ISSN 1671-5411 CN 11-5329/R

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2017 Vol. 14, No. 3

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Atrial fibrillation in the elderly
Manuel Martinez-Selles, Antonio Bayes de Luna
2017, 14(3): 155-157. doi: 10.11909/j.issn.1671-5411.2017.03.012
Prevalence and incidence of interatrial block in global population and in different clinical situations
Manuel Martinez-Selles
2017, 14(3): 158-160. doi: 10.11909/j.issn.1671-5411.2017.03.006
Diagnosis of interatrial block
Antoni Bayes de Luna, Adrian Baranchuk, Luis Alberto Escobar Robledo, Albert Masso van Roessel, Manuel Martinez-Selles
2017, 14(3): 161-165. doi: 10.11909/j.issn.1671-5411.2017.03.007
Anticoagulation in elderly patients at high risk of atrial fibrillation without documented arrhythmias
Manuel Martinez-Selles, Eusebio Garcia-Izquierdo Jaen, Ignacio Fernandez Lozano
2017, 14(3): 166-168. doi: 10.11909/j.issn.1671-5411.2017.03.004
Advanced interatrial block as a key marker for atrial fibrillation recurrence: Bayes’ syndrome
Adrian Baranchuk, Andres Enriquez, Pavel Antiperovitch, Bryce Alexander, Goksel Cinier
2017, 14(3): 169-173. doi: 10.11909/j.issn.1671-5411.2017.03.005
Atrial fibrosis: an obligatory component of arrhythmia mechanisms in atrial fibrillation?
Pyotr G Platonov
2017, 14(3): 174-178. doi: 10.11909/j.issn.1671-5411.2017.03.009
Predisposing factors for atrial fibrillation in the elderly
Kristina Wasmer, Lars Eckardt, Gunter Breithardt
2017, 14(3): 179-184. doi: 10.11909/j.issn.1671-5411.2017.03.010
Atrial fibrillation (AF) in the elderly occurs as a consequence of cardiovascular aging and an age related increase of comorbidity. Several predisposing factors for AF have been identified for the overall AF population. Most of them, cardiovascular disease in particular, play a role in younger and older patients. The longer time period during which these risk factors can cause structural changes that ultimately lead to AF may, at least in part, explain the association between age and AF. In addition, less well defined age-related changes in cellular electrophysiologic properties and structure predispose to AF in the elderly.
How to detect atrial fibrosis
Juan Lacalzada-Almeida, Javier Garcia-Niebla
2017, 14(3): 185-194. doi: 10.11909/j.issn.1671-5411.2017.03.008
In the last twenty years, new imaging techniques to assess atrial function and to predict the risk of recurrence of atrial fibrillation after treatment have been developed. The present review deals with the role of these techniques in the detection of structural and functional changes of the atrium and diagnosis of atrial remodeling, particularly atrial fibrosis. Echocardiography allows the detection of anatomical, functional changes and deformation of the atrial wall during the phases of the cardiac cycle. For this, adequate acquisition of atrial images is necessary using speckle tracking imaging and interpretation of the resulting strain and strain rate curves. This allows to predict new-onset atrial fibrillation and recurrences. Its main limitations are inter-observer variability, the existence of different software manufacturers, and the fact that the software used were originally developed for the evaluation of the ventricular function and are now applied to the atria. Cardiac magnetic resonance, using contrast enhancement with gadolinium, plays a key role in the visualization and quantification of atrial fibrosis. This is the established method for in vivo visualization of myocardial fibrotic tissue. The non-invasive evaluation of atrial fibrosis is associated with the risk of recurrence of atrial fibrillation and with electro-anatomical endocardial mapping. We discuss the limitations of these techniques, derived from the difficulty of demonstrating the correlation between fibrosis imaging and histology, and poor intra- and inter- observer reproducibility. The sources of discordance are described, mainly due to image acquisition and processing, and the challenges ahead in an attempt to eliminate differences between operators.
Atrial fibrillation: the current epidemic
Carlos A Morillo, Amitava Banerjee, Pablo Perel, David Wood, Xavier Jouven
2017, 14(3): 195-203. doi: 10.11909/j.issn.1671-5411.2017.03.011
Atrial fibrillation (AF) is the most common arrhythmia diagnosed in clinical practice. The consequences of AF have been clearly established in multiple large observational cohort studies and include increased stroke and systemic embolism rates if no oral anticoagulation is prescribed, with increased morbidity and mortality. With the worldwide aging of the population characterized by a large influx of “baby boomers” with or without risk factors for developing AF, an epidemic is forecasted within the next 10 to 20 years. Although not all studies support this evidence, it is clear that AF is on the rise and a significant amount of health resources are invested in detecting and managing AF. This review focuses on the worldwide burden of AF and reviews global health strategies focused on improving detection, prevention and risk stratification of AF, recently recommended by the World Heart Federation.
Transcatheter aortic valve implantation: a revolution in the therapy of elderly and high-risk patients with severe aortic stenosis
Teoman Kilic, Irem Yilmaz
2017, 14(3): 204-217. doi: 10.11909/j.issn.1671-5411.2017.03.002
Transcatheter aortic valve implantation (TAVI) represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk surgical patients with severe symptomatic aortic valve stenosis. Today, TAVI seems to play a key and a reliable role in the treatment of intermediate and maybe low-risk patients with severe aortic stenosis. TAVI has also evolved from a complex and hazardous procedure into an effective and safe therapy by the development of new generation devices. This article aims to review the background and future of TAVI, clinical trials and registries with old and new generation TAVI devices and to focus on some open issues related to post-procedural outcomes.
A rare case of single right coronary artery arising from the right sinus of valsalva with severe three-vessel disease
Saif Ibrahim, Nachiket Patel, Sayf Said, Bashar Al-Turk DO, Melissa Dakak DO, Farah Al-Saffar
2017, 14(3): 218-221. doi: 10.11909/j.issn.1671-5411.2017.03.003
Is there any link between homocysteine and atherosclerosis?
Hamza Duygu
2017, 14(3): 222-222. doi: 10.11909/j.issn.1671-5411.2017.03.001