centered design sessions to identify challenges in GDMT optimization posthospitalization and inform the development of a digital toolkit aimed at optimizing HF GDMTs.

The Virtual Inclusive Digital Health Intervention Design to Promote Health Equity (iDesign) Framework for Atrial Fibrillation: Co-design and Development Study.

Background: Smartphone ownership and mobile app use are steadily increasing in individuals of diverse racial and ethnic backgrounds living in the United States. Growing adoption of technology creates a perfect opportunity for digital health interventions to increase access to health care. To successfully implement digital health interventions and engage users, intervention development should be guided by user input, which is best achieved by the process of co-design.

Medicine 2032: The future of cardiovascular disease prevention with machine learning and digital health technology.

Machine learning (ML) refers to computational algorithms that iteratively improve their ability to recognize patterns in data. The digitization of our healthcare infrastructure is generating an abundance of data from electronic health records, imaging, wearables, and sensors that can be analyzed by ML algorithms to generate personalized risk assessments and promote guideline-directed medical management. ML's strength in generating insights from complex medical data to guide clinical decisions must be balanced with the potential to adversely affect patient privacy, safety, health equity, and clinical interpretability.

Large Atrial Septal Aneurysm Associated with Secundum Atrial Septal Defect.

• A structured multimodality approach is imperative in evaluating interatrial anatomy. • Secundum ASDs may be associated with ASA. • Interatrial shunts may be missed, especially when aneurysms are large.

C-reactive Protein Elevation Is Associated With QTc Interval Prolongation in Patients Hospitalized With COVID-19.

Background: The relationship between inflammation and corrected QT (QTc) interval prolongation is currently not well defined in patients with COVID-19.

Objective: This study aimed to assess the effect of marked interval changes in the inflammatory marker C-reactive protein (CRP) on QTc interval in patients hospitalized with COVID-19.

Methods: In this retrospective cohort study of hospitalized adult patients admitted with COVID-19 infection, we identified 85 patients who had markedly elevated CRP levels and serial measurements of an ECG and CRP during the same admission.

Secular Trends in Risk Profiles Among Adults With Cardiovascular Disease in the United States.

Background: Documenting trends in risk factors among individuals with cardiovascular disease (CVD) may inform policy and secondary prevention initiatives.

Objectives: This study aimed to examine 20-year trends in risk profiles among U.S.

Starting a Research Career in Cardiology: Advice for Fellows in Training and Early-Career Cardiologists.

Launching an academic career in cardiology can be challenging. Mentorship has long been considered a core component in the academic career advancement of trainees across different disciplines and career stages, including cardiovascular disease. But simply having a mentor may not be sufficient to embark on a successful academic journey in cardiology.

Application of the very high risk criterion and evaluation of cholesterol guideline adherence in acute myocardial infarction patients at an urban academic medical center.

Objective: The 2018 AHA/ACC cholesterol guidelines recommend considering non-statin agents among very high-risk (VHR) patients with LDL-C ≥ 70 mg/dL after maximizing statin therapy. We aimed to evaluate the prevalence of VHR status in acute myocardial infarction (AMI) patients at hospital discharge and the adherence to guideline-directed cholesterol therapy (GDCT) within one-year follow-up post-AMI.

Methods: We performed a retrospective analysis of patients who suffered a type 1 AMI between October 2015 and March 2019, and then were followed at our institution for 1 year after hospital discharge.

Acquired Long QT and Ventricular Arrhythmias in the Setting of Acute Inflammation: A Case Series.

We report a case series of 4 patients with transient marked QTc prolongation and ventricular arrhythmias in the setting of inflammation with very high ferritin levels. Three patients were positive for coronavirus disease-2019. In the setting of an acute rise in inflammatory markers, electrocardiography screening for QTc prolongation is warranted.

Mobile health in preventive cardiology: current status and future perspective.

Purpose Of Review: Despite cutting edge acute interventions and growing preventive strategies supported by robust clinical trials, cardiovascular disease (CVD) has stubbornly persisted as a leading cause of death in the United States and globally. The American Heart Association recognizes mobile health technologies (mHealth) as an emerging strategy in the mitigation of CVD risk factors, with significant potential for improving population health. The purpose of this review is to highlight and summarize the latest available literature on mHealth applications and provide perspective on future directions and barriers to implementation.

Strengthening the Learning Health System in Cardiovascular Disease Prevention: Time to Leverage Big Data and Digital Solutions.

Purpose Of Review: The past few decades have seen significant technologic innovation for the treatment and diagnosis of cardiovascular diseases. The subsequent growing complexity of modern medicine, however, is causing fundamental challenges in our healthcare system primarily in the spheres of patient involvement, data generation, and timely clinical implementation. The Institute of Medicine advocated for a learning health system (LHS) in which knowledge generation and patient care are inherently symbiotic.

Heart Rate Measurements in Patients with Obstructive Sleep Apnea and Atrial Fibrillation: Prospective Pilot Study Assessing Apple Watch's Agreement With Telemetry Data.

Background: Patients with obstructive sleep apnea (OSA) are at a higher risk for atrial fibrillation (AF). Consumer wearable heart rate (HR) sensors may be a means for passive HR monitoring in patients with AF.

Objective: The aim of this study was to assess the Apple Watch's agreement with telemetry in measuring HR in patients with OSA in AF.

Detecting heart failure using wearables: a pilot study.

Objective: Heart failure (HF) can be difficult to diagnose by physical examination alone. We examined whether wristband technologies may facilitate more accurate bedside testing.

Approach: We studied on a cohort of 97 monitored in-patients and performed a cross-sectional analysis to predict HF with data from the wearable and other clinically available data.