Background: Epicardial adipose tissue (EAT) has been considered as one of the probable triggers of atrial fibrillation (AF). CT‐rediomics is a perspective noninvasive method of assessment of EAT. We evaluate the radiomic phenotype of EAT in patients with lone AF in the prognosis of AF recurrence after catheter ablation.Methods: A total of 43 patients with lone AF referred for CA and 20 out‐hospital patients without arrhythmia underwent multidetector computed tomography coronary angiography. Segmentation of EAT and extraction radiomic features were performed on calcium scoring series using by 3D‐Slicer. Clinical follow‐up was performed for 12 months period after the CA.Results: EAT in patients with lone AF had a distinct radiomic phenotype. Thus, 45 of 93 calculated radiomic features, volume and attenuation of EAT were significantly different between patients with lone AF and persons without any arrhythmia. In addition, 17 radiomic features were significantly different in subgroups with and without AF recurrence. Multivariate regression analysis demonstrated that only gray level nonuniformity normalized (GLSZM) was an independent predictor of AF recurrence (OR 1.0027, 95%CI 1.0009–1.0044, p = 0.002). ROC analysis data showed that GLSZM >1227.4 indicates high probability of AF recurrence during 12 months (sensitivity 89.4%, specificity 70.8%, AUC: 0.809; p = 0.001).Conclusion: The radiomic parameter GLSZM is associated with late AF recurrence after CA in patients with lone AF. In current study GLSZM was a stronger predictor of lone AF recurrence in multivariate analysis comparing with other established risk factors and EAT volume and attenuation.

Aim To evaluate efficacy and safety of the anticoagulant therapy in patients with atrial fibrillation (AF) during a 36-month follow-up after an interventional treatment. Material and methods This study included 302 patients aged 29 to 81 years with various forms of AF. Catheter ablation (CA) of AF foci was performed for all patients. The patients were divided into 3 groups: group 1 with paroxysmal AF, group 2 with persistent AF, and group 3 with longstanding persistent AF. Two subgroups were isolated in each group, with effective and ineffective CA. Results of the follow-up were analyzed at 12, 24, and 36 months after discharge from the hospital. The follow-up interview recorded complaints of palpitation attacks, effectiveness of administered CA, compliance with the treatment, adverse clinical outcomes, including thromboembolic complications (TEC), bleeding, and hospitalizations. Results Efficacy of the interventional treatment for 36 months was 65.3 % in patients with paroxysmal AF, 59.7 % in patients with persistent AF, and 57.1 % in patients with longstanding persistent AF. Patients with paroxysmal AF and effective CA had no adverse events throughout the same period during the antithrombotic treatment (ATT). In contrast, the group with ineffective ablation had both TEC and hemorrhagic complications during the ATT. In the group with persistent AF and effective CA throughout the follow-up period, TECs were less frequent than in the group of ineffective ablations during the ATT treatment. Patients with longstanding persistent AF and effective CA throughout the follow-up period, had no TECs in contrast to patients with ineffective ablation during the ATT treatment. There were no fatal outcomes in patients with effective procedure. Conclusion A successful CA procedure for AF provides a significant decrease in the risk of ischemic stroke. Furthermore, the invasive strategy does not increase the risk of major and minor bleedings.

Цель: оценить возможность использования Speckle-tracking эхокардиографию (STE) у пациентов с фибрилляцией предсердий (ФП) при катетарном лечении по данным внутрисердечной эхокардиографии (ВСЭхоКГ). Материалы и методы: в исследование включено 30 пациентов с персистирующей и пароксизмальной формами ФП. У 25 пациентов (84 %) основным заболеванием была гипертоническая болезнь, из них у 14 человек (46 %) гипертония сочеталась с ишемической болезнью сердца. В 16 % случаев (4 пациента) ФП носило идиопатический характер. Все пациенты имели показания к катетерному лечению аритмии. Результаты: у пациентов до начала радиочастотного (РЧ) воздействия деформация левой верхней легочной вены (ЛВ) составила в среднем 24,5±1,5 %, после 17,5±1,1%, тканевая деформация уменьшилась на 7% (р<0,001); левой нижней ЛВ до РЧА - 21,5±0,9%, после - 14,4±0,9%, уменьшение тканевой деформации на 7,1% (р<0,001); правой верхней ЛВ до РЧА - 21,2±1,3%, после -14,9±1,1%, изменение тканевой деформации на 6,2% (р<0,001); правой нижней ЛВ до РЧА- 20,5±1,1%, после - 14,4±1,1%, изменение деформации составило 6,1%( р<0,001. Под действием РЧА скорость деформации в левой верхней ЛВ уменьшилась на 8,1% (р <0,001) составила в среднем до РЧА -5,36±0,5 %, после -4,93±0,35%; в левой нижней ЛВ уменьшение скорости деформации на 8,3% (р<0,001), до РЧА -5,38±0,6%, после – 4,93±0,55%,; правой верхней ЛВ снижение скорости деформации на 8,5% (р<0,001), до РЧА -5,5±0,15%, после -5,0±0,33%,; в правой нижней ЛВ снижение скорости деформации составило 8,2%( р<0,001) до РЧА -5,9±0,4%, после -5,4±0,4%. Заключение. Снижение деформации на более чем 6 % и скорости деформации на 8% после нанесения радиочастотного воздействия является достоверным признаком изоляции легочных вен.

The article describes clinical cases demonstrating the advantages of non-invasive long-term electrocardiogram (ECG) monitoring allowing to detect asymptomatic atrial fibrillation (AF) and transient atrioventricular (AV) and sinoatrial (SA) blocks.

Background/Objectives: Atrial fibrillation (AF) is a prevalent arrhythmia that significantly complicates the management of heart failure (HF) patients, particularly those who have implantable cardioverter–defibrillators (ICDs). The interplay between AF and inappropriate ICD therapy poses a critical challenge in optimizing patient outcomes, as inappropriate shocks can lead to increased morbidity, psychological distress, and a reduced quality of life. We aimed to explore the various clinical and demographic predictors of AF in HF patients with indications for ICD implantation. Methods: This study included 122 patients who were indicated for ICD implantation and had undergone transthoracic echocardiography (TE). We evaluated the relationships between clinical and demographic factors and the occurrence of AF, which was recorded either before ICD implantation or during the follow-up period afterward. From our findings, we established predictors and a risk model for AF. Results: Out of 122 HF patients with ICDs, 52 (42.6%) experienced an episode of AF either prior to ICD implantation or during a follow-up period of 20.5 [6.0; 53.0] months, as recorded by the ICDs’ endogram. Patients with AF were older compared to those without AF (p < 0.001). Additionally, they exhibited a higher left ventricular early diastolic filling rate (LVE) (p = 0.006) and a greater left atrial index (LAI) (p = 0.002). These three factors—age, LVE and LAI—were found to be independently associated with AF in both univariable and multivariable logistic regression analyses. The final model, including age, LVE, and LAI, showed a good discrimination capability with an AUC of 0.775. At a cutoff value of >0.47, the model achieved a sensitivity of 67.3% and a specificity of 77.2% in identifying HF patients with ICDs at risk for AF. Conclusions: This study found that 42.6% of HF patients with ICDs experienced AF, with older age, higher LVE, and greater LAI identified as significant predictors.