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Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and...
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Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and Future Directions

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 5439

Special Issue Editor

Dr. Siamak Salavatian

E-Mail Website
Guest Editor
1. Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
2. Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA
Interests: neuroradiology; cardiac arrhythmias; myocardial ischemia; myocardial infarction; heart failure; autonomic nervous system dysfunction; neuromodulation therapies

Special Issue Information

Dear Colleagues,

This Special Issue is dedicated to exploring advances in cardiac arrhythmias and arrhythmogenic disorders. The scope involves the following key areas.

Diagnostic innovations: Within this issue, we seek contributions that explore innovative diagnostic tools and technologies. These contributions should emphasize novel approaches for the early detection and precise characterization of various cardiac arrhythmias.

Therapeutic breakthroughs: This Special Issue welcomes articles presenting groundbreaking advancements in therapeutic interventions. This includes (but is not limited to) targeted drug therapies, the development of novel antiarrhythmic agents, neuromodulation therapies, and innovations in catheter ablation techniques. We aim to highlight studies that are reshaping the treatment paradigm for patients with cardiac arrhythmias.

Technological frontiers: We encourage submissions that investigate the role of cutting-edge technologies in reshaping the landscape of cardiac arrhythmia management. This includes the application of artificial intelligence, wearable devices, and remote monitoring systems. Articles in this domain should explore how these technological frontiers assist patients in monitoring, predicting, and managing arrhythmic conditions.

Future directions: This Special Issue aims to encourage discussions on the challenges existing in the field and propose future directions for cardiac arrhythmia research. Authors can present their perspectives on addressing gaps in current knowledge and envisioning innovative solutions that will lead to future advancements in understanding and managing cardiac arrhythmias.

We would like to invite researchers and clinicians to contribute their expertise and insights to this Special Issue, which will advance the science and clinical practice surrounding cardiac arrhythmias.

Dr. Siamak Salavatian
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiac arrhythmias
  • arrhythmias diagnostic
  • arrhythmias therapy
  • technological frontiers
  • personalized medicine
  • biomarkers
  • neuromodulation
  • artificial intelligence

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Published Papers (4 papers)

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Research

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15 pages, 838 KiB  
Article
Missense and Non-Missense Lamin A/C Gene Mutations Are Similarly Associated with Major Arrhythmic Cardiac Events: A 20-Year Single-Centre Experience
by Cinzia Forleo, Maria Cristina Carella, Paolo Basile, Eugenio Carulli, Michele Luca Dadamo, Francesca Amati, Francesco Loizzi, Sandro Sorrentino, Ilaria Dentamaro, Marco Maria Dicorato, Stefano Ricci, Rosanna Bagnulo, Matteo Iacoviello, Vincenzo Ezio Santobuono, Carlo Caiati, Martino Pepe, Jean-Francois Desaphy, Marco Matteo Ciccone, Nicoletta Resta and Andrea Igoren Guaricci
Biomedicines 2024, 12(6), 1293; https://doi.org/10.3390/biomedicines12061293 - 11 Jun 2024
Cited by 1 | Viewed by 1729
Abstract
Arrhythmic risk stratification in patients with Lamin A/C gene (LMNA)-related cardiomyopathy influences clinical decisions. An implantable cardioverter defibrillator (ICD) should be considered in patients with an estimated 5-year risk of malignant ventricular arrhythmia (MVA) of ≥10%. The risk prediction score for MVA includes [...] Read more.
Arrhythmic risk stratification in patients with Lamin A/C gene (LMNA)-related cardiomyopathy influences clinical decisions. An implantable cardioverter defibrillator (ICD) should be considered in patients with an estimated 5-year risk of malignant ventricular arrhythmia (MVA) of ≥10%. The risk prediction score for MVA includes non-missense LMNA mutations, despite their role as an established risk factor for sudden cardiac death (SCD) has been questioned in several studies. The purpose of this study is to investigate cardiac features and find gene–phenotype correlations that would contribute to the evidence on the prognostic implications of non-missense vs. missense mutations in a cohort of LMNA mutant patients. An observational, prospective study was conducted in which 54 patients positive for a Lamin A/C mutation were enrolled, and 20 probands (37%) were included. The median age at first clinical manifestation was 41 (IQR 19) years. The median follow-up was 8 years (IQR 8). The type of LMNA gene mutation was distributed as follows: missense in 26 patients (48%), non-frameshift insertions in 16 (30%), frameshift deletions in 5 (9%), and nonsense in 7 (13%). Among the missense mutation carriers, two (8%) died and four (15%) were admitted onto the heart transplant list or underwent transplantation, with a major adverse cardiovascular event (MACE) rate of 35%. No statistically significant differences in MACE prevalence were identified according to the missense and non-missense mutation groups (p value = 0.847). Our data shift the spotlight on this considerable topic and could suggest that some missense mutations may deserve attention regarding SCD risk stratification in real-world clinical settings. Full article
(This article belongs to the Special Issue Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and Future Directions)
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Review

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13 pages, 474 KiB  
Review
MicroRNAs as Prognostic Biomarkers for Atrial Fibrillation Recurrence After Catheter Ablation: Current Evidence and Future Directions
by Emmanouil P. Vardas, Evangelos Oikonomou, Panos E. Vardas and Dimitris Tousoulis
Biomedicines 2025, 13(1), 32; https://doi.org/10.3390/biomedicines13010032 (registering DOI) - 26 Dec 2024
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and Future Directions)
13 pages, 1669 KiB  
Review
Epicardial Ablation for Arrhythmogenic Disorders in Patients with Brugada Syndrome
by Andrea Matteucci, Marco Valerio Mariani, Luca Sgarra, Michela Bonanni, Marco Frazzetto, Vincenzo Mirco La Fazia, Nicola Pierucci, Carlo Lavalle, Claudio Pandozi, Federico Nardi and Furio Colivicchi
Biomedicines 2025, 13(1), 27; https://doi.org/10.3390/biomedicines13010027 (registering DOI) - 26 Dec 2024
Abstract
Brugada syndrome (BrS) is an inherited arrhythmogenic disorder characterized by distinct electrocardiographic patterns and an increased risk of sudden cardiac death due to ventricular arrhythmias. Effective management of BrS is essential, particularly for high-risk patients with recurrent arrhythmias. While implantable cardioverter–defibrillator (ICD) is [...] Read more.
Brugada syndrome (BrS) is an inherited arrhythmogenic disorder characterized by distinct electrocardiographic patterns and an increased risk of sudden cardiac death due to ventricular arrhythmias. Effective management of BrS is essential, particularly for high-risk patients with recurrent arrhythmias. While implantable cardioverter–defibrillator (ICD) is effective in terminating life-threatening arrhythmias, it does not prevent arrhythmia onset and can lead to complications such as inappropriate shocks. Epicardial ablation has emerged as a promising treatment option for patients with recurrent ventricular arrhythmias and frequent ICD interventions. This review examines the latest advancements in the management of Brugada syndrome, focusing on the role and rationale of epicardial ablation for the treatment of patients at risk of sudden cardiac death. Full article
(This article belongs to the Special Issue Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and Future Directions)
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21 pages, 4117 KiB  
Review
Pulsed Field Ablation of Atrial Fibrillation: A Novel Technology for Safer and Faster Ablation
by Alejandro Carta-Bergaz, Gonzalo R. Ríos-Muñoz, Pablo Ávila, Felipe Atienza, Esteban González-Torrecilla and Ángel Arenal
Biomedicines 2024, 12(10), 2232; https://doi.org/10.3390/biomedicines12102232 - 30 Sep 2024
Viewed by 2804
Abstract
Atrial fibrillation (AF), the most common arrhythmia, is associated with increased morbidity, mortality, and healthcare costs. Evidence indicates that rhythm control offers superior cardiovascular outcomes compared to rate control, especially when initiated early after the diagnosis of AF. Catheter ablation remains the single [...] Read more.
Atrial fibrillation (AF), the most common arrhythmia, is associated with increased morbidity, mortality, and healthcare costs. Evidence indicates that rhythm control offers superior cardiovascular outcomes compared to rate control, especially when initiated early after the diagnosis of AF. Catheter ablation remains the single best therapy for AF; however, it is not free from severe complications and only a small percentage of AF patients in the Western world ultimately receive ablation. Ensuring that AF ablation is safe, effective, and efficient is essential to make it accessible to all patients. With the limitations of traditional thermal ablative energies, pulsed field ablation (PFA) has emerged as a novel non-thermal energy source. PFA targets irreversible electroporation of cardiomyocytes to achieve cell death without damaging adjacent structures. Through its capability to create rapid, selective lesions in myocytes, PFA presents a promising alternative, offering enhanced safety, reduced procedural times, and comparable, if not superior, efficacy to thermal energies. The surge of new evidence makes it challenging to stay updated and understand the possibilities and challenges of PFA. This review aims to summarize the most significant advantages of PFA and how this has translated to the clinical arena, where four different catheters have received CE-market approval for AF ablation. Further research is needed to explore whether adding new ablation targets, previously avoided due to risks associated with thermal energies, to pulmonary vein isolation can improve the efficacy of AF ablation. It also remains to see whether a class effect exists or if different PFA technologies can yield distinct clinical outcomes given that the optimization of PFA parameters has largely been empirical. Full article
(This article belongs to the Special Issue Cardiac Arrhythmias and Arrhythmogenic Disorders: Technological Frontiers, Drug Development and Future Directions)
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