Recent highlights from the International Journal of Cardiology heart & Vasculature: Comprehensive management of atrial fibrillation
Bibliographic record
Abstract
Comprehensive management of atrial fibrillationHerein we provide an update on manuscripts focussing on the comprehensive management of atrial fibrillation (AF) recently published in the International Journal of Cardiology Heart & Vasculature.AF is the most common and complex sustained arrhythmia in men and requires a comprehensive management [1,2].Current treatment options have limited efficacy, largely due to the lack of mechanismbased therapeutic approaches.Although many potential drug targets were identified over the last 20 years [3], there are still many important obstacles in their clinical translation [4,5], with only a few (e.g.SK channels) being successfully translated to the clinical phase of drug development [6,7].The AF better care (ABC) pathway is one management strategy for AF that incorporates anticoagulation, better rhythm control and comorbidity management.Compliance with this management strategy of AF is associated with general improvements in patient outcomes during follow-up [8].Stroke prevention: Stroke risk management among patients with AF has improved between 2011 and 2019; however, there is still scope for further gains as many high-risk patients remain inadequately anticoagulated [9].Better stroke risk assessment by clinicians coupled with addressing practitioner concerns about bleeding risk may improve management of high-risk patients [2].Interestingly, with increasing CHADS2 score, not just the risk of stroke, but also the prevalence of coexisting coronary artery disease increases, which underscores the importance of screening for coexisting coronary artery disease in patients who are at high risk for thromboembolic events [10].Rhythm control: Conceptually, it is logical that maintaining sinus rhythm in patients with AF will permit patients to live longer and better.Accordingly, data from the GARFIELD-AF registry showed that early rhythm control strategy in patients with newly diagnosed nonpermanent AF was associated with a lower risk of all-cause mortality and non-haemorrhagic stroke [11].Recent advances in AF ablation techniques have proved effective in restoring and maintaining sinus rhythm with improved safety profiles.Catheter ablation demonstrated lower rates of atrial tachycardia recurrence over time, as well as a significant reduction in the progression from paroxysmal to persistent AF, with no difference in terms of energy source, complications, and clinical outcomes [12].Newer studies and an updated meta-analysis show a good acute outcomes of two cryoballoon technologies for pulmonary vein isolation [13][14][15][16][17][18].Current randomized clinical trials, including the "Cryoballoon Ablation versus Radiofrequency Ablation in Patients with Persistent Atrial Fibrillation (CRRF-PeAF)", are comparing the traditional thermal energy sources cryo-vs radiofrequency energy for catheter ablation of AF [19].Additionally,
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".