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We compared the efficacy and complication rates of quantitative radiofrequency ablation guided by ablation index (RFCA-AI) with those of second-generation cryoballoon ablation (CBA-2). Consecutive patients (n = 230) with symptomatic atrial fibrillation (AF) undergoing a first ablation CBA-2 (92 patients) or RFCA-AI (138 patients) procedure were enrolled in this study. The late recurrence rate in the CBA-2 group was higher than that in the RFCA-AI group (P =.012). Subgroup analysis showed the same result in patients with paroxysmal AF (PAF) (P =.039), but no difference was found in patients with persistent AF (P =.21). The average operation duration in the CBA-2 group (85 [75-99.5] minutes) was shorter than that in the RFCA-AI group (100 [84.5-120] minutes) (P <.0001), but the average exposure time (17.36(13.87-22.49) vs 5.49(4.00-8.24) minutes) in the CBA-2 group and X-ray dose (223.25(149.15-336.95) vs 109.15(80.75-168.7) mGym) were significantly longer than those in RFCA-AI group (P <.0001). Multivariate logistic regression analysis showed that left atrial diameter (LAD), early recurrence, and methods of ablation (cryoballoon ablation) were independent risk factors for late recurrence after AF ablation. Early recurrence of AF and LAD were independent risk factors for predicting late recurrence after AF ablation. [ABSTRACT FROM AUTHOR]

Telmisartan is an angiotensin II receptor blocker that displays unique PPAR-γ modulating activity. PPAR-γ Agonists have been shown to decrease susceptibility to atrial fibrillation through their antioxidant and antiapoptotic effects. The aim of this study was to determine whether telmisartan would have a greater effect on susceptibility to atrial arrhythmia in a hypertensive rat model than valsartan, which is a traditional angiotensin II receptor blocker. In this study, spontaneously hypertensive rats were treated with 10 mg *[(kg body mass).sup.-1]*[d.sup.-1] telmisartan (TEL group), 10 mg-[(kg body mass).sup.-1]*[d.sup.-1] valsartan (VAL group), or vehicle (saline; SHR group) for 4 weeks. Age-matched Wistar-Kyoto rats (WKY) were used as normotensive controls. After 4 weeks of treatment, we performed echocardiographic assessment, electrophysiological analysis, histological evaluation, and Western blot analysis. Telmisartan decreased systolic blood pressure to a similar extent as valsartan. Relative to the WKY controls, atrial arrhythmia susceptibility was significantly increased in the SHR group, and was significantly decreased by both telmisartan and valsartan, albeit to a greater extent with telmisartan. Arrhythmogenic atrial remodeling, including enlargement of the left atrium, myocyte hypertrophy, interstitial fibrosis, and myocyte apoptosis, was observed in the SHR group, and was accompanied by activated RAS-ERK signaling and suppressed PI3K-Akt-eNOS signaling. The results suggest that telmisartan reduced susceptibility to atrial arrhythmia to a greater extent than valsartan, ameliorated atrial remodeling, and reversed imbalances in the RAS-ERK and PI3K-Akt-eNOS pathways. Key words: hypertension, atrial fibrillation, structural remodeling, angiotensin receptor blockers, signaling pathway. Le telmisartan est un antagoniste du recepteur de l'angiotensine II qui exerce une activite modulatrice PPAR-γ unique. Les agonistes du PPAR-γ se sont averes diminuer la susceptibilite a la fibrillation auriculaire grace a leurs proprietes antioxydantes et anti-apoptose. Le but de cette etude etait de determiner si le telmisartan exercerait un effet sur la susceptibilite a l'arythmie auriculaire superieur a celui du valsartan, un antagoniste du recepteur de l'angiotensine II traditionnel, dans un modele de rats hypertendus. Dans cette etude, des rats spontanement hypertendus (SHR) ont ete traites avec 10 mg x [(kg de masse corporelle).sup.-1] x [jour.sup.-1] de telmisartan (TEL), 10 mg-[(kg de masse corporelle).sup.-1] x [jour.sup.-1] de valsartan (VAL) ou le vehicule (saline) pendant 4 semaines. Des rats Wistar-Kyoto (WKY) appareilles suivant l'age ont ete utilises comme controles normotensifs. Apres 4 semaines de traitement, des evaluations par echocardiographie, des analyses par electrophysiologie, des evaluations histologiques et des buvardages Western ont ete realises. Le telmisartan diminuait la pression sanguine systolique au meme degre que le valsartan. Comparativement aux controles WKY, la susceptibilite a l'arythmie auriculaire etait significativement accrue chez les rats SHR et significativement diminuee par le telmisartan et la valsartan, quoique le telmisartan ait ete plus efficace (TEL vs VAL). Un remodelage auriculaire arythmogenique, incluant l'elargissement de l'oreillette gauche, l'hypertrophie des myocytes, la fibrose interstitielle et l'apoptose des myocytes, etait observe chez les animaux SHR et il etait accompagne d'une activation de la signalisation RAS-ERK et d'une suppression de la signalisation PI3K-Akt-eNOS. Ces resultats suggerent que le telmisartan a reduit la susceptibilite a l'arythmie auriculaire dans une plus large mesure que le valsartan, a ameliore le remodelage auriculaire et a renverse les debalancements entre les voies de signalisation RAS-ERK et PI3K-Akt-eNOS. [Traduit par la Redaction] Mots-cles : hypertension, fibrillation auriculaire, remodelage structural, antagonistes du recepteur de l'angiotensine, voie de signalisation., Introduction Atrial fibrillation (AF), an important risk factor for stroke and mortality, is the most prevalent arrhythmia diagnosed in clinical practice (Wilhelmsen et al. 2001). Hypertension is a strong and [...]

Lindera strychnifolia (Tendai-Uyaku), a medicinal plant, has long been used for the treatment of cardiac, renal and rheumatic diseases in Japan. We aim to clarify (1) whether L. strychnifolia is protective against post-ischemic myocardial dysfunction, and (2) whether its effect is related to scavenging hydroxyl radicals and opening the mitochondrial KATP channels in isolated rat hearts. Male Sprague-Dawley rats were orally given 1 ml/day of L. strychnifolia, which was extracted from 0.75 and 1.5 g/kg of roots of L. strychnifolia for 4 days. The rat hearts were excised and perfused on a Langendorff apparatus with Krebs-Henseleit solution with a gas mixture of 95% O2 and 5% CO2. The hearts were paced at 320 beats/min except during ischemia. Left ventricular developed pressure (LVDP, mmHg), ± dP/dt (mmHg/sec) and coronary flow (ml/min) were continuously monitored. All hearts were perfused for a total of 120 minutes consisting of a 30-minute pre-ischemic period followed by 30 minutes of global ischemia and 60 minutes of reperfusion with or without 5-HD, a mitochondrial KATP channel blocker. The levels of lactate, LDH and 2,5-DHBA, an indicator of hydroxyl radicals, in the perfusate during reperfusion period were also measured. Treatment with L. strychnifolia significantly improved LVDP and ± dP/dt without altering coronary flow during reperfusion. The 100 μM of 5-HD in Krebs-Henseleit solution was perfused during the 10 minutes of pre-ischemic periods. Pretreatment with 5-HD abolished the improvement of LVDP and ± dP/dt by L. strychnifolia. L. strychnifolia significantly attenuated the levels of lactate, LDH and 2,5-DHBA during reperfusion, and which were restored by pretreatment with 5-HD. In conclusion, L. strychnifolia is protective against post-ischemic left ventricular dysfunction through scavenging hydroxyl radicals and opening the KATP channels in the isolated rat heart. [ABSTRACT FROM AUTHOR]

Objective: Collect the characteristics of patients' baseline data, and explore the predictive factors of late recurrence of atrial fibrillation (AF) after catheter ablation according to whether late recurrence or not. The purpose of this study was to determine the significance of the APPLE score in conjunction with the monocyte-high-density lipoprotein cholesterol ratio (MHR) in predicting the late recurrence of AF after catheter ablation in patients with AF., Methods: Baseline data were collected to explore the predictors of late recurrence after AF catheter ablation. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to compare the predictive value of MHR, the APPLE score and their combined variables in the late recurrence of AF after catheter ablation., Results: This is a retrospective study. A total of 438 patients were followed-up, including 303 cases of paroxysmal AF, 135 cases of persistent AF (28 cases of long-term persistent AF) and 115 cases of late recurrence. The Cox multivariate regression analysis revealed that MHR, the APPLE score and early recurrence were independent predictors of the late recurrence of AF. The AUC of the combined variables for predicting late recurrence after catheter ablation in patients with AF was higher than that of MHR and the APPLE score (p<0.05). The ROC AUC of the combined variables in predicting the late recurrence of AF after catheter ablation was 0.733 (p<0.001, 95% CI: 0.660 to 0.806), and the best cut-off point was 0.2711 (sensitivity: 69.20%, specificity: 68.00%)., Conclusions: Early recurrence, MHR and the APPLE score are independent risk factors for the late recurrence of AF after catheter ablation. The combination of the APPLE score with MHR improved the value of predicting the late recurrence of AF after catheter ablation. The combined variables were a predictor of an increased late recurrence rate after catheter ablation for AF when the value was greater than 0.2711., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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Objective: To observe whether ginsenoside Rg1 could reduce the infarcted area and improve the heart function by path of promoting bone marrow stem cells differentiated to vascular endothelial cells (VECs)., Methods: Bone marrow was drawn from rabbit's ilium and labelled with red fluorochrome DiI, then it was transferred again into the rabbit's body. The rabbits was then made into myocardiac infarction model. The model rabbits were divided into the control group and the ginsenoside Rgl treated group (treated group). The infracted area at two weeks, and the left ventricular function at one and two weeks after infarction were determined respectively. The DiI positive cell rate of myelogenetic cells in ischmia area and CD31 positive cell rate of VECs were determined by confocal microscopy. Myocardial interstitial granulocyte colony-stimulating factor(GCSF) levels during ischemia and reperfusion period were determined also., Results: DiI positive rate of CD31 staining positive cells in the treated group was obviously increased, and the concentration of G-CSF in myocardium interstitial obviously increased, accompanied with obviously improving of heart function and obviously reducing of infarcted area., Conclusion: Ginsenoside Rgl could stimulate the G-CSF secretion in local myocardiac tissues, thus to induce bone marrow mononuclear cells migrate to myocadial tissue and further differentiate to VECs. The regeneration of endothelium cells show certain direct action in promoting capillary regeneration of infarcted myocardium tissue and maintaining the blood supply.