Atrial fibrillation (AF) is a common arrhythmia affecting 8–10% of the population older than 80 years old. The importance of early diagnosis of atrial fibrillation has been broadly recognized since arrhythmias significantly increase the risk of stroke, heart failure and tachycardia-induced cardiomyopathy with reduced cardiac function. However, the prevalence of atrial fibrillation is often underestimated due to the high frequency of clinically silent atrial fibrillation as well as paroxysmal atrial fibrillation, both of which are hard to catch by routine physical examination or 12-lead electrocardiogram (ECG). The development of wearable devices has provided a reliable way for healthcare providers to uncover undiagnosed atrial fibrillation in the population, especially those most at risk. Furthermore, with the advancement of artificial intelligence and machine learning, the technology is now able to utilize the database in assisting detection of arrhythmias from the data collected by the devices. In this review study, we compare the different wearable devices available on the market and review the current advancement in artificial intelligence in diagnosing atrial fibrillation. We believe that with the aid of the progressive development of technologies, the diagnosis of atrial fibrillation shall be made more effectively and accurately in the near future.
Polycystic ovary syndrome (PCOS) is a complex endocrinopathy affecting many women of reproductive age. Although its physiology is poorly understood, hyperandrogenemia and insulin resistance play a pivotal role in this complex syndrome, predisposing patients to a variety of cardiovascular and metabolic modalities. Current therapeutic options, including lifestyle modifications and medications, often do not satisfactorily improve clinical outcomes. SGLT2 inhibitors (SGLT‐2i) are a novel option which can potentially improve many hormonal and metabolic parameters for patients with PCOS, though the net cardiovascular effects remain under investigation in this population of patients with PCOS. Overall, the use of SGLT‐2i may be associated with beneficial somatometric, metabolic and hormonal outcomes of PCOS. To date, all available studies have recorded body mass index, waist and hip circumference, and fat mass reductions, improved insulin and androgen levels, and reduced blood pressure. The aim of the present review is to summarise PCOS‐related manifestations and mechanisms leading to cardiovascular disease, to explore the cardiometabolic impact of SGLT2i on PCOS, and to critically analyse the cardiometabolic and hormonal outcomes of the recent studies on the use of SGLT2i in women with PCOS.
BackgroundPrevious studies have shown that patients with heart failure (HF) and cardiogenic shock (CS) have worse outcomes when admitted over the weekend. Since peripartum cardiomyopathy (PPCM) is a cause of CS and persisting HF, it is reasonable to extrapolate that admission over the weekend would also have deleterious effects on PPCM outcomes. However, the impact of weekend admission has not been specifically evaluated in patients with PPCM. MethodsWe analyzed the National Inpatient Sample (NIS) from 2016 to 2019. The International Classification of Diseases, tenth revision (ICD-10) codes were used to identify all admissions with a primary diagnosis of PPCM. The sample was divided into weekday and weekend groups. We performed a multivariate regression analysis to estimate the effect of weekend admission on specified outcomes. ResultsA total of 6,120 admissions met the selection criteria, and 25.3% (n=1,550) were admitted over the weekend. The mean age was 31.3 ± 6.4 years. There were no significant differences in baseline characteristics between study groups. After multivariate analysis, weekend admission for PPCM was not associated with in-hospital mortality, ventricular arrhythmias, sudden cardiac arrest, thromboembolic events, cardiovascular implantable electronic device placement, and mechanical circulatory support insertion. ConclusionIn conclusion, although HF and CS have been associated with worse outcomes when admitted over the weekend, we did not find weekend admission for PPCM to be independently associated with worse clinical outcomes after multivariate analysis. These findings could reflect improvement in the coordination of care over the weekend, improvement in physician handoff, and increased utilization of shock teams.
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