Cardiology Research and Practice Atrial Fibrillation Guest Editors: Natig Gassonov, Evren Caglayan, Firat Duru, and Fikret Er Atrial Fibrillation Cardiology Research and Practice Atrial Fibrillation Guest Editors: Natig Gassonov, Evren Caglayan, Firat Duru, and Fikret Er Copyright © 2013 Hindawi Publishing Corporation. All rights reserved. This is a special issue published in “Cardiology Research and Practice.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Atul Aggarwal, USA H. A. Katus, Germany J. D. Parker, Canada Jesus´ M. Almendral, Spain Hosen Kiat, Australia Fausto J. Pinto, Portugal Peter Backx, Canada Anne A. Knowlton, USA Bertram Pitt, UK J Brugada, Spain GavinW.Lambert,Australia Robert Edmund Roberts, Canada Ramon Brugada, Canada Chim Choy Lang, UK Terrence D. Ruddy, Canada Hans R. Brunner, Switzerland F. H H Leenen, Canada Frank T. Ruschitzka, Switzerland Vicky A. Cameron, New Zealand Seppo Lehto, Finland Christian Seiler, Switzerland David J. Chambers, UK John C. Longhurst, USA Sidney G. Shaw, Switzerland Robert Chen, Taiwan Lars S. Maier, Germany Pawan K. Singal, Canada Mariantonietta Cicoira, Italy Olivia Manfrini, Italy Felix C. Tanner, Switzerland Antonio Colombo, Italy Gerald Maurer, Austria Hendrik T. Tevaearai, Switzerland Omar H. Dabbous, USA G. A. Mensah, USA G. Thiene, Italy Naranjan S. Dhalla, Canada Robert M. Mentzer, USA H. O. Ventura, USA Firat Duru, Switzerland Piera Angelica Merlini, Italy Stephan von Haehling, Germany Vladim´ır Dzavˇ ´ık, Canada Marco Metra, Italy James T. Willerson, USA Gerasimos Filippatos, Greece Veselin Mitrovic, Germany Michael S. Wolin, USA Mihai Gheorghiade, USA Claudio Moretti, Italy Michael Wolzt, Austria Enrique P. Gurfinkel, Argentina Joseph Brent Muhlestein, USA Paul Holvoet, Belgium Debabrata P. Mukherjee, USA Contents Atrial Fibrillation, Natig Gassonov, Evren Caglayan, Firat Duru, and Fikret Er Volume 2013, Article ID 142673, 2 pages Chronobiological Analysis of Blood Pressure in a Patient with Atrial Fibrillation at the Development of Heart Failure and Its Therapeutic and Surgical Treatmen, Sergey Chibisov, George Katinas, Inna Brodskaya, Aleksandr Ertman, Grigory Gromyko, Aleksandra Konradi, Oleg Mamontov, Anna Merkuryeva, Ekaterina Polunicheva, Evgeny Shlyakhto, Anna Soboleva, Sergey Yashin, and Bharadva Bhavdip Volume 2013, Article ID 490705, 16 pages Comparison of Atrial Fibrillation in the Young versus That in the Elderly: A Review, Rajiv Sankaranarayanan, Graeme Kirkwood, Katharine Dibb, and Clifford J. Garratt Volume 2013, Article ID 976976, 16 pages The Use of Cardiac Magnetic Resonance Imaging in the Diagnostic Workup and Treatment of Atrial Fibrillation, Peter Haemers, Piet Claus, and Rik Willems Volume 2012, Article ID 658937, 6 pages Left Atrial Appendage Exclusion for Stroke Prevention in Atrial Fibrillation, Taral K. Patel, ClydeW.Yancy,andBradleyP.Knight Volume 2012, Article ID 610827, 8 pages Long-Term Costs of Ischemic Stroke and Major Bleeding Events among Medicare Patients with Nonvalvular Atrial Fibrillation, Catherine J. Mercaldi, Kimberly Siu, Stephen D. Sander, David R. Walker, You Wu, Qian Li, and Ning Wu Volume 2012, Article ID 645469, 13 pages Effect of Preoperative Atrial Fibrillation on Postoperative Outcome following Cardiac Surgery, Nael Al-Sarraf, Lukman Thalib, Anne Hughes, Michael Tolan, Vincent Young, and Eillish McGovern Volume 2012, Article ID 272384, 7 pages Hindawi Publishing Corporation Cardiology Research and Practice Volume 2013, Article ID 142673, 2 pages http://dx.doi.org/10.1155/2013/142673 Editorial Atrial Fibrillation Natig Gassanov,1 Evren Caglayan,1 Firat Duru,2 and Fikret Er1 1 Department of Internal Medicine III, University of Cologne, Kerpener Stra e 62, 50937 Cologne, Germany 2 Clinic for Cardiology, University Hospital Zurich, 8091 Zürich, Switzerland Correspondence should be addressed to Natig Gassanov; [email protected] Received 23 December 2012; Accepted 23 December 2012 Copyright © 2013 Natig Gassanov et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Atrial �brillation (AF) is the most common clinically impor- 46.6 of patients aer one procedure [7]. Long-term out- tant cardiac arrhythmia. e prevalence of AF roughly come data aer catheter ablation for persistent AF are even doubles with each advancing decade of age, from 0.5 at age less favourable% [8]. ese data highlight important aspects of of 50–59 years to almost 9 at age of 80–89 years [1]. AF is catheter ablation, in particular the need for improved tools associated with substantial morbidity and mortality. us,% AF for patient selection, energy delivery for durable transmural is a signi�cant risk factor for% ischemic stroke and accounts for lesions, and more studies on long-term outcomes and the 15–20 of all strokes [2]. Considering the clinical relevance management of very late recurrences as mediators of initial of AF, this journal initiated a special issue dealing with the procedural approach re�nement. Radiological investigations recent% developments in AF over the past few years. is such as CT scan or cardiac magnetic resonance imaging issue contains important work—both review and original (cMRI) can demonstrate the complex LA anatomy very well articles—addressing the epidemiology, economic impact of in all three dimensions and should reduce the �uoroscopy AF, and new therapeutic/diagnostic developments and their times. In this special issue, P. Haemers et al. review the potential clinical implications. potential application of cMRI in the diagnostic workup and e general therapeutic strategies in AF include heart rate treatment of AF. Besides its value in the guidance of catheter or rhythm control and anticoagulation. Current drugs used ablation, the authors describe the role of cMRI in identifying for AF therapy have major limitations, including incomplete the underlying pathophysiological mechanisms of AF and efficacy and risks of life-threatening proarrhythmic events in stroke prevention. cMRI can be used for le atrial scar and bleeding complications. However, there have been sev- quanti�cation to assist not only in the procedural approach eral recent advancements in therapy of AF. ey included but also in patient selection. the availability of new anticoagulants, such as dabigatran, As mentioned above, stroke is a major critical AF- rivaroxaban, and apixaban, as well as guideline changes associated complication. Today, stroke prevention with anti- to incorporate the catheter-based isolation of pulmonary coagulant agents based on the CHADS /CHA DS -VASc- veins (PV) as a class IIa/A indication [3]. Since the �rst Score is the main cornerstone of AF management. However, paper evidencing the role of PV as triggers of AF [4], anticoagulation—even with newly developed2 oral2 anticoag-2 various ablation techniques targeting PV (focal ablation, PV ulants—has several limitations. In addition to the bleeding isolation, circumferential antral ablation, cryoballoon) were risk, anticoagulation is not effectively utilized or contraindi- introduced into clinical practice [5, 6]. ough PV isolation cated in signi�cant number of eligible AF patients, oen by catheter-based radiofrequency ablation has become an due to the limitations highlighted in the current paper by effective treatment option in AF, the studies on long-term T. K. Patel et al. While newer oral anticoagulants overcome outcomes are still limited and less encouraging. many of these limitations, all anticoagulants suffer from an Recently, F. Ouyang et al. examined 5-year outcomes in unavoidable lifelong commitment to medication and elevated paroxysmal AF and found that sinus rhythm was present in bleeding risk. 2 Cardiology Research and Practice e le atrial appendage (LAA) is particularly vulnerable [5] J. G. Andrade, P. Khairy, P. G. Guerra et al., “Efficacy and to thrombus formation due to its complex anatomy and low safety of cryoballoon ablation for atrial �brillation: a system- blood �ow during AF. erefore, LAA exclusion may be an atic review of published studies,” Heart Rhythm, vol. 8, pp. especially appealing option for patients with intolerance or 1444–1451, 2011. contraindications to anticoagulation. e procedure of LAA [6] G. Lee, P. Sanders, and J. M. Kalman, “Catheter ablation of excision as well as the device characteristics are now high- atrial arrhythmias: state of the art,” e Lancet, vol. 380, pp. lighted in the current special issue. Indeed, LAA appendage 1509–1519, 2012. may be a true alternative to anticoagulation in some patients. [7] F. Ouyang, R. Tilz, J. Chun et al., “Long-term results of catheter However, there is a very limited clinical experience with this ablation in paroxysmal atrial �brillation: lessons from a 5-year novel procedure, and it is obvious that further studies are follow-up,” Circulation, vol. 122, no. 23, pp. 2368–2377, 2010. urgently required to clarify the bene�ts and disadvantages of [8] R. R. Tilz, A. Rillig, A. M. um et al., “Catheter ablation of long- LAA removal in patients with AF. standing persistent atrial �brillation: 5-year outcomes of the In another study of the current issue, C. J. Mercaldi et al. hamburg sequential ablation strategy,” Journal of the American College of Cardiology, vol.