Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, impacting approximately 6.1 million adults in the United States, with projections to increase two-fold by 2030. AF significantly increases the risk of stroke and other adverse cardiovascular events, leading to increased morbidity and mortality. The 2023 ACC/AHA/ACCP/HRS guidelines present a paradigm shift in AF management, moving from a duration-based classification to a more comprehensive, patient-centered approach. This includes a novel AF classification system that emphasizes early detection and intervention, including risk factors and lifestyle modification tailored to each patient’s risk profile. Moreover, the recommendations advocate for a multidisciplinary care model, ensuring coordinated management involving primary care providers and specialists. Primary care providers play a crucial role in initiating risk factor management and lifestyle interventions, even before the development of AF. This review aims to thoroughly examine the guidelines for the diagnosis and management of AF and equip general internists with the necessary insights to navigate the evolving landscape of AF care effectively.

Stroke

10.3390/jcm13247846

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Dynamic electrocardiogram changes are a novel risk marker for sudden cardiac death

European Heart Journal (2023)

Hoang Nhat Pham Lauri Holmström Harpriya Chugh Audrey Uy‐Evanado Kotoka Nakamura

Electrocardiogram (ECG) abnormalities have been evaluated as static risk markers for sudden cardiac death (SCD), but the potential importance of dynamic ECG remodelling has not been investigated. In this study, the nature and prevalence of dynamic ECG remodelling were studied among individuals who eventually suffered SCD.

10.1093/eurheartj/ehad770

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Impact of the COVID-19 Pandemic on Takotsubo Syndrome: Updated Insights From a Retrospective Analysis Using the Nationwide Inpatient Sample

Cureus (2024)

Viet Nghi Tran Chau Nguyen Hong Hieu Truong Hoang Nhat Pham Amreen Dhindsa

Background We explored the impact of the COVID-19 pandemic on the prevalence and outcomes of takotsubo syndrome (takotsubo) using the National Inpatient Sample (NIS) to compare trends before and during the pandemic. Methods This retrospective study examined data from over 137 million admissions during 2017-2018 (pre-pandemic) and 2020-2021 (pandemic). Results Our analysis revealed a marked increase in takotsubo prevalence, from 109.07 to 131.19 per 100,000 admissions over each two-year period. The majority of patients were elderly females, with a notable rise in associated comorbidities such as hypertension and diabetes during the pandemic. Mortality among takotsubo patients rose significantly, with an adjusted odds ratio of 1.28. Patients with concurrent COVID-19 infection had a mortality rate of 23.02%, significantly higher than 7.61% for those without. The length of hospital stays also increased, particularly among COVID-19 patients. Interestingly, the odds of developing takotsubo were lower in COVID-19 patients than in non-infected individuals, suggesting a broader pandemic-related stress impact. Conclusion Our findings highlight a complex interaction between viral infections, stress, and cardiovascular health, underscoring the need for integrated care strategies during global health crises.

Pandemic

Odds

Takotsubo Syndrome

10.7759/cureus.73546

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Social Phenotyping for Cardiovascular Risk Stratification in Electronic Health Registries

Current Atherosclerosis Reports (2024)

Hoang Nhat Pham Hoang Nhat Pham Sarju Ganatra Zulqarnain Javed Khurram Nasir

Angiology

Risk Stratification

Cardiovascular Health

Electronic health record

10.1007/s11883-024-01222-6

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Intracerebral hemorrhage mortality in individuals with atrial fibrillation: a nationwide analysis of mortality trends in the United States

Journal of Interventional Cardiac Electrophysiology (2023)

Hoang Nhat Pham Enkhtsogt Sainbayar Ramzi Ibrahim Justin Z. Lee

Death certificate

10.1007/s10840-023-01674-x

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Citations (3)

Regional Disparities and Death Trends Related to Hemopericardial Cardiovascular Mortality

The American Journal of Cardiology (2023)

Enkhtsogt Sainbayar Hoang Nhat Pham Wisam Beauti Mahek Shahid Natalie Hickerson

10.1016/j.amjcard.2023.10.013

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Omecamtiv mecarbil for heart failure: Unpacking the latest systematic review and meta-analysis

International Journal of Cardiology and Cardiovascular Diseases (2024)

Hoang Nhat Pham

Unpacking

10.46439/cardiology.4.028

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Artificial Intelligence Model Predicts Sudden Cardiac Arrest Manifesting With Pulseless Electric Activity Versus Ventricular Fibrillation

Circulation Arrhythmia and Electrophysiology (2024)

Lauri Holmström Bryan Bednarski Harpriya Chugh Habiba Aziz Hoang Nhat Pham

There is no specific treatment for sudden cardiac arrest (SCA) manifesting as pulseless electric activity (PEA) and survival rates are low; unlike ventricular fibrillation (VF), which is treatable by defibrillation. Development of novel treatments requires fundamental clinical studies, but access to the true initial rhythm has been a limiting factor.

Pulseless electrical activity

Sudden cardiac arrest

10.1161/circep.123.012338

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Citations (9)