Cardiac arrhythmias are a growing global health concern, and the need for accessible, continuous monitoring has driven rapid advancements in wearable technologies. This review explores the evolution, capabilities, and clinical impact of modern wearables for arrhythmia detection, including smartwatches, smart rings, ECG patches, and smart textiles. In light of the recent surge in commercially available wearables across all categories, this review offers a detailed comparative analysis of leading devices, evaluating cost, regulatory approval, model specifications, and system compatibility. Smartwatches and patches, in particular, show a strong performance in atrial fibrillation detection, with patches outperforming Holter monitors in long-term monitoring and diagnostic yield. This review highlights a paradigm shift toward patient-initiated diagnostics but also discusses challenges such as false positives, regulatory gaps, and healthcare integration. Overall, wearable devices hold significant promise for reshaping arrhythmia management through early detection and remote monitoring.

Background and objectives: Atrial fibrillation (AF), the most prevalent sustained arrhythmia, poses a significant public health challenge due to its links with stroke, heart failure, and mortality. Hypertension, a primary modifiable cardiovascular risk factor, is a well-established risk factor for AF that facilitates structural and electrical changes in the atria, including dilation, fibrosis, and pressure overload. Material and Methods: we conducted a literature search regarding the shared mechanisms, risks and treatments of hypertension and atrial fibrillation. Results: The renin–angiotensin–aldosterone system plays a pivotal role in this remodelling and inflammation, increasing AF susceptibility. Uncontrolled hypertension complicates AF management, diminishing the effectiveness of mainstay treatments, including antiarrhythmic drugs, catheter ablation, and cardioversion. Effective blood pressure management, particularly with therapies targeting the renin–angiotensin–aldosterone system (RAAS), can lower the risk of new-onset AF and reduce the incidence of recurrent AF, enhancing the success of rhythm control strategies. These antihypertensive therapies mitigate myocardial hypertrophy and fibrosis and attenuate both atrial pressure strain and the inflammatory response, mitigating the substrates for AF. Conclusion: This review highlights the urgent need for integrated strategies that combine BP control, AF screening, and lifestyle modifications to minimise the burden of AF and its complications. Future research should investigate the specific mechanisms of cellular-level interactions associated with a hypertensive predisposition to AF, including systematic inflammation and the role of genetics, the impact of blood pressure variations on AF risk, and individualised treatment strategies specifically targeting the shared mechanisms, simultaneously propagating hypertension and AF.

Aims: Atrioventricular node ablation (AVNA) with permanent pacemaker implantation is an established rate-control treatment approach for patients with AF with uncontrolled ventricular rates. Conduction system pacing (CSP) utilizing His bundle pacing (HBP) or left bundle branch area pacing (LBBAP) has advanced as a treatment alternative to standard right ventricular pacing in addition to biventricular pacing (BVP). This systematic review and meta-analysis aim to provide a comprehensive summary and evaluation of clinical outcomes in the literature for CSP in comparison to BVP in conjunction with AVNA. Methods and results: This study protocol was registered in the PROSPERO registry (CRD42024510974), and the review was conducted as per the PRISMA guidelines. Databases were searched for relevant studies from inception till 11 January 2024. Results were synthesized using a random effects meta-analysis. From a total of 259 references identified, 122 full texts were assessed, and 25 studies were included in the systematic review. Of these included studies, five were used for comparative meta-analysis. A total of 1652 (HBP 1069 and LBBAP 644) and 369 patients received CSP and BVP implantation with AVNA, respectively. Conduction system pacing resulted in a narrower QRS duration (QRSd) with a change of −35.8 ms (95% CI −61.8 to −9.72; P < 0.05; I2 = 96.3%) vs. BVP. Conduction system pacing also resulted in better symptomatic improvement in from of NYHA reduction (MD −0.53, 95% CI −1.01 to −0.04, I2 = 62.1; P = 0.03). For left ventricular ejection fraction, a non-significant weighted mean increases of 3.36% (95% CI −0.75–7.47%; P = 0.11, I2 = 68.5%) was observed following CSP implantation in comparison to BVP. Conduction system pacing showed no significant differences in procedural and fluoroscopy times and had comparable periprocedural complications. His bundle pacing demonstrated a non-significant reduction in the events of acute threshold elevation in comparison to BVP (Log odds ratio −0.69, 95% CI −2.05–0.66, I2 = 0.00; P = 0.32). Conclusion: Conduction system pacing with AVNA is a safe and feasible treatment option for symptomatic (AF) patients undergoing a pace and ablate strategy, offering an alternative to BVP. Overall, CSP results in a narrower QRS duration while providing comparable clinical and echocardiographic outcomes.

Background: Pulmonary vein isolation (PVI) is an effective management method for paroxysmal atrial fibrillation (PAF). The P wave in the 12-lead electrocardiogram (ECG) represents atrial depolarisation. This study aims to utilise the P wave to predict PVI outcomes for PAF. Methods: This single-centre retrospective study aimed to predict PVI outcomes using P wave parameters. It included 211 consecutive patients with first PVI for PAF between 2018 and 2019 and targeted the pulmonary veins (PVs). Procedure success was defined by freedom of ECG-documented AF at 12 months. Digital 12-lead ECGs with 1–50 hertz bandpass filters were monitored before the procedure. Corrected P wave duration (PWDc), P wave amplitude (PWV), P wave dispersion (PWDisp), intra-atrial block (IAB), P wave area (PWA), and P wave terminal force in V1 (PTFV1) were measured before ablation and correlated with the outcomes. Results: Successful PVI occurred in 154 patients (73%). Demographics were similar between both arms. P wave parameters correlated with PVI failure included increased PWDc in all leads except for lead III, aVR, and V3, decreased PWV in lead I (hazard ratio [HR]: 0.7, 95% confidence interval [CI]: 0.53–0.95), lead II (HR: 0.45, 95% CI: 0.22–0.65), aVL (HR: 0.58, 95% CI: 0.22–0.98), and aVF (HR: 0.67, 95% CI: 0.58–0.87), decreased PWA in lead I (HR: 0.55, 95% CI: 0.21–0.76), lead II (HR: 0.48, 95% CI: 0.34–0.87), aVL (HR: 0.65, 95% CI: 0.45–0.96), and aVF (HR: 0.61, 95% CI: 0.32–0.89), and the presence of IAB (HR: 2, 95% CI: 1.4–4.2, p = 0.02). PWDisp and PTFV1 were not correlated with PVI outcome. Conclusions: PWDc, PWA, PWV, and IAB are valuable predictors for PVI outcome for PAF at 12 months.

Yemen is one of the poorest countries in the world. It suffers from a genuine crisis in all areas, the most important of which is the health sector. Yemen has been suffering from conflicts for the last six years, and a high percentage of the population is dependent on international aid. After the worldwide spread of the SARS-CoV-2 virus, the virus that causes Coronavirus Disease 2019 (COVID-19), the first laboratory-confirmed case was announced in Yemen on April 10, 2020. Since then, as of 22 December 2020, 2,091 confirmed cases and 607 deaths have been reported. These numbers are not trustworthy because many cases are hidden by Houthi rebels (14). Citizens took the necessary precautions out of fear of infection, such as imposing quarantines, closing airports, and restricting public gatherings (1,8,14). Quarantines are only imposed in some cities in the southern part of the country, while the part controlled by Houthi rebels is not well organized in terms of imposing quarantines, and schools were opened due to the lack of technical devices and internet for online education.