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Neuro-arrhythmology

a challenging field of action and research

a review from the Task Force of Neuro-arrhythmology of Italian Association of Arrhythmias and Cardiac Pacing

Strano, Stefanoa; Toni, Danilob; Ammirati, Fabrizioc; Sanna, Tommasod; Tomaino, Marcoe; Brignole, Michelef; Mazza, Andreag; Nguyen, Bich L.h; Di Bonaventura, Carloi; Ricci, Renato P.j; Boriani, Giuseppek

Journal of Cardiovascular Medicine: November 2019 - Volume 20 - Issue 11 - p 731–744
doi: 10.2459/JCM.0000000000000866
Review
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There is a growing interest in the study of the mechanisms of heart and brain interactions with the aim to improve the management of high-impact cardiac rhythm disorders, first of all atrial fibrillation. However, there are several topics to which the scientific interests of cardiologists and neurologists converge constituting the basis for enhancing the development of neuro-arrhythmology. This multidisciplinary field should cover a wide spectrum of diseases, even beyond the classical framework corresponding to stroke and atrial fibrillation and include the complex issues of seizures as well as loss of consciousness and syncope. The implications of a more focused interaction between neurologists and cardiologists in the field of neuro-arrhythmology should include in perspective the institution of research networks specifically devoted to investigate ‘from bench to bedside’ the complex pathophysiological links of the abovementioned diseases, with involvement of scientists in the field of biochemistry, genetics, molecular medicine, physiology, pathology and bioengineering. An investment in the field could have important implications in the perspectives of a more personalized approach to patients and diseases, in the context of ‘precision’medicine. Large datasets and electronic medical records, with the approach typical of ‘big data’ could enhance the possibility of new findings with potentially important clinical implications. Finally, the interaction between neurologists and cardiologists involved in arrythmia management should have some organizational implications, with new models of healthcare delivery based on multidisciplinary assistance, similarly to that applied in the case of syncope units.

aDepartment of Heart and Great Vessels ‘A. Reale’

bEmergency Department Stroke Unit, Department of Human Neurosciences, Sapienza University of Rome

cCardiology Division, ‘Giovan Battista Grassi’ Hospital, Ostia

dFondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Institute of Cardiology, Rome

eDepartment of Cardiology, Ospedale di Bolzano, Bolzano

fDepartment of Cardiology, Arrhythmologic Centre, Ospedali del Tigullio, Lavagna

gCardiology Division, Santa Maria della Stella Hospital, Orvieto

hDepartment of Heart and Great Vessels ‘A. Reale’

iEpilepsy Unit, Department of Human Neurosciences, Sapienza University of Rome

jCardio Arrhythmology Center, Rome

kDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena University Hospital, Modena, Italy

Correspondence to Giuseppe Boriani, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena University Hospital, Modena, Italy E-mail: giuseppe.boriani@unimore.it

Received 28 March, 2019

Revised 9 July, 2019

Accepted 16 August, 2019

© 2019 Italian Federation of Cardiology. All rights reserved.