94 research outputs found
Obesity and atrial fibrillation outcomes and risk: increasing the weight of evidence
No full textEditorial CommentaryChrishan J. Nalliah, Prashanthan Sanders, Jonathan M. Kalma
Segmental pulmonary vein isolation for atrial fibrillation
No full textPrashanthan Sanders, Mélèze Hocini, Pierre Jaïs, Chrishan J. Nalliah, Yoshihide Takahashi, Li-Fern Hsu, Thomas Rostock, Martin Rotter, Fredéric Sacher, Jaques Clémenty, Michel Haïssaguerrehttp://www.elsevier.com/wps/find/bookdescription.cws_home/706399/description#descriptio
Moderate alcohol consumption is associated with atrial electrical and structural changes: insights from high-density left atrial electroanatomic mapping
No full textAbstract not availableAleksandr Voskoboinik, Geoffrey Wong, Geoff Lee, Chrishan Nalliah, Joshua Hawson, Sandeep Prabhu, Hariharan Sugumar, Liang-Han Ling, Alex McLellan, Joseph Morton, Jonathan M. Kalman, Peter M. Kistle
Obstructive sleep apnea treatment and atrial fibrillation: a need for definitive evidence
No full textObstructive Sleep Apnea Treatment. Prevalence rates of atrial fibrillation (AF) and obstructive sleep apnea (OSA) are rising on a global scale. Epidemiological data have consistently demonstrated an independent association between the 2 conditions. Investigators pose that pathophysiologic features of OSA enable progression of the AF substrate; these features include abnormalities of gas exchange, autonomic remodeling, atrial stretch, and inflammation. Furthermore, many of the mechanistic perturbations that impact the AF substrate in OSA can be substantially attenuated by effective treatment with continuous positive airway pressure (CPAP). Clear associations of OSA treatment and improved AF control have been observed across multiple clinical contexts. However, the precision and generalizability of these findings are unclear in view of the data’s observational nature. Although risk factor management has emerged as a critical component of AF treatment, effective control of many AF risk factors can be challenging in the longer term. In view of the efficacy and sustainability of CPAP therapy, OSA raises its profile as a prime candidate for intervention. However, translation of this strategy to the broader framework for AF management requires robust data from randomized controlled trials.Chrishan J. Nalliah, Prashanthan Sanders and Jonathan M. Kalma
The impact of diet and lifestyle on atrial fibrillation
No full textPURPOSE OF REVIEW:Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in humans, affecting more than 33 million people globally. Its association with complex, resource intensive medical conditions such as stroke, heart failure and dementia have had profound impacts across existing health care structures. The global prevalence of AF has enjoyed significant growth despite significant improvement in our armamentarium for arrhythmia treatment. RECENT FINDINGS:Efforts aimed at curtailing the incidence, prevalence, or progression of AF have prompted re-evaluation of traditional frameworks for understanding and managing this debilitating disease. It is in this context that focus has shifted toward lifestyle-associated factors such as obesity, hypertension, sleep apnoea, exercise, alcohol and diet, as mechanistic drivers and putative targets for therapy. Compelling evidence exists for weight loss and management of associated risk factors to improve outcomes of AF treatment. This review will address the epidemiologic and mechanistic evidence that link lifestyle-associated factors with AF and in light of this analysis evaluate the clinical impacts of their upstream management. Traditional paradigms of AF are shifting in light of emerging evidence, such that risk factor modification has become positioned as the fourth pillar of AF management.Chrishan J. Nalliah, Prashanthan Sanders, Jonathan M. Kalma
Surgical weight loss to treat atrial fibrillation risk and progression
No full textPurpose of Review: This review aims to examine the breadth of data associating atrial fibrillation (AF) with obesity at epidemiologic, mechanistic, and clinical levels. We then proceed to place surgical weight loss within that context. Recent Findings: Epidemiologic studies have demonstrated a robust correlation between overweight and AF. Various mechanistic factors including concomitant risk factors, diastolic impairment, inflammation, and pericardial fat have been observed to contribute to the atrial substrate for AF. However, weight loss can institute a process of reverse atrial remodeling improving arrhythmias profile. Thus, weight loss has emerged as an indispensable aspect of effective AF management. Yet, effective weight management is often a challenging and frustrating journey for clinician and patient, raising surgical weight loss as a potential option. However, data on the role of surgical weight loss on AF are limited. Observations indicate that the dramatic and sustained weight loss availed by surgical intervention may be capable of attenuating rates of incident AF. The impact of surgical weight loss on AF populations remains unknown. However, it is likely that most of the antiarrhythmic benefits of non-surgical weight loss would be paralleled in surgical candidates, mediated by similar mechanisms. Surgical weight loss has been associated with reverse structural remodeling, improvement of diastolic function, and modulation of the autonomic profile. Summary: There exists a compelling case for the utilization of surgical weight loss to circumvent the obstacle of treatment failure. However, resort to an invasive procedure with antedant risks for AF management alone would be premature in the absence of robust data. However, it may find a more immediate role in the context of AF ablation, where exposure to procedural risk must be justified by optimizing procedural success. Further data surrounding surgical weight loss and its antiarrhythmic benefits are required to define its role in the battle against the dual and closely linked epidemics of AF and obesity. Surgical weight loss would be a powerful weapon in the clinician’s armamentarium that would further consolidate weight loss as the fourth pillar of AF management.C. J. Nalliah, P. Sanders, Jonathan M. Kalma
The role of obesity in atrial fibrillation
No full textAtrial fibrillation (AF) is commonly associated with overweight and obesity. Both conditions have been identified as major global epidemics associated with increased mortality and morbidity. Overweight populations have higher incidence, prevalence, severity, and progression of AF compared with their normal weight counterparts. Additionally, weight change appears to accompany alteration of arrhythmia profile, raising overweight, and obesity as potential targets for intervention. Recent clinical data confirm hypothesis drawn from epidemiological studies that durable weight reduction strategies facilitate effective management of AF. Stable weight loss decreases AF burden and AF recurrence following treatment. Structural remodelling in response to weight loss suggests that reverse remodelling of the AF substrate mediates improvement of arrhythmia profile. Obesity often co-exists with multiple AF risk factors that improve in response to weight loss, making a consolidated approach of weight loss and AF risk factor management preferable. However, weight loss for AF remains in its infancy, and its broad adoption as a management strategy for AF remains to be defined.Chrishan Joseph Nalliah, Prashanthan Sanders, Hans Kottkamp, Jonathan M. Kalma
On local distance antimagic chromatic number of graphs disjoint union with 1-regular graphs
No full textLet be a graph on vertices and edges with no isolated vertices. A bijection is called local distance antimagic labeling, if for any two adjacent vertices and , we have , where . The local distance antimagic chromatic number is defined to be the minimum number of colors taken over all colorings of induced by local distance antimagic labelings of . In this paper, we obtained the necessary and sufficient condition for the local distance antimagic chromatic number of some disjoint union of graphs with 1-regular graphs equal to the number of distinct neighbors of its pendant vertices. We also gave a correct result in [Local Distance Antimagic Vertex Coloring of Graphs, https://arxiv.org/abs/2106.01833v1(2021)].%magic Vertex Coloring of Graphs, https://arxiv.org/abs/2106.01833v
Local total anti-magic chromatic number of graphs
No full textLet G=(V,E) be a graph without isolated vertices and let |V(G)|=n and |E(G)|=m. A bijection π:V(G)∪E(G)→{1,2,....,n+m} is said to be local total anti-magic labeling of a graph G if it satisfies the conditions: (i.) for any edge uv, ω(u)≠ω(v), where u and v in V(G) (ii.) for any two adjacent edges e and e′, ω(e)≠ω(e′) (iii.) for any edge uv∈E(G) is incident to the vertex v, ω(v)≠ω(uv), where weight of vertex u is, ω(u)=∑e∈S(u)π(e), S(u) is the set of edges with every edge of S(u) one end vertex is u and an edge weight is ω(e=uv)=π(u)+π(v). In this paper, we have introduced a local total anti-magic labeling (LTAL) and the local total anti-magic chromatic number (LTACN). Also, we obtain the LTACN for the graphs Pn, K1,n, Fn and Sn,n
On local edge antimagic chromatic number of graphs
No full textLet G=(V,E) be a graph of order p and size q having no isolated vertices. A bijection f from V to {1,2,3,...,p} is called a local edge antimagic labeling if for any two adjacent edges e=uv and e'=vw of G, we have w(e) is not equal to w (e'), where the edge weight w(e=uv)=f(u)+f(v) and w(e')=f(v)+f(w). A graph G is local edge antimagic if G has a local edge antimagic labeling. The local edge antimagic chromatic number is defined to be the minimum number of colors taken over all colorings of G induced by local edge antimagic labelings of G. In this paper, we determine the local edge antimagic chromatic number for a friendship graph, wheel graph, fan graph, helm graph, flower graph, and closed helm
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