World Heart Rhythm Week (WHRW)
5-11 June 2023
World Heart Rhythm Week (WHRW) is Arrhythmia Alliance's annual awareness week to raise awareness of arrhythmias amongst both healthcare professionals and the general public. The 2023 theme is 'Take Fainting to Heart', aims to promote awareness of the link between syncope and arrhythmias. Arrhythmia Alliance
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Diagnosis
General
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Cochrane Library
Articles
Diagnosis and screening
Research
Treatment
E-books
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Cochrane Library
Oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation
The authors found evidence to suggest that the use of Class I and/or III antiarrhythmics up to 3 months after ablation is associated with a reduced recurrence of ATa 0 to 6 months after ablation, which may not persist beyond 6 months, and an immediate reduction in hospitalisation for ATa 0 to 3 months after ablation. The evidence suggests there is no difference in rates of all‐cause mortality, thromboembolic events, or myocardial infarction between Class I and/or III antiarrhythmics versus control. Cochrane Database of Systematic Reviews – Intervention 13 March 2023
Interventions for the management of transient tachypnoea of the newborn ‐ an overview of systematic reviews
This overview summarises the evidence from six Cochrane Reviews of randomised trials regarding the effects of postnatal interventions in the management of TTN. Salbutamol may reduce the duration of tachypnoea slightly. We are uncertain as to whether salbutamol reduces the need for mechanical ventilation. We are uncertain whether epinephrine, corticosteroids, diuretics, fluid restriction, or non‐invasive respiratory support reduces the duration of tachypnoea and the need for mechanical ventilation, due to the extremely limited evidence available. Data on harms were lacking. Cochrane Database of Systematic Reviews – Intervention 24 February 2022
Interrupted versus uninterrupted anticoagulation therapy for catheter ablation in adults with arrhythmias
This meta‐analysis showed that the evidence is uncertain to inform the decision to either interrupt or continue anticoagulation therapy around CA procedure in adults with arrhythmia on outcomes of thromboembolic events, major and minor bleeding, all‐cause mortality, asymptomatic thromboembolic events, and a composite endpoint of thromboembolic events (stroke, systemic embolism, major bleeding, and all‐cause mortality). Cochrane Database of Systematic Reviews – Intervention 21 October 2021
Anticoagulation versus placebo for heart failure in sinus rhythm
Based on the three RCTs, there is no evidence that oral anticoagulant therapy modifies mortality in people with HF in sinus rhythm. The evidence is uncertain if warfarin has any effect on all‐cause death compared to placebo or no treatment, but it may increase the risk of major bleeding events. There is no evidence of a difference in the effect of rivaroxaban on all‐cause death compared to placebo. It probably reduces the risk of stroke, but probably increases the risk of major bleedings. The available evidence does not support the routine use of anticoagulation in people with HF who remain in sinus rhythm. Cochrane Database of Systematic Reviews – Intervention 18 May 2021
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Articles
Diagnosis and screening
Increasing screening for atrial fibrillation in general practice: the Atrial Fibrillation Self‐Screening, Management And guideline‐Recommended Therapy (AF Self‐SMART) study
AF self‐screening in general practice waiting rooms is a feasible approach to increasing AF screening and diagnosis rates by reducing time barriers to screening by GPs. AF self‐screening could reduce the number of AF‐related strokes. MJA 16 February 2023
Efficient ECG beats classification techniques for the cardiac arrhythmia detection based on wavelet transformation
Arrhythmia is one of the cardiovascular disease types that affect humans and often leads to death. generally, ECG signals uses to diagnose the patient’s heart state where the ECG illustrates the electrical activities and physiological state of the heart. This paper proposes ECG classification model to classify four types of heartbeats for the early detection of Arrhythmia. Detail wavelet coefficients of ECG were extracted using discrete wavelet transform (DWT) to produce new datasets of ECG with for the dimensions and processed information to ensure the efficiency of proposed classification techniques. In addition, power spectral density (PSD) has been calculated for approximate wavelet coefficients of ECG to extract more relevant features that improve the performance of the classifier. The two classifier models use, the convolution neural network (CNN) utilizes for deep learning networks with artificial neural network (ANN) and the Random forest ensemble method. The experiments and results show that, the proposed model with RF archives 98.5% classification accuracy considering all decomposition levels of DWT. Additionally, the solution with CNN-ANN achieves 96% classification accuracy at the third decomposition level. Therefore, the results show the impact of the proposed solution with high efficiency in terms of fewer dimensions and high accuracy. International journal of intelligent engineering and systems 20 April 2023
24-hour Holter monitoring for identification of an ideal Ventricular rate for a better quality of life in Atrial Fibrillation patients
Significant differences were observed in the QoL scores among Atrial fibrillation (AF) patients, with a cut-off ventricular rate (VR) of 90 bpm favoring patients with the higher rate. Hence, higher VR is better in terms of QoL among stable AF patients. Cureus 5 April 2023
Prevalence and prognostic significance of Bradyarrhythmias in patients screened for Atrial Fibrillation vs usual care: Post hoc analysis of the LOOP randomized clinical trial
Bradyarrhythmias are highly common in older persons, and while these arrhythmias may constitute risk markers, their detection and treatment is not associated with reduced incidence of clinical outcomes. JAMA 15 February 2023
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Research
Orthostatic tachycardia after covid-19
What you need to know
BMJ 24 February 2023
The Liver-Heart connection: A literature review of Liver Disease as a risk factor for Atrial Fibrillation
Atrial fibrillation (AFib) is a common type of cardiac arrhythmia, characterized by disorganized atrial electrical activity with features of irregularly irregular heart rhythm and often with rapid ventricular response increasing the risk of stroke and heart failure due to tachyarrhythmia. The pathophysiology mechanism of AFib is either triggered by atrial distension, abnormality in conducting system, catecholamine excess, or increased atrial irritation or automaticity. Risk factors include uncontrolled diabetes, obesity, obstructive sleep apnea, hypothyroidism, and certain stimulants. Based on recent research, liver disease has recently been identified as a risk factor for AFib. Considering the progression of chronic liver disease, this literature review aims to investigate and summarize the relationship between liver disease and AFib and explore clinical interventions that can be utilized to prevent AFib aggravation. Cureus 1 May 2023
Opioid agents and Cardiac Arrhythmia: A literature review
This literature review will play a role in determining the association between the use of opioids and cardiac arrhythmias. It will further highlight the practical implications of opioids for the management of cardiac issues based on their dose, frequency, and intensity. Cureus 25 April 2023
Ablation of ventricular arrhythmias in cardiogenetic diseases
Sudden cardiac death is a leading cause of mortality, claiming millions of lives every year. Recent advances in cardiac arrhythmia mapping have demonstrated that the ventricular epicardial region has a critical arrhythmogenic role in some inherited cardiogenetic diseases. Historically, electroanatomic abnormalities have been identified in the ventricular epicardium of patients with arrhythmogenic right ventricular cardiomyopathy. More recently, epicardial pathological substrates have been identified also in electrical disease (Brugada syndrome, early repolarization syndrome) and currently in long QT syndrome. In light of these findings, the epicardial area has emerged as an important determinant in sudden cardiac death-related cardiomyopathies. European heart journal 21 April 2023
Alcohol and Cardiac Arrythmias: A review of the current data
Alcohol consumption has a significant interplay with cardiac arrhythmia. Reviews in cardiovascular medicine 6 April 2023
Paroxysmal atrial fibrillation
What you need to know
BMJ 30 December 2021
Clinical profile of Atrial Fibrillation with reference to Echocardiographyo
Atrial fibrillation (AF) is more common in the age group of 21 – 50 years, more in females compared to males. Major symptoms were breathlessness & palpitation. Rheumatic heart disease was commonest cause. Echocardiography is useful to identify the etiology and complications of AF. Journal of cardiovascular disease research 28 March 2023
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Treatment
Cardioversion in patients with newly diagnosed non-valvular atrial fibrillation: observational study using prospectively collected registry data
In this large dataset of patients with recent onset non-valvular atrial fibrillation, a small proportion were treated with cardioversion. Direct current cardioversion was performed twice as often as pharmacological cardioversion, and there appeared to be no major difference in outcome events for these two cardioversion modalities. For the overall cardioversion group, after adjustments for confounders, a significantly lower risk of mortality was found in patients who received early cardioversion compared with those who did not receive early cardioversion. BMJ 27 October 2021
Efficacy and safety of an extravascular implantable cardioverter–defibrillator
In this prospective global study, we found that extravascular ICDs were implanted safely and were able to detect and terminate induced ventricular arrhythmias at the time of implantation. NEJM 6 October 2022
COVID-19 HEART unveiling as atrial fibrillation: pathophysiology, management and future directions for research
This review builds upon the current literature of COVID-19-induced A-fib, including pathophysiology, clinical presentation, treatment and complications. Furthermore, it provides recommendations for future research moving forward that can open avenues for developing novel remedies that can prevent as well as hasten clinical recovery of atrial fibrillation in COVID-19 patients. The Egyptian heart journal 30 April 2023
Heart failure with reduced ejection fraction: What’s new in the 2022 guideline?
The 2022 guideline from the American College of Cardiology, American Heart Association, and Heart Failure Society of America provides practical recommendations for preventing, diagnosing, and managing patients with heart failure. This article summarizes the most important of these recommendations, specifically for managing patients with heart failure with reduced ejection fraction (HFrEF), and how they should change daily practice. Cleveland Clinic journal of medicine 1 April 2023
Epinephrine before defibrillation in patients with shockable in-hospital cardiac arrest: propensity matched analysis
Contrary to current guidelines that prioritize immediate defibrillation for in-hospital cardiac arrest due to a shockable rhythm, one in five patients are treated with epinephrine before defibrillation. Use of epinephrine before defibrillation was associated with worse survival outcomes. BMJ 10 November 2023
Standard vs augmented ablation of paroxysmal Atrial Fibrillation for reduction of Atrial Fibrillation recurrence: The AWARE randomized clinical trial
In this randomized clinical trial of patients with paroxysmal AF, additional ablation by performing a double ablation lesion set did not result in improved freedom from recurrent AA compared with a standard single ablation set. JAMA 24 March 2023
Early versus later Anticoagulation for stroke with Atrial Fibrillation
In this trial, the incidence of recurrent ischemic stroke, systemic embolism, major extracranial bleeding, symptomatic intracranial hemorrhage, or vascular death at 30 days was estimated to range from 2.8 percentage points lower to 0.5 percentage points higher (based on the 95% confidence interval) with early than with later use of direct oral anticoagulants (DOACs). NEJM 24 May 2023
Progression of Atrial Fibrillation after Cryoablation or drug therapy
Initial treatment of paroxysmal atrial fibrillation with catheter cryoballoon ablation was associated with a lower incidence of persistent atrial fibrillation or recurrent atrial tachyarrhythmia over 3 years of follow-up than initial use of antiarrhythmic drugs. NEJM 12 January 2023
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