Expert consensus document: Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care

Personalized management of atrial fibrillation:Proceedings from the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association consensus conference

<p>The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability to detect AF. Most clinical management decisions in AF patients can be based on validated parameters that encompass type of presentation, clinical factors, electrocardiogram analysis, and cardiac imaging. Despite these advances, patients with AF are still at increased risk for death, stroke, heart failure, and hospitalizations. During the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association (AFNET/EHRA) consensus conference, we identified the following opportunities to personalize management of AF in a better manner with a view to improve outcomes by integrating atrial morphology and damage, brain imaging, information on genetic predisposition, systemic or local inflammation, and markers for cardiac strain. Each of these promising avenues requires validation in the context of existing risk factors in patients. More importantly, a new taxonomy of AF may be needed based on the pathophysiological type of AF to allow personalized management of AF to come to full fruition. Continued translational research efforts are needed to personalize management of this prevalent disease in a better manner. All the efforts are expected to improve the management of patients with AF based on personalized therapy.</p>

Search for Bc+→π+μ+μ−B_c^+\to\pi^+\mu^+\mu^- decays and measurement of the branching fraction ratio B(Bc+→ψ(2S)π+)/B(Bc+→J/ψπ+){\cal B}(B_c^+\to\psi(2S)\pi^+)/{\cal B}(B_c^+\to J/\psi \pi^+)

International audienceThe first search for nonresonant $B_c^+\to\pi^+\mu^+\mu^-$ decays is reported. The analysis uses proton-proton collision data collected with the LHCb detector between 2011 and 2018, corresponding to an integrated luminosity of 9 fb$^{-1}$. No evidence for an excess of signal events over background is observed and an upper limit is set on the branching fraction ratio ${\cal B}(B_c^+\to\pi^+\mu^+\mu^-)/{\cal B}(B_c^+\to J/\psi \pi^+) < 2.1\times 10^{-4}$ at $90\%$ confidence level. Additionally, an updated measurement of the ratio of the $B_c^+\to\psi(2S)\pi^+$ and $B_c^+\to J/\psi \pi^+$ branching fractions is reported. The ratio ${\cal B}(B_c^+\to\psi(2S)\pi^+)/{\cal B}(B_c^+\to J/\psi \pi^+)$ is measured to be $0.254\pm 0.018 \pm 0.003 \pm 0.005$, where the first uncertainty is statistical, the second systematic, and the third is due to the uncertainties on the branching fractions of the leptonic $J/\psi$ and $\psi(2S)$ decays. This measurement is the most precise to date and is consistent with previous LHCb results

Observation of the Bc+→J/ψπ+π0B_c^+ \to J/\psi \pi^+ \pi^0 decay

International audienceThe first observation of the $B_c^+ \to J/\psi \pi^+ \pi^0$ decay is reported with high significance using proton-proton collision data, corresponding to an integrated luminosity of 9fb$^{-1}$, collected with the LHCb detector at centre-of-mass energies of 7, 8, and 13 TeV. The ratio of its branching fraction relative to the $B_c^+ \to J/\psi \pi^+$ channel is measured to be $$\frac{ {\cal{B}}( B_c^+ \to J/\psi \pi^+\pi^0 ) } { {\cal{B}}( B_c^+ \to J/\psi \pi^+ ) } = 2.80 \pm 0.15 \pm 0.11 \pm 0.16 \,,$$ where the first uncertainty is statistical, the second systematic and the third related to imprecise knowledge of the branching fractions for $B^+ \to J/\psi K^{*+}$ and $B^+ \to J/\psi K^+$ decays, which are used to determine the $\pi^0$ detection efficiency. The $\pi^+\pi^0$ mass spectrum is found to be consistent with the dominance of an intermediate $\rho^+$ contribution in accordance with a model based on QCD factorisation

Search for Bc+→π+μ+μ−B_c^+\to\pi^+\mu^+\mu^- decays and measurement of the branching fraction ratio B(Bc+→ψ(2S)π+)/B(Bc+→J/ψπ+){\cal B}(B_c^+\to\psi(2S)\pi^+)/{\cal B}(B_c^+\to J/\psi \pi^+)

International audienceThe first search for nonresonant $B_c^+\to\pi^+\mu^+\mu^-$ decays is reported. The analysis uses proton-proton collision data collected with the LHCb detector between 2011 and 2018, corresponding to an integrated luminosity of 9 fb$^{-1}$. No evidence for an excess of signal events over background is observed and an upper limit is set on the branching fraction ratio ${\cal B}(B_c^+\to\pi^+\mu^+\mu^-)/{\cal B}(B_c^+\to J/\psi \pi^+) < 2.1\times 10^{-4}$ at $90\%$ confidence level. Additionally, an updated measurement of the ratio of the $B_c^+\to\psi(2S)\pi^+$ and $B_c^+\to J/\psi \pi^+$ branching fractions is reported. The ratio ${\cal B}(B_c^+\to\psi(2S)\pi^+)/{\cal B}(B_c^+\to J/\psi \pi^+)$ is measured to be $0.254\pm 0.018 \pm 0.003 \pm 0.005$, where the first uncertainty is statistical, the second systematic, and the third is due to the uncertainties on the branching fractions of the leptonic $J/\psi$ and $\psi(2S)$ decays. This measurement is the most precise to date and is consistent with previous LHCb results

Helium identification with LHCb

International audienceThe identification of helium nuclei at LHCb is achieved using a method based on measurements of ionisation losses in the silicon sensors and timing measurements in the Outer Tracker drift tubes. The background from photon conversions is reduced using the RICH detectors and an isolation requirement. The method is developed using $pp$ collision data at $\sqrt{s}=13\,{\rm TeV}$ recorded by the LHCb experiment in the years 2016 to 2018, corresponding to an integrated luminosity of $5.5\,{\rm fb}^{-1}$. A total of around $10^5$ helium and antihelium candidates are identified with negligible background contamination. The helium identification efficiency is estimated to be approximately $50\%$ with a corresponding background rejection rate of up to $\mathcal O(10^{12})$. These results demonstrate the feasibility of a rich programme of measurements of QCD and astrophysics interest involving light nuclei

Observation of Cabibbo-suppressed two-body hadronic decays and precision mass measurement of the Ωc0\Omega_{c}^{0} baryon

International audienceThe first observation of the singly Cabibbo-suppressed $\Omega_{c}^{0}\to\Omega^{-}K^{+}$ and $\Omega_{c}^{0}\to\Xi^{-}\pi^{+}$ decays is reported, using proton-proton collision data at a centre-of-mass energy of $13\,{\rm TeV}$, corresponding to an integrated luminosity of $5.4\,{\rm fb}^{-1}$, collected with the LHCb detector between 2016 and 2018. The branching fraction ratios are measured to be $\frac{\mathcal{B}(\Omega_{c}^{0}\to\Omega^{-}K^{+})}{\mathcal{B}(\Omega_{c}^{0}\to\Omega^{-}\pi^{+})}=0.0608\pm0.0051({\rm stat})\pm 0.0040({\rm syst})$, $\frac{\mathcal{B}(\Omega_{c}^{0}\to\Xi^{-}\pi^{+})}{\mathcal{B}(\Omega_{c}^{0}\to\Omega^{-}\pi^{+})}=0.1581\pm0.0087({\rm stat})\pm0.0043({\rm syst})\pm0.0016({\rm ext})$. In addition, using the $\Omega_{c}^{0}\to\Omega^{-}\pi^{+}$ decay channel, the $\Omega_{c}^{0}$ baryon mass is measured to be $M(\Omega_{c}^{0})=2695.28\pm0.07({\rm stat})\pm0.27({\rm syst})\pm0.30({\rm ext})\,{\rm MeV}/c^{2}$, improving the precision of the previous world average by a factor of four

Measurement of CP violation in B0→ψ(→ℓ+ℓ−)KS0(→π+π−)decaysB^0\to \psi(\to\ell^+\ell^-)K^0_\mathrm{S}(\to \pi^+\pi^-)decays

A measurement of time-dependent $C\!P$ violation in the decays of $B^0$ and $\overline{B}^0$ mesons to the final states ${J\!/\!\psi(\to\mu^+\mu^-)K^0_\mathrm{S}}$, $\psi(2S)(\to\mu^+\mu^-)K^0_\mathrm{S}$ and $J\!/\!\psi(\to e^+e^-)K^0_\mathrm{S}$ with $K^0_\mathrm{S}\pi^+\pi^-$ is presented. The data correspond to an integrated luminosity of $6\,\mathrm{fb}^{-1}$ collected at a centre-of-mass energy of $\sqrt{s}=13\,\mathrm{TeV}$ with the LHCb detector. The $C\!P$-violation parameters are measured to be \begin{align*} S_{\psi K^0_\mathrm{S}} &= 0.717 \pm 0.013\,(\text{stat}) \pm 0.008\,(\text{syst}), \\ C_{\psi K^0_\mathrm{S}} &= 0.008 \pm 0.012\,(\text{stat}) \pm 0.003\,(\text{syst}). \end{align*} This measurement of $S_{\psi K^0_\mathrm{S}}$ represents the most precise single measurement of the CKM angle $\beta$ to date and is more precise than the current world average. In addition, measurements of the $C\!P$-violation parameters of the individual channels are reported and a combination with the LHCb Run 1 measurements is performed.A measurement of time-dependent CP violation in the decays of $B^0$ and $\overline{B}^0$ mesons to the final states $J/\psi(\to\mu^+\mu^-)K^0_S$, $\psi(2S)(\to\mu^+\mu^-)K^0_S$ and $J/\psi(\to e^+e^-)K^0_S$ with $K^0_S\to\pi^+\pi^-$ is presented. The data correspond to an integrated luminosity of 6 fb${}^{-1}$ collected at a centre-of-mass energy of $\sqrt{s}=13$ TeV with the LHCb detector. The CP-violation parameters are measured to be \begin{align*} S_{\psi K^0_S} &= 0.717 \pm 0.013 (\text{stat}) \pm 0.008 (\text{syst}), \\ C_{\psi K^0_S} &= 0.008 \pm 0.012 (\text{stat}) \pm 0.003 (\text{syst}). \end{align*} This measurement of $S_{\psi K^0_S}$ represents the most precise single measurement of the CKM angle $\beta$ to date and is more precise than the current world average. In addition, measurements of the CP-violation parameters of the individual channels are reported and a combination with the LHCb Run 1 measurements is performed