Effect of remote ischemic preconditioning on electrophysiological parameters in nonvalvular paroxysmal atrial fibrillation: The RIPPAF Randomized Clinical Trial

Kosiuk, Jędrzej; Langenhan, Katharina; Stegmann, Clara; Uhe, Tobias; Dagres, Nikolaos; Dinov, Borislav; Kircher, Simon; Richter, Sergio; Sommer, Philipp; Bertagnolli, Livio; Bollmann, Andreas; Hindricks, Gerhard

doi:10.1016/j.hrthm.2019.07.026

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…The results of this meta‐analysis are however incongruous with the results of a randomized control trial which concluded that remote ischemic preconditioning reduced the inducibility and sustainability of nonvalvular atrial fibrillation. Additionally, the study also concluded that these changes were possibly mediated by alteration in the electrophysiological properties of the atria . In a study by Candilio et al, remote ischemic precondition significantly reduced the incidence of NOAF among subjects undergoing cardiac surgery .…”

Section: Discussionmentioning

confidence: 89%

“…Additionally, the study also concluded that these changes were possibly mediated by alteration in the electrophysiological properties of the atria. 17 In a study by Candilio et al, remote ischemic precondition significantly reduced the incidence of NOAF among subjects undergoing cardiac surgery. 6 Furthermore, Candilio et al also concluded that remote ischemic preconditioning reduced perioperative myocardial injury in patients undergoing cardiac surgery, which could have contributed to the reduced incidence of NOAF.…”

Section: Discussionmentioning

confidence: 97%

“…It has been postulated that activation of protein kinase akt plays a beneficial role in the survival of myocardial cells during cardiac surgery . The possible role of remote ischemic preconditioning in altering the ionic distribution along the cellular component of the atria has also been postulated …”

Section: Discussionmentioning

confidence: 99%

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Remote ischemic preconditioning and its role in the prevention of new onset atrial fibrillation post‐cardiac surgery. A meta‐analysis of randomized control trials

Kumar

Singh²,

Shariff

2019

Journal of Arrhythmia

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Background The denouement of remote ischemic preconditioning on new onset atrial fibrillation (NOAF) post‐cardiac surgery is not well‐established. An updated meta‐analysis of randomized control trials was performed by comparing remote ischemic preconditioning with controls and the outcome of interest was NOAF. Methods The systemic review was performed in accordance with the PRISMA (Preferred reporting items for systemic review) and AHA (American Heart Association) guidelines. PubMed database was searched to include relevant randomized control trials from inception to July 2019. We used Mantel‐Haenzsel method with random error model to calculate risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was assessed using the I2 test> 50% or χ2 P < .05. Publication bias was visually assessed using a funnel plot. Results Twelve randomized control trials were included in the final analysis. Remote ischemic preconditioning did not alter the risk of NOAF post‐cardiac surgery [RR: 0.95, CI: 0.83‐1.09, P = .48, I2 = 37%, χ2 P = .09]. Conclusion In conclusion, the present meta‐analysis failed to provide any evidence for the beneficial effect of remote ischemic preconditioning in the prevention of NOAF.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 97%

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Remote ischemic preconditioning and its role in the prevention of new onset atrial fibrillation post‐cardiac surgery. A meta‐analysis of randomized control trials

Kumar

Singh²,

Shariff

2019

Journal of Arrhythmia

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“…It was showed that RIC before CABG surgery and/or valve surgery could reduce the incidence of postoperative AF by 54% (11% RIC vs 24% control; p = 0.031) 16 . Kosiuk et al recently found RIC reduced the inducibility and sustainability of paroxysmal AF (PAF), which was probably mediated by changes in electrophysiological properties of the atria 17 . But the effect of CRIC on AF burden is still unknown.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism of effects of CRIC on AF has not been fully elucidated. Kosiuk et al17 demonstrated that 3 sessions of RIC reduced the inducibility (23.3% vs 46.6%, p = 0.003) and sustainability (15.1% vs 32.9%, p = 0.01) of PAF signi cantly, which was possibly mediated by decrease in dispersion of atrial refractory periods (16.0 ± 14.0 ms vs 22.7 ± 19.0 ms, p = 0.21) and reduction in atrial conduction delay. Han et al30 …”

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confidence: 99%

Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

Chen

Liu

Zhu

et al. 2020

Preprint

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Background: The burden of atrial fibrillation (AF) has been attractive recently and may be associated with stroke risk and mortality. Remote ischemic conditioning could reduce the incidence, inducibility and sustainability of AF. But the effects of chronic remote ischemic conditioning (CRIC) on atrial fibrillation burden in patients with pacemaker implanted are still unknown.Design: This was a single‑center, prospective, randomized, open-labeled clinical study.Methods: Sixty-six patients with permanent pacemakers were randomly divided into CRIC group and control group after 4 weeks screening. CRIC treatment was performed twice a day for 12 weeks. A remote ischemic conditioning protocol consisted of 4 × 5 min inflation/deflation of the blood pressure cuff applied in the upper arm to create intermittent arm ischemia. Pacemaker programming was performed for four times: before screening (-4-week), after screening and before randomization (0-week, baseline), 4-week and 12-week follow-up. Data including AF burden, longest duration of AF and cumulative numbers of atrial high-rate episodes (AHREs) were collected.Results: Sixty-one patients (31 patients in CRIC group and 30 patients in control group) completed the study. CRIC was well-tolerated by patients after 12 weeks treatment. The burden of AF in CRIC group was decreased significantly at 4-week compared with that at 0-week (14.7%±18.5% vs 17.0%±20.7%, p < 0.001), which further decreased at 12-week compared with that at 0-week (8.6%±10.2% vs 17.0%±20.7%, p < 0.001) and that at 4-week (8.6%±10.2% vs 14.7%±18.5%, p < 0.001), which was not observed in the control group. AF burden also reduced significantly after 12-week CRIC compared with that in control group (8.6%±10.2% vs 17.6%±19.5%, p = 0.013). Repeated measurement ANOVA showed that the changes of AF burden was associated with CRIC instead of time (p < 0.01). In addition, there were trends that longest duration of AF and cumulative numbers of AHREs were reduced after 12-week CRIC.Conclusions: This study suggests that a 12-week course of CRIC treatment could reduce AF burden in patients with permanent pacemakers, supporting widespread use of CRIC in the daily lives of these patients, which need to be verified in the future.Clinical Trial RegistrationRegistration name: Effects of remote ischemic conditioning on atrial fibrillation burden in patients with paroxysmal atrial fibrillationRegistration number: ChiCTR-IOR-17012666Registered 14 September 2017; URL: www.chictr.org.cn/showproj.aspx?proj=21591

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Heart Conditioning as a Healthy Strategy in Adjunctive Treatment of Cardiovascular Disease: Clinical Trials

Lee,

Lee

2024

Curr Treat Options Cardio Med

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Effect of remote ischemic preconditioning on electrophysiological parameters in nonvalvular paroxysmal atrial fibrillation: The RIPPAF Randomized Clinical Trial

Cited by 7 publications

References 34 publications

Remote ischemic preconditioning and its role in the prevention of new onset atrial fibrillation post‐cardiac surgery. A meta‐analysis of randomized control trials

Remote ischemic preconditioning and its role in the prevention of new onset atrial fibrillation post‐cardiac surgery. A meta‐analysis of randomized control trials

Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers

Heart Conditioning as a Healthy Strategy in Adjunctive Treatment of Cardiovascular Disease: Clinical Trials

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