Gender Differences in Arrhythmias: Focused on Atrial Fibrillation

Tian, Xiaoting; Xu, Ying‐Jia; Yang, Yi‐Qing

doi:10.1007/s12265-019-09918-w

Cited by 24 publications

(11 citation statements)

References 112 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As we know, age and gender played important roles in the occurrence and recurrence of atrial arrhythmia. 49,50 However, in our meta-analysis, age and gender did not seem to have an influence on the long-term freedom from atrial arrhythmia, considering to be related to small sample size, reporting bias, follow-up bias, and confounding factors. In addition, only one study reported the procedure strategy (First ablation or First LAAC) in combined ablation and LAAC, and the results showed the rates of freedom from atrial arrhythmia were comparable between the First ablation group and First LAAC group with a mean follow-up of 11.2 months (75.0% vs. 70.0%, log-rank p = .311), which was consistent with our subgroup analysis.…”

Section: Discussioncontrasting

confidence: 59%

The long‐term efficacy and safety of combining ablation and left atrial appendage closure: A systematic review and meta‐analysis

Sun

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Background: Combined ablation and left atrial appendage closure (LAAC) is an alternative for atrial fibrillation patients with a high risk of stroke. However, the long-term outcomes of this combined procedure remain elusive.Methods: PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from the establishment of databases to 1 January 2021. Studies on the long-term (defined as a mean follow-up of approximately 12 months or longer) efficacy and safety outcomes of combined ablation and LAAC were included.Results: A total of 16 studies comprising 1428 patients were enrolled. The pooled long-term freedom rate from atrial arrhythmia was 0.66 (95% confidence interval[CI]: 0.59-0.71), long-term successful rate sealing of LAAC was 1.00 (95% CI:1.00-1.00), and ischemic stroke/transient ischemic attack/systemic embolism during follow-up was 0.01 (95% CI: 0.00-0.02). Meanwhile, of the periprocedural adverse events, phrenic nerve palsy, intracoronary air embolus, device embolization, and periprocedural death had a rate of 0.00 (95% CI: 0.00-0.00), procedure-related bleeding events of 0.03 (95% CI: 0.02-0.04), and pericardial effusion requiring or not requiring intervention of 0.00 (95% CI: 0.00-0.01). Moreover, for the long-term adverse events, device dislocation, intracranial bleeding, pericardial effusion requiring or not requiring intervention, and all-cause mortality had a rate of 0.00 (95% CI: 0.00-0.00), device embolization of 0.01 (95% CI: 0.00-0.01), and other bleeding events of 0.01 (95% CI: 0.00-0.03). Conclusion:This meta-analysis suggests that the combined atrial ablation and LAAC is an effective and safe strategy with long-term benefits.

show abstract

Section: Discussioncontrasting

confidence: 59%

The long‐term efficacy and safety of combining ablation and left atrial appendage closure: A systematic review and meta‐analysis

Sun

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…The myocardial hypertrophy commonly observed in high performance athletes may degenerate in fibrosis remodeling [64]. Furthermore, the severity extent in which fibrosis affects the cardiac function can be submitted to the interaction with multiple factors, such as, genetic conditions [65], gender [66] and ageing [67]. Moreover, in an AF scenario, the presence of fibrosis is expected to increase the proarrhythmic risk [15,18,[68][69][70].…”

Section: Discussionmentioning

confidence: 99%

The Effects of Fibrotic Cell Type and Its Density on Atrial Fibrillation Dynamics: An In Silico Study

Palacio

Ugarte

Sáiz

et al. 2021

Cells

View full text Add to dashboard Cite

Remodeling in atrial fibrillation (AF) underlines the electrical and structural changes in the atria, where fibrosis is a hallmark of arrhythmogenic structural alterations. Fibrosis is an important feature of the AF substrate and can lead to abnormal conduction and, consequently, mechanical dysfunction. The fibrotic process comprises the presence of fibrotic cells, including fibroblasts, myofibroblasts and fibrocytes, which play an important role during fibrillatory dynamics. This work assesses the effect of the diffuse fibrosis density and the intermingled presence of the three types of fibrotic cells on the dynamics of persistent AF. For this purpose, the three fibrotic cells were electrically coupled to cardiomyocytes in a 3D realistic model of human atria. Low (6.25%) and high (25%) fibrosis densities were implemented in the left atrium according to a diffuse fibrosis representation. We analyze the action potential duration, conduction velocity and fibrillatory conduction patterns. Additionally, frequency analysis was performed in 50 virtual electrograms. The tested fibrosis configurations generated a significant conduction velocity reduction, where the larger effect was observed at high fibrosis density (up to 82% reduction in the fibrocytes configuration). Increasing the fibrosis density intensifies the vulnerability to multiple re-entries, zigzag propagation, and chaotic activity in the fibrillatory conduction. The most complex propagation patterns were observed at high fibrosis densities and the fibrocytes are the cells with the largest proarrhythmic effect. Left-to-right dominant frequency gradients can be observed for all fibrosis configurations, where the fibrocytes configuration at high density generates the most significant gradients (up to 4.5 Hz). These results suggest the important role of different fibrotic cell types and their density in diffuse fibrosis on the chaotic propagation patterns during persistent AF.

show abstract

“…Auch bei Herzrhythmusstörungen mit Vorhofflimmern als der häufigsten Form, gibt es Unterschiede zwischen den Geschlechtern. So erkranken zwar mehr Männer an Vorhofflimmern, Frauen leiden jedoch häufiger unter einem symptomatischen Verlauf [7]. Dennoch erhalten sie seltener eine interventionelle Therapie.…”

Section: Manifestation Und Symptomeunclassified