2024
Atrial cardiomyopathy revisited—evolution of a concept: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS)
Goette A, Corradi D, Dobrev D, Aguinaga L, Cabrera J, Chugh S, de Groot J, Soulat-Dufour L, Fenelon G, Hatem S, Jalife J, Lin Y, Lip G, Marcus G, Murray K, Pak H, Schotten U, Takahashi N, Yamaguchi T, Zoghbi W, Nattel S, Mont L, Akar J, Akoum N, Althoff T, Diaz J, Guichard J, Jadidi A, Kalman J, Lim H, Teixeira R. Atrial cardiomyopathy revisited—evolution of a concept: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asian Pacific Heart Rhythm Society (APHRS), and the Latin American Heart Rhythm Society (LAHRS). EP Europace 2024, 26: euae204. PMID: 39077825, PMCID: PMC11431804, DOI: 10.1093/europace/euae204.Peer-Reviewed Original ResearchMeSH KeywordsAction PotentialsAtrial FibrillationCardiomyopathiesConsensusHeart AtriaHeart RateHumansPrognosisTerminology as TopicConceptsEuropean Heart Rhythm AssociationLatin American Heart Rhythm SocietyHeart Rhythm SocietyClinical consensus statementAtrial fibrillationConsensus statementDevelopment of atrial fibrillationConsensus documentAtrial cardiomyopathyStaging systemElectrophysiological changesClinical validationExpert working groupAtrial geometryHeartObservational study protocol for an arrhythmia notification feature
Kumar S, Weinstein J, Melchinger H, Smith A, Capodilupo E, Akar J, Garg K, O’Connor K, Staunton M, Martin M, Akhlaghi N, Edeh O, Perez S, Lee V, Lee K, Wilson F. Observational study protocol for an arrhythmia notification feature. BMJ Open 2024, 14: e075110. PMID: 38830741, PMCID: PMC11149124, DOI: 10.1136/bmjopen-2023-075110.Peer-Reviewed Original ResearchConceptsAtrial fibrillationInstitution of appropriate treatmentGold standardClinical research journalsAssessment of risk factorsObservational study protocolRecruited participantsEthics BoardGeneral populationDiagnosed AFHealthy controlsPrimary outcomeAppropriate treatmentStudy protocolRisk factorsConsent documentsWHOOP strapParticipantsArrhythmiasDetect AFWearable technology
2023
Atrial fibrosis by cardiac MRI is a correlate for atrial stiffness in patients with atrial fibrillation
Lamy J, Taoutel R, Chamoun R, Akar J, Niederer S, Mojibian H, Huber S, Baldassarre L, Meadows J, Peters D. Atrial fibrosis by cardiac MRI is a correlate for atrial stiffness in patients with atrial fibrillation. The International Journal Of Cardiovascular Imaging 2023, 40: 107-117. PMID: 37857929, PMCID: PMC11378145, DOI: 10.1007/s10554-023-02968-x.Peer-Reviewed Original ResearchMeSH KeywordsAtrial FibrillationCatheter AblationContrast MediaFibrosisGadoliniumHeart AtriaHumansMagnetic Resonance ImagingPredictive Value of TestsConceptsLate gadolinium enhancementLA reservoir strainLeft atrial pressureLA volumeReservoir strainLA fibrosisLA strainStiffness indexLA late gadolinium enhancementAtrial stiffness indexMaximal LA volumeAtrial fibrillation cohortLA minimum volumeAtrial tissue fibrosisMaximum LA volumeCardiac MR examsAtrial stiffnessAtrial strainAF ablationAtrial pressureAF cohortAtrial fibrillationAtrial fibrosisPatient subgroupsLGE volumePPP1R12C Promotes Atrial Hypocontractility in Atrial Fibrillation
Perike S, Gonzalez-Gonzalez F, Abu-Taha I, Damen F, Hanft L, Lizama K, Aboonabi A, Capote A, Aguilar-Sanchez Y, Levin B, Han Z, Sridhar A, Grand J, Martin J, Akar J, Warren C, Solaro R, Ong S, Darbar D, McDonald K, Goergen C, Wolska B, Dobrev D, Wehrens X, McCauley M. PPP1R12C Promotes Atrial Hypocontractility in Atrial Fibrillation. Circulation Research 2023, 133: 758-771. PMID: 37737016, PMCID: PMC10616980, DOI: 10.1161/circresaha.123.322516.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsAtrial FibrillationHeart AtriaHumansMicePhosphorylationProtein Phosphatase 1StrokeConceptsSinus rhythm controlsAtrial hypocontractilityAF inducibilityAtrial contractilityAtrial fibrillationRhythm controlHuman patientsRight atrial appendage tissuePacing-induced AFThromboembolic stroke riskAtrial ejection fractionAtrial appendage tissueAtrial HL-1 cellsHL-1 cellsAtrial strainStroke riskAtrial sizeEjection fractionContractile functionElectrophysiology studyHypocontractilityWestern blotPatientsAtrial myosin light chainSarcomere functionPredicting Malignant Ventricular Arrhythmias Using Real-Time Remote Monitoring
Ginder C, Li J, Halperin J, Akar J, Martin D, Chattopadhyay I, Upadhyay G. Predicting Malignant Ventricular Arrhythmias Using Real-Time Remote Monitoring. Journal Of The American College Of Cardiology 2023, 81: 949-961. PMID: 36889873, DOI: 10.1016/j.jacc.2022.12.024.Peer-Reviewed Original ResearchConceptsAppropriate device therapyMalignant ventricular arrhythmiasDevice therapyVentricular arrhythmiasImplantable cardioverter-defibrillator therapyLogistic regressionSeparate multivariable logistic regressionsLead impedanceAppropriate ICD therapyCardioverter-defibrillator therapyCardiac resynchronization therapyMultivariable logistic regressionRemote monitoring dataShock lead impedanceAtrial lead impedanceICD therapyHeart failureResynchronization therapyAppropriate therapyAtrial tachyarrhythmiasVentricular tachycardiaVentricular fibrillationDefibrillator devicesHeart ratePatientsInitial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures
Hsu J, Darden D, Du C, Marine J, Nichols S, Marcus G, Natale A, Noseworthy P, Selzman K, Varosy P, Masoudi F, Freeman J, Curtis J, Akar J, Kowey P. Initial Findings From the National Cardiovascular Data Registry of Atrial Fibrillation Ablation Procedures. Journal Of The American College Of Cardiology 2023, 81: 867-878. PMID: 36858707, DOI: 10.1016/j.jacc.2022.11.060.Peer-Reviewed Original ResearchMeSH KeywordsAgedAtrial FibrillationCardiovascular SystemFemaleHospital MortalityHumansMaleMiddle AgedProspective StudiesRegistriesConceptsAtrial fibrillation ablation proceduresAblation RegistryHospital outcomesAblation proceduresSuccessful pulmonary vein isolationNational Cardiovascular Data RegistryOutcomes of patientsProspective cohort studyMajority of patientsPulmonary vein isolationEvidence-based guidelinesDifferent patient outcomesReal-world prevalenceProcedural admissionsHospital deathAF ablationCohort studyPericardial effusionVein isolationHeart failureLarge multicenterMajor complicationsCatheter ablationTreatment patternsPatient population
2022
Sex-based differences in atrial fibrillation ablation adverse events
Mszar R, Friedman D, Ong E, Du C, Wang Y, Zeitler E, Cunningham S, Akar J, Curtis J, Freeman J. Sex-based differences in atrial fibrillation ablation adverse events. Heart 2022, 109: 595-605. PMID: 36104219, DOI: 10.1136/heartjnl-2022-321192.Peer-Reviewed Original ResearchMeSH KeywordsAdultAtrial FibrillationCatheter AblationCohort StudiesFemaleHumansLungMaleQuality of LifeTreatment OutcomeConceptsAcute pulmonary vein isolationAdverse eventsPulmonary vein isolationAtrial fibrillationHigh riskSex-based differencesVein isolationCatheter ablationFemale sexLarge prospective registryHospital adverse eventsMajor adverse eventsObservational cohort studyPhrenic nerve damageAF ablation proceduresQuality of lifeAblation RegistryMore comorbiditiesProspective registryAF ablationCohort studyPericardial effusionNerve damagePatient sexVascular injury
2020
Understanding tricuspid valve remodelling in atrial fibrillation using three-dimensional echocardiography.
Ortiz-Leon XA, Posada-Martinez EL, Trejo-Paredes MC, Ivey-Miranda JB, Pereira J, Crandall I, DaSilva P, Bouman E, Brooks A, Gerardi C, Ugonabo I, Chen W, Houle H, Akar JG, Lin BA, McNamara RL, Lombo-Lievano B, Arias-Godinez JA, Sugeng L. Understanding tricuspid valve remodelling in atrial fibrillation using three-dimensional echocardiography. European Heart Journal - Cardiovascular Imaging 2020, 21: 747-755. PMID: 32372089, DOI: 10.1093/ehjci/jeaa058.Peer-Reviewed Original ResearchMeSH KeywordsAtrial FibrillationEchocardiography, Three-DimensionalHeart AtriaHumansTricuspid ValveTricuspid Valve InsufficiencyConceptsLeft heart diseaseSevere tricuspid regurgitationTricuspid regurgitationAtrial fibrillationTransoesophageal echocardiographyBiatrial dilatationHigher systolic pulmonary artery pressureNormal right ventricular sizeSystolic pulmonary artery pressureImpact of AFSevere functional tricuspid regurgitationTricuspid annulus dilationPulmonary artery pressureRight ventricular sizeFunctional tricuspid regurgitationFractional area changeTA fractional area changeThree-dimensional echocardiographyRV enlargementArtery pressureBiventricular functionTricuspid valveVentricular sizeAF groupSinus rhythm3-Dimensional Transseptal Puncture Based on Electrographic Characteristics of Fossa Ovalis A Fluoroscopy-Free and Echocardiography-Free Method
Yu R, Liu N, Lu J, Zhao X, Hu Y, Zhang J, Xu F, Tang R, Bai R, Akar JG, Dong J, Ma C. 3-Dimensional Transseptal Puncture Based on Electrographic Characteristics of Fossa Ovalis A Fluoroscopy-Free and Echocardiography-Free Method. JACC Cardiovascular Interventions 2020, 13: 1223-1232. PMID: 32438994, DOI: 10.1016/j.jcin.2020.03.015.Peer-Reviewed Original ResearchConceptsAtrial fibrillation ablationFossa ovalisElectrographic characteristicsFibrillation ablationElectroanatomic mappingTransseptal puncture techniqueMajor complicationsRight atriumAncillary imagingAtrial potentialsCatheter connectionsTransseptal needleTransseptal punctureElectrogram voltageIntracardiac echocardiographyElectroanatomic mapsPuncture techniqueEchocardiographyFos mappingPatientsFluoroscopyAblationComplicationsPrecise localizationAtriumThe NCDR Left Atrial Appendage Occlusion Registry
Freeman JV, Varosy P, Price MJ, Slotwiner D, Kusumoto FM, Rammohan C, Kavinsky CJ, Turi ZG, Akar J, Koutras C, Curtis JP, Masoudi FA. The NCDR Left Atrial Appendage Occlusion Registry. Journal Of The American College Of Cardiology 2020, 75: 1503-1518. PMID: 32238316, PMCID: PMC7205034, DOI: 10.1016/j.jacc.2019.12.040.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAtrial AppendageAtrial FibrillationEndovascular ProceduresFemaleHumansMaleRegistriesStrokeConceptsHospital adverse event ratesAdverse event ratesEvent ratesMean HAS-BLED scoreHAS-BLED scoreHospital adverse eventsMean patient ageAtrial appendage occlusionMedian annual numberMajor bleedingMean CHAMore comorbiditiesVASc scoreWATCHMAN procedureAdverse eventsCommon complicationPatient agePericardial effusionPivotal trialsAppendage occlusionRandomized trialsAtrial fibrillationPatient populationPresent patientPhysician characteristicsPredictors of Cardiac Perforation With Catheter Ablation of Atrial Fibrillation
Friedman DJ, Pokorney SD, Ghanem A, Marcello S, Kalsekar I, Yadalam S, Akar JG, Freeman JV, Goldstein L, Khanna R, Piccini JP. Predictors of Cardiac Perforation With Catheter Ablation of Atrial Fibrillation. JACC Clinical Electrophysiology 2020, 6: 636-645. PMID: 32553212, DOI: 10.1016/j.jacep.2020.01.011.Peer-Reviewed Original ResearchMeSH KeywordsAgedAtrial FibrillationCatheter AblationFemaleHumansMedicareRisk FactorsTreatment OutcomeUnited StatesConceptsPrevious cardiac surgeryCardiac perforationAF ablationIntracardiac echocardiographyCardiac surgeryFemale sexDiagnosis of hemopericardiumPatient risk factorsSubset of patientsAtrial fibrillation ablationContemporary clinical practiceIntraprocedural intracardiac echocardiographyLogistic regression modelsCardiac tamponadeFatal complicationProcedural complicationsRare complicationCatheter ablationFibrillation ablationAtrial fibrillationModifiable factorsRisk factorsProcedural safetyRisk scoreLower risk
2019
Recurrence quantification analysis of complex‐fractionated electrograms differentiates active and passive sites during atrial fibrillation
Baher A, Buck B, Fanarjian M, Mounsey J, Gehi A, Chung E, Akar FG, Webber CL, Akar JG, Hummel JP. Recurrence quantification analysis of complex‐fractionated electrograms differentiates active and passive sites during atrial fibrillation. Journal Of Cardiovascular Electrophysiology 2019, 30: 2229-2238. PMID: 31507008, DOI: 10.1111/jce.14161.Peer-Reviewed Original Research
2018
Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus
Hummel JP, Kadado AJ, Baker M, Gehi AK, Mounsey JP, Sadaf MI, Enriquez AD, Freeman JV, Akar JG. Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus. Circulation Arrhythmia And Electrophysiology 2018, 11: e006814. PMID: 30562101, DOI: 10.1161/circep.118.006814.Peer-Reviewed Original ResearchLuminal esophageal temperature monitoring to reduce esophageal thermal injury during catheter ablation for atrial fibrillation: A review
Kadado AJ, Akar JG, Hummel JP. Luminal esophageal temperature monitoring to reduce esophageal thermal injury during catheter ablation for atrial fibrillation: A review. Trends In Cardiovascular Medicine 2018, 29: 264-271. PMID: 30282588, DOI: 10.1016/j.tcm.2018.09.010.Peer-Reviewed Original ResearchPostoperative Atrial Fibrillation and Maslow’s Hammer
Kadado AJ, Freeman J, Akar JG. Postoperative Atrial Fibrillation and Maslow’s Hammer. Anesthesia & Analgesia 2018, 126: 19-20. PMID: 29252478, DOI: 10.1213/ane.0000000000002414.Peer-Reviewed Original Research
2017
Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes
Karam BS, Chavez-Moreno A, Koh W, Akar JG, Akar FG. Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes. Cardiovascular Diabetology 2017, 16: 120. PMID: 28962617, PMCID: PMC5622555, DOI: 10.1186/s12933-017-0604-9.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsAntioxidantsAtrial FibrillationDiabetes MellitusHumansInflammationInflammation MediatorsObesityOxidative StressConceptsAtrial fibrillationOxidative stressCommon sustained cardiac arrhythmiaMaintenance of AFSustained cardiac arrhythmiaDiabetic heartElectrical remodelingRisk factorsAtrial excitabilityTherapeutic strategiesCardiac arrhythmiasInflammationCentral mediatorObesityDiabetesFibrillationMechanistic linkMellitusArrhythmiasExcitability2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary
Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Wyn Davies D, Day JD, d’Avila A, de Groot N, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary. Journal Of Interventional Cardiac Electrophysiology 2017, 50: 1-55. PMID: 28914401, PMCID: PMC5633646, DOI: 10.1007/s10840-017-0277-z.Peer-Reviewed Original Research2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen J, Curtis AB, Davies DW, Day JD, d’Avila A, de Groot N, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T, Blomström-Lundqvist C, De Paola A, Kistler P, Lip G, Peters N, Pisani C, Raviele A, Saad E, Satomi K, Stiles M, Willems S. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. EP Europace 2017, 20: e1-e160. PMID: 29016840, PMCID: PMC5834122, DOI: 10.1093/europace/eux274.Peer-Reviewed Original Research2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary
Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Davies DW, Day JD, d'Avila A, de Groot NMSN, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary. EP Europace 2017, 20: 157-208. PMID: 29016841, PMCID: PMC5892164, DOI: 10.1093/europace/eux275.Peer-Reviewed Original ResearchA method for quantifying recurrent patterns of local wavefront direction during atrial fibrillation
Hummel JP, Baher A, Buck B, Fanarjian M, Webber CL, Akar JG. A method for quantifying recurrent patterns of local wavefront direction during atrial fibrillation. Computers In Biology And Medicine 2017, 89: 497-504. PMID: 28889077, DOI: 10.1016/j.compbiomed.2017.08.027.Peer-Reviewed Original Research