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Heart Rhythm Disorders: Diagnosis, Treatment, and Management
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Heart Rhythm Disorders: Diagnosis, Treatment, and Management

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Electrophysiology and Cardiovascular Physiology".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 2997

Special Issue Editor

Prof. Dr. Rajeev K. Pathak

E-Mail Website
Guest Editor
Canberra Heart Rhythm, Australian Capital Territory, Garran 2605, Australia
Interests: catheter ablation; myocardial scar; 3D mapping; physiological pacing; sudden cardiac death; risk stratification

Special Issue Information

Dear Colleagues,

Heart rhythm disorders form a major component of cardiac morbidity, significantly impacting health and contributing to serious complications such as stroke or heart failure. Recent strides in technology for diagnosing and treating tachyarrhythmias and bradyarrhythmias have propelled remarkable advancements in the field.

While the diagnostic landscape encompasses a stepladder of modalities ranging from traditional electrocardiograms, Holter monitors and echocardiography to cardiac MRI and diagnostic EP studies, the true challenge facing electrophysiologists lies in adeptly leveraging these diagnostic modalities to achieve precise and accurate diagnoses. A quick dive into existing literature reveals the existing disparities in evidence pertaining to optimal management, encompassing variability in treatment efficacy and long-term prognosis. This Special Issue aims to address these gaps by highlighting the influence of modern cardiac imaging techniques and exploring the role of catheter interventions and device therapies in managing heart rhythm disorders. This Special Issue seeks contributions discussing the utilization and interpretation of cardiac imaging, device and catheter ablation data to improve clinical workflows and optimize the distribution of imaging services. Articles can include reviews, editorials, case studies or original research across pediatric, adult, critical care and perioperative settings.

Prof. Dr. Rajeev K. Pathak
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. Journal of Cardiovascular Development and Disease 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 2700 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

  • tachyarrhythmias
  • bradyarrhythmias
  • myocardial strain
  • cardiac MRI
  • myocardial scar
  • atrial fibrillation ablation
  • ventricular arrhythmia ablation
  • physiological pacing
  • sudden cardiac death

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Published Papers (3 papers)

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Research

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12 pages, 2134 KiB  
Article
Left Atrial Low-Voltage Extent Predicts the Recurrence of Supraventricular Arrhythmias
by Yannick Teumer, Luca Gold, Lyuboslav Katov, Carlo Bothner, Wolfgang Rottbauer and Karolina Weinmann-Emhardt
J. Cardiovasc. Dev. Dis. 2024, 11(10), 334; https://doi.org/10.3390/jcdd11100334 - 21 Oct 2024
Viewed by 1156
Abstract
The incidence of left atrial (LA) supraventricular arrhythmias is increasing. Even after LA ablation, recurrence of these tachycardias is common. MRI studies show that LA cardiomyopathy is a significant risk factor for recurrence and correlates with low voltage areas detected via 3D electroanatomic [...] Read more.
The incidence of left atrial (LA) supraventricular arrhythmias is increasing. Even after LA ablation, recurrence of these tachycardias is common. MRI studies show that LA cardiomyopathy is a significant risk factor for recurrence and correlates with low voltage areas detected via 3D electroanatomic mapping (EAM). There are limited data on the impact of low voltage extent detected by EAM on recurrence-free survival. Voltage thresholds defining low voltage vary across different studies. This study aims to investigate the impact of the extent of low voltage areas in the LA on recurrence-free survival and to assess whether defining low voltage areas using thresholds of 0.5, 0.4, or 0.3 mV offers better predictive performance. Patients with atrial arrhythmia who underwent LA EAM at Ulm University Heart Center between September 2018 and September 2022 were included from the ATRIUM registry. ROC analysis determined the voltage threshold for predicting recurrence-free survival. Kaplan–Meier and logistic regression models adjusted for patient variables were used to analyze recurrence-free survival. Of 1089 screened patients, 108 met the inclusion criteria. ROC analysis indicated that a 0.4 mV threshold for low voltage provided the best predictive performance. Logistic regression showed a 1.039-fold increase in recurrence risk per percent increase in LA low voltage area (odds ratio = 1.039, 95% CI 1.014–1.064). Low voltage extent in EAM correlates with 1-year recurrence rate after ablation of left atrial supraventricular arrhythmias. The threshold of 0.4 mV is the most suitable for predicting recurrences of those examined. Full article
(This article belongs to the Special Issue Heart Rhythm Disorders: Diagnosis, Treatment, and Management)
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Review

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21 pages, 2034 KiB  
Review
Bridging the Gaps in Atrial Fibrillation Management in the Emergency Department
by Brian Xiangzhi Wang
J. Cardiovasc. Dev. Dis. 2025, 12(1), 20; https://doi.org/10.3390/jcdd12010020 - 8 Jan 2025
Viewed by 517
Abstract
Atrial fibrillation (AF) frequently presents in emergency departments (EDs), contributing significantly to adverse cardiovascular outcomes. Despite established guidelines, ED management of AF often varies, revealing important gaps in care. This review addresses specific challenges in AF management for patients in the ED, including [...] Read more.
Atrial fibrillation (AF) frequently presents in emergency departments (EDs), contributing significantly to adverse cardiovascular outcomes. Despite established guidelines, ED management of AF often varies, revealing important gaps in care. This review addresses specific challenges in AF management for patients in the ED, including the nuances of rate versus rhythm control, the timing of anticoagulation initiation, and patient disposition. The updated 2024 European Society of Cardiology (ESC) guidelines advocate early rhythm control for select patients while recommending rate control for others; however, uncertainties persist, particularly regarding these strategies’ long-term impact on outcomes. Stroke prevention through timely anticoagulation remains crucial, though the ideal timing, especially for new-onset AF, needs further research. Additionally, ED discharge protocols and follow-up care for AF patients are often inconsistent, leaving many without proper long-term management. Integration of emerging therapies, including direct oral anticoagulants and advanced antiarrhythmic drugs, shows potential but remains uneven across EDs. Innovative multidisciplinary models, such as “AF Heart Teams” and observation units, could enhance care but face practical challenges in implementation. This review underscores the need for targeted research to refine AF management, optimize discharge protocols, and incorporate novel therapies effectively. Standardizing ED care for AF could significantly reduce stroke risk, lower readmission rates, and improve overall patient outcomes. Full article
(This article belongs to the Special Issue Heart Rhythm Disorders: Diagnosis, Treatment, and Management)
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25 pages, 3570 KiB  
Review
Contemporary Trends in Pulsed Field Ablation for Cardiac Arrhythmias
by Hagai Yavin, Mark Prasad, Jonathan Gordon, Tolga Aksu and Henry D. Huang
J. Cardiovasc. Dev. Dis. 2025, 12(1), 10; https://doi.org/10.3390/jcdd12010010 - 30 Dec 2024
Viewed by 860
Abstract
Pulsed field ablation (PFA) is a catheter-based procedure that utilizes short high voltage and short-duration electrical field pulses to induce tissue injury. The last decade has yielded significant scientific progress and quickened interest in PFA as an energy modality leading to the emergence [...] Read more.
Pulsed field ablation (PFA) is a catheter-based procedure that utilizes short high voltage and short-duration electrical field pulses to induce tissue injury. The last decade has yielded significant scientific progress and quickened interest in PFA as an energy modality leading to the emergence of the clinical use of PFA technologies for the treatment of atrial fibrillation. It is generally agreed that more research is needed to improve our biophysical understanding of PFA for clinical cardiac applications as well as its potential as a potential alternative energy source to thermal ablation modalities for the treatment of other arrhythmias. In this review, we discuss the available preclinical and clinical evidence for PFA for atrial fibrillation, developments for ventricular arrhythmia (VA) ablation, and future perspectives. Full article
(This article belongs to the Special Issue Heart Rhythm Disorders: Diagnosis, Treatment, and Management)
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