AFib Research from UCSF and Beyond
Below you will find 2 significant UCSF research articles related to AFib and 2 recently published abstracts on BEAT-AFib study research. Continue reading to learn more about AFib and how your contributions are advancing our knowledge about AFib!
Last Night’s Sleep, Today’s Heart Rhythm
In the I-STOP-AFIB randomized trial, Dr. Jeffrey Olgin, Professor of Medicine and Chief of Cardiology at UCSF, and Dr. Gregory Marcus, Professor of Medicine and Associate Chief of Cardiology for Research at UCSF, investigated if the quality of sleep can directly trigger atrial fibrillation (AFib).
419 patients with symptomatic paroxysmal AFib reported daily sleep quality, were queried daily about AFib episodes, and were given smartphone-based mobile electrocardiograms (AliveCor KardiaMobile). Participants were on average middle-aged, more often male (58%) and were mostly White (89%).
Poor sleep was associated with a heightened risk of self-reported AFib episodes the following day. Additionally, progressively worse sleep was associated with longer episodes of AFib the next day. Read more here, about how sleep quality may be a trigger for the risk of AFib episodes the following day.
References:
- Wong, C. X., Faulkner Modrow, M., Sigona, K., Tang, J. J., Vittinghoff, E., Hills, M. T., McCall, D., Sciarappa, K., Pletcher, M. J., Olgin, J. E., & Marcus, G. M. (2023, November 1). Preceding night sleep quality and atrial fibrillation episodes in the I-stop-afib randomized trial. JACC. https://www.jacc.org/doi/abs/10.1016/j.jacep.2023.09.009
Smoking Cessation and Incident Atrial Fibrillation in a Longitudinal Cohort
In this study researchers, including Dr. Gregory Marcus, Professor of Medicine and Associate Chief of Cardiology for Research at UCSF and BEAT-AFib Co-investigator, followed a large group of adults over time to see if quitting smoking affected their chances of developing atrial fibrillation (AFib).
Among the 146,772 participants, 37,377 (25.5%) currently smoked; 105,429 (72.0%) were former smokers; and 3,966 (2.7%) quit smoking during the study. Over a period of 12 years 11,214 (7.6%) participants developed AFib. Compared to current smokers, the risk of AFib was 13% lower in former smokers and 18% lower in those who quit smoking during the study.
The study found that smokers had a significantly higher risk of developing AFib compared to people who never smoked. For former smokers, the longer they stayed smoke-free the lower their AFib risk became. This study adds to the existing research that quitting not only improves overall heart health but also gradually lowers your risk of developing serious rhythm problems like AFib. Read the full article here.
References:
- Teraoka, J. T., Tang, J. J., Delling, F. N., Vittinghoff, E., & Marcus, G. M. (2024, September 11). Smoking cessation and incident atrial fibrillation in a longitudinal cohort. JACC. https://www.jacc.org/doi/10.1016/j.jacep.2024.06.019
Non-Invasive Discrimination of Patients At-Risk of Atrial Fibrillation from the Normal Population Using the Sinus Rhythm CineECG
Chang Hee Kwon, a UCSF post-doctoral research fellow, under the mentorship of Dr. Edward Gerstenfeld, Professor of Medicine and Chief of Cardiac Electrophysiology at UCSF, presented BEAT-AFib study data at the 2025 Heart Rhythm Society Conference (HRS) in San Diego. Our researchers converted the 12-lead ECG data captured at study visits into a 3D visual to show how electrical signals move through the heart by using a new analysis method called CineECG1.
The analysis used 12-lead ECG data from 3 groups: 1) the At-Risk group, those who have no atrial fibrillation (AFib) and ≥ 2 clinical AFib risk factors (age ≥65, sleep apnea, BMI ≥30, hypertension, heart failure, chronic kidney disease), 2) the AFib group, described as participants with paroxysmal AFib, and 3) a control group (CTRL).
Specific CineECG measurements such as maximum deflection angle were used to find the average change in direction of electrical activity. In a healthy patient this angle is narrow or smaller, in the At-Risk group the angle widens and is larger, and in the AFib group the angle is the largest. The larger the angle, the greater the electrical signal deviates from the normal pathway (Figure 1). CineECG may lead to earlier identification of patients at risk for AFib. Read the abstract here.
Figure 1: The first heart chambers depict the average max deflection angle of the control (CTRL) group. This max deflection angle is small and narrow, showing little to no deviation from the heart’s normal electrical pathway. The next chambers show the average max deflection angle of the At-Risk group. Note that the angle widens and becomes larger, signifying a slight deviation from the normal electrical pathway. The last chambers show the average max deflection angle in the AFib (AF) group. The angle is the widest here and makes the greatest deviation from the heart’s normal electrical current.
References:
- Kashou, A. H., & van Dam, P. (2022, December 8). CineECG for ECG Analysis Podcast. Cardiovascular CME Mayo Clinic. https://cardiovascularcmemayoclinic.podbean.com/e/cineecg-for-ecg-analysis/
- Kwon, C. H., van Dam, P. M., Venkateswaran, R., Kataoka, S., Cristal, A., Carp, V., Namjou Khaless, A., Duarte, K., Council, O., Olgin, J. E., & Gerstenfeld, E. P. (2025, April 24). PO-02-125 Non-Invasive Discrimination of Patients at-risk of Atrial Fibrillation from the Normal Population Using the Sinus Rhythm CINEECG. Heart Rhythm. https://doi.org/10.1016/j.hrthm.2025.03.607
- Mouzes, C. (n.d.). CINEECG analysis: The future of cardiac diagnosis? ” mayo clinic cardiac monitoring. Mayo Clinic. https://cardiovascularservices.mayoclinic.com/2023/03/21/cineecg-analysis-the-future-of-cardiac-diagnosis/
Frequent Premature Atrial Complexes Are Associated with Atrial Myopathy and Dyssynchrony in Humans: Insights from the BEAT-AFib Study
Dr. Shohei Kataoka, a UCSF visiting assistant professor under the mentorship of Dr. Gerstenfeld, presented BEAT-AFib study data at the 2025 HRS Conference in San Diego as well. The function of the atria, the top chambers of the heart, was analyzed using echo data from our participants without atrial fibrillation. The data from two groups were analyzed: One group had frequent premature atrial contractions (PACs) and was compared to the At-Risk group with no PACs (At-Risk group is defined in the CineECG abstract summary above).
Atrial remodeling and dyssynchrony were measured due to the atria being the area of the heart where both PACs and AFib occur. Atrial remodeling can be defined as changes in the heart’s size, mass, geometry, and function1. Dyssynchrony can be defined as a disturbance in the timing of the heart’s rhythm2.
Results showed that frequent PACs can lead to atrial remodeling. The PAC group was also found to have more atrial dyssynchrony compared to the At-Risk group. These results suggest that echo data was able to reveal atrial dysfunction and dyssynchrony in the PAC group. Read the abstract here.
References:
- Azevedo, P. S., Polegato, B. F., Minicucci, M. F., Paiva, S. A. R., & Zornoff, L. A. M. (2016, January). Cardiac remodeling: Concepts, clinical impact, pathophysiological mechanisms and pharmacologic treatment. Scielo.br. https://doi.org/10.5935/abc.20160005
- Hammersboen, L.-E. R., Stugaard, M., Puvrez, A., Larsen, C. K., Remme, E. W., Kongsgård, E., Duchenne, J., Galli, E., Khan, F. H., Sletten, O. J., Penicka, M., Donal, E., Voigt, J.-U., Smiseth, O. A., & Aalen, J. M. (2024). Mechanism and Impact of Left Atrial Dyssynchrony on Long-Term Clinical Outcome During Cardiac Resynchronization Therapy. JACC: Cardiovascular Imaging, 18(4), 421–432. https://doi.org/10.1016/j.jcmg.2024.09.008
- Kataoka, S., Lee, S. H., Fang, Q., Igata, S., Bibby, D., Council, O., Cristal, A., Olgin, J. E., Marcus, G. M., Abraham, T., Schiller, N. B., & Gerstenfeld, E. P. (2025, April 24). PO-02-029 Frequent Premature Atrial Complexes are Associated with Atrial Myopathy and Dyssynchrony in Humans: Insights from the Beat Afib Study. Heart Rhythm. https://doi.org/10.1016/j.hrthm.2025.03.607
