Atrial fibrillation burden and symptom, quality of life, and healthcare resource utilization after cryoballoon ablation in persistent atrial fibrillation.

Aims: To investigate the relationship between continuously monitored atrial fibrillation (AF) burden after cryoballoon ablation (CBA) and improvements in AF-related symptoms, quality of life (QoL), and AF-related healthcare resource utilization (HCRU) in early persistent AF.

Methods And Results: This secondary analysis of the multicentre COOL-PER trial included patients with early persistent AF who underwent CBA and continuous monitoring via an implantable loop recorder. Post-CBA AF burden was defined as the percentage of time in AF between 9- and 12-month after CBA, categorized as <0.

Comparison of Artificial Intelligence-Derived Heart Age with Chronological Age Using Normal Sinus Electrocardiograms in Patients with No Evidence of Cardiac Disease.

: Chronological age (CA) is commonly used in clinical decision-making, yet it may not accurately reflect biological aging. Recent advances in artificial intelligence (AI) allow estimation of electrocardiogram (ECG)-derived heart age, which may serve as a non-invasive biomarker for physiological aging. This study aimed to develop and validate a deep learning model to predict ECG-heart age in individuals with no structural heart disease.

External assessment of an artificial intelligence-enabled electrocardiogram for aortic stenosis detection.

Aims: To assess the performance of an artificial intelligence-enabled electrocardiogram (AI-ECG) algorithm in identifying patients with moderate to severe aortic stenosis (AS) in an Asian cohort from a tertiary care centre.

Methods And Results: We identified a randomly selected patients ≥60 years old who underwent echocardiography and ECG within in 31 days between 2012 and 2021 at the Samsung Medical Center in Korea. Patients with previous cardiac surgery, prosthetic valves, or pacemakers were excluded.

An Artificial Intelligence Algorithm for Early Detection of Left Ventricular Systolic Dysfunction in Patients with Normal Sinus Rhythm.

Most previous studies using artificial intelligence (AI) to detect left ventricular systolic dysfunction (LVSD) from electrocardiograms (ECGs) relied on data obtained near the time of echocardiography or included patients with known cardiac disease, limiting their specificity for screening. We aimed to evaluate whether AI models could predict future LVSD from ECGs interpreted as normal and recorded one to two years before echocardiography. We retrospectively analyzed 24,203 sinus rhythm ECGs from 11,131 patients.

Real-World Effectiveness of Adaptive Left Ventricular-Only Pacing for Cardiac Resynchronization Therapy in Asian Population: Insights From the K-Adaptive CRT Study.

Background And Objectives: Conflicting results have been reported regarding the efficacy of left ventricular-only pacing (LVP) synchronized with intrinsic right ventricular conduction (adaptive LVP) for cardiac resynchronization therapy (CRT) in Western heart failure (HF) populations. We compared adaptive LVP with conventional biventricular pacing (BVP) in Asian HF patients.

Methods: The K-adaptive CRT study, the largest adaptive CRT study to date in Asian HF patients, evaluated 368 HF patients who received CRT devices with an adaptive pacing algorithm between September 2013 and March 2020 from 25 tertiary hospitals in Korea.

Cryoballoon Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: From the Korean Cryoballoon Ablation Registry.

Background And Objectives: Atrial fibrillation (AF) occurs in more than 20% of hypertrophic cardiomyopathy (HCM) patients, further increasing the risk of stroke. Although radiofrequency catheter ablation in AF patients with HCM has been performed, data on cryoballoon ablation (CBA) in HCM patients are limited. We evaluated the efficacy and safety of CBA in HCM patients with AF.

Reduction of AF Burden After Cryoballoon Ablation in Patients With Early Persistent AF: The COOL-PER Trial.

Background: Limited data exist on reducing the atrial fibrillation (AF) burden, the regression from persistent to paroxysmal AF, and symptom improvement after cryoablation in patients with persistent AF.

Objectives: This study sought to evaluate the efficacy of cryoablation in reducing the AF burden, regression to paroxysmal AF, and symptom improvement in patients with early persistent AF.

Methods: This investigator-initiated, multicenter, and prospective cohort study enrolled the patients with early persistent AF (≤3 years).

Apixaban outcomes in atrial fibrillation patients with a single-dose reduction criterion: ASPIRE 1-year results.

Aims: This study, using a prospective cohort, evaluated the effectiveness and safety of off-label reduced-dose apixaban vs. the on-label dose in atrial fibrillation (AF) patients meeting a single-dose reduction criterion.

Methods And Results: The efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE) study is a multicentre, prospective observational cohort involving AF patients who met a single-dose reduction criterion of apixaban.

Safety and Performance of the Micra VR Leadless Pacemaker in a South Korean Cohort: A Comparison to Global Studies.

Background And Objectives: The Micra leadless pacemaker demonstrated a favorable safety and efficacy profile in global trials, but its performance and safety in a South Korean-specific population are unknown.

Methods: The prospective, single-arm Micra Acute Performance South Korean registry was designed to study the performance of the Micra VR leadless pacemaker in patients from South Korea. The primary objectives were to characterize the rate of acute (30 days) and longer-term (12 months) major complications.

Incidence, Predictors, and Management of Femoral Vascular Complications Following Catheter Ablation for Atrial Fibrillation: A Systematic Duplex Ultrasound Study.

Catheter ablation is an effective treatment for atrial fibrillation (AF) but is associated with femoral vascular complications. While anticoagulation therapy has been linked to these complications, specific risk factors remain unclear. This study assessed the incidence and predictors of vascular complications after catheter ablation using systematic duplex ultrasound (DUS) as well as their outcomes.

Long-term Outcome of Cryoballoon Ablation in Korean Patients With Atrial Fibrillation: Real-World Experience From the Cryo Global Registry.

Background And Objectives: Atrial fibrillation (AF), the most common atrial arrhythmia (AA), is an increasing healthcare burden in Korea. The objective of this sub-analysis of the Cryo Global Registry was to evaluate long-term efficacy, symptom burden, quality of life (QoL), and healthcare utilization outcomes and factors associated with AA recurrence in Korean patients treated with cryoballoon ablation (CBA).

Methods: Patients were treated and followed up according to local standard-of-care in 3 Korean hospitals.

Clinical characteristics of apixaban prescription in AF patients with single dose-reduction criterion: the ASPIRE (efficAcy and safety of aPixaban in rEal-world practice in Korean frail patients with atrial fibrillation) study.

Background: Data on off-label reduced dose risk among patients with atrial fibrillation (AF) who qualify for a single-dose reduction of apixaban is scarce.

Objectives: We prospectively assessed apixaban dosing and clinical characteristics in AF patients meeting a dose reduction criterion.

Methods: The multicentre, prospective cohort study, the efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE), encompasses patients with AF who met the criteria for a single-dose reduction of apixaban and were given varying doses of apixaban, either the on-label standard dose or the off-label reduced dose.

Optimal Dose of Edoxaban for Very Elderly Atrial Fibrillation Patients at High Risk of Bleeding: The LEDIOS Registry.

Background And Objectives: Optimal anticoagulation in very elderly patients is challenging due to the high risk of anticoagulant-induced bleeding. The aim of this study was to assess outcomes of on-label reduced-dose edoxaban (30 mg) in very elderly patients who had additional risk factors for bleeding.

Methods: This was a multi-center, prospective, non-interventional observational study to evaluate the efficacy and safety of on-label reduced-dose edoxaban in atrial fibrillation (AF) patients 80 years of age or older and who had more than 1 risk factor for bleeding.

Comparison of High- and Low-Dose Rivaroxaban Regimens in Elderly East Asian Patients With Atrial Fibrillation.

Background: In the Rivaroxaban Once-daily oral direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) trial, rivaroxaban 20 mg was the on-label dose, and the dose-reduction criterion for rivaroxaban was a creatinine clearance of < 50 mL/min. Some Asian countries are using reduced doses label according to the J-ROCKET AF trial. The aim of this study was to assess the safety and efficacy of a high-dose rivaroxaban regimen (HDRR, 20/15 mg) and low-dose rivaroxaban regimen (LDRR, 15/10 mg) among elderly East Asian patients with atrial fibrillation (AF) in real-world practice.

Identification of concealed cardiomyopathy using next-generation sequencing-based genetic testing in Korean patients initially diagnosed with idiopathic ventricular fibrillation.

Aims: Idiopathic ventricular fibrillation (IVF) is a disease in which the cause of ventricular fibrillation cannot be identified despite comprehensive clinical evaluation. This study aimed to investigate the clinical yield and implications of genetic testing for IVF.

Methods And Results: This study was based on the multi-centre inherited arrhythmia syndrome registry in South Korea from 2014 to 2017.

Exercise capacity and risk of incident atrial fibrillation in healthy adults.

Background/aims: Atrial fibrillation (AF) is a common arrhythmia and is associated with cardiovascular morbidity and mortality. It is important to identify and control the modifiable risk factors of AF. We aimed to examine the association of exercise capacity with the risk of incident AF within 3 years in healthy subjects.

Totally Thoracoscopic Ablation in Patients With Recurrent Atrial Fibrillation After Catheter Ablation.

Background: The objective of this study was to evaluate the efficacy and safety of totally thoracoscopic ablation (TTA) in patients with recurrent atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA).

Methods: From February 2012 to May 2020, 460 patients who underwent TTA were classified into two groups: CA (presence of RFCA history, n = 74) and nCA groups (absence of RFCA history, n = 386). Inverse probability of treatment weighting (IPTW) analyses were used to adjust for confounders.

Non-Invasive Risk Assessment and Prediction of Mortality in Patients Undergoing Coronary Artery Bypass Graft Surgery.

Heart rate turbulence (HRT) and T-wave alternans (TWA), non-invasive markers of cardiac autonomic dysfunction, and ventricular repolarization abnormality, reportedly, predict the risk of cardiovascular death after myocardial infarction. We investigated whether pre-operative assessment of HRT and/or TWA could predict long-term mortality following coronary artery bypass graft (CABG) surgery. From May 2010 to December 2017, patients undergoing elective CABG and receiving 24 h ambulatory electrocardiogram monitoring 1 to 5 days prior to CABG surgery were prospectively enrolled.

A Comparative Study of Thoracoscopic Left Atrial Appendage Clipping vs Stapled Resection.

Background: The left atrial appendage (LAA) is the predominant site of thrombus formation in atrial fibrillation (AF), which is associated with ischemic stroke. This study comparatively evaluated the complete LAA closure rates between LAA clipping and stapled resections.

Methods: The study included 333 patients who underwent thoracoscopic operation with both preoperative and postoperative computed tomographic scans.