Atrial fibrillation (AF) is the most frequent arrhythmia managed in clinical practice, and it is linked to an increased risk of death, stroke, and peripheral embolism. The Global Burden of Disease shows that the estimated prevalence of AF is up to 33.5 million patients. So far, successful therapeutic techniques have been implemented, with a high health-care cost burden. As a result, identifying modifiable risk factors for AF and suitable preventive measures may play a significant role in enhancing community health and lowering health-care system expenditures. Several mechanisms, including electrical and structural remodeling of atrial tissue, have been proposed to contribute to the development of AF. This review article discusses the predisposing factors in AF including the different pathogenic mechanisms, sedentary lifestyle, and dietary habits, as well as the potential genetic burden.

The European Union's Artificial Intelligence Act (AI Act), published in July 2024, is a pioneering horizontal regulatory framework aimed at ensuring the ethical and safe integration of AI technologies across sectors, including healthcare. While it offers the potential to improve patient care and drive innovation, it also presents challenges for healthcare providers, such as identifying high-risk applications, ensuring transparency in algorithms, and mitigating data bias. However, there are several challenges in its implementation. These include unclear guidance for certain technologies, the need to ensure fairness for diverse patient populations, effective monitoring of AI performance after deployment, and clarifying responsibility in cases of errors. Additionally, varying levels of resources among EU countries may lead to inconsistent implementation of the regulations. This article explores the core elements of the AI Act and its relevance to cardiology and identifies key gaps and unanswered questions that need to be addressed to effectively advance AI-driven medical practices.

Atrial fibrillation (AFib), the most prevalent arrhythmia in clinical practice, presents a growing global health concern, particularly with the aging population, as it is associated with devastating complications and an impaired quality of life. Its pathophysiology is multifactorial, including the pathways of fibrosis, inflammation, and oxidative stress. MicroRNAs (miRNAs), small non-coding RNA molecules, have emerged as substantial contributors in AFib pathophysiology, by affecting those pathways. In this review, we explore the intricate relationship between miRNAs and the aforementioned aspects of AFib, shedding light on the molecular pathways as well as the potential diagnostic applications. Recent evidence also suggests a possible role of miRNA therapeutics in maintenance of sinus rhythm via the antagonism of miR-1 and miR-328, or the pharmacological upregulation of miR-27b and miR-223-3p. Unraveling the crosstalk between specific miRNA profiles and genetic predispositions may pave the way for personalized therapeutic approaches, setting the tone for precision medicine in atrial fibrillation.

Over the many centuries that lie between Hippocrates and modern clinical practice, medicine—and clinical medicine in particular—has undergone dramatic progress. Numerous and varied contributions made by individuals and groups to clinical observation, rigorous experiment, and the systematic study of pathophysiology and therapeutics over the whole range of known diseases have transformed our profession.

Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice and is associated with significant morbidity and mortality. Even though catheter ablation has emerged as an available and effective treatment for AF, recurrence remains a significant challenge. This review presents the existing evidence on the prognostic role of microRNAs (miRNAs) in the prediction of AF recurrence after catheter ablation. We examined studies investigating the association between miRNA expression and post-ablation AF recurrence. Multiple miRNAs have been highlighted as potential biomarkers, which are involved in pathophysiological processes such as atrial remodeling, fibrosis, and inflammation. Despite some promising results, there has been significant heterogeneity across the studies. In this review, we demonstrate the potential miRNAs that can be routinely used as biomarkers of AF recurrence, and we identify areas that require further research to validate their clinical utility.

New-onset postoperative atrial fibrillation (POAF) after coronary artery bypass surgery (CABG) occurs with an incidence of 20-40%. The clinical relevance of POAF remains a concern and the need for further studies regarding the clinical management of POAF is necessary. The AFRODITE study, a prospective multicenter cohort study, had as its primary endpoint the evaluation of AF recurrence in patients post CABG over a one-year period. Two hundred twenty-eight patients aged >50 years who underwent isolated CABG were included in the study. Patients were stratified into two groups, POAF and non-POAF, and followed for 12 months for AF recurrence, hospitalizations and death. Two hundred twenty-eight patients (mean age 67 years, 88.6% male) were included in the study. The 28.5% of patients experienced at least one episode of POAF during index hospitalization (POAF group) and were compared with the non-POAF group (n=163). Multivariate stepwise logistic regression analysis showed that the strongest prognostic parameter for POAF was the CHA₂DS₂-Vasc score (odds ratio=1.61, p<0.001). POAF patients had a worse in-hospital outcome but the incidence of long-term AF recurrence was not statistically different (3.6% vs 4.8%, p=0.9). Interestingly, a one-year prospective follow-up of patients in the study did not reveal significant differences between POAF and non-POAF patients. A notable finding was that patients with a higher CHA₂DS₂-Vasc score were more likely to develop POAF.