Atrial Fibrillation
Conditions
Brief summary
In the proposed study the investigators aim to clarify the relative contribution of these different mechanisms to the progression of atrial fibrillation (AF). Also the contribution of the individual genetic background will be investigated. Furthermore, the investigators aim to identify clinical parameters and biomarkers informing on the main mechanisms of AF progression in atrial tissue. For this purpose, in all included patients atrial biopsies will be taken during cardiac surgery.
Detailed description
An estimated 380 patients will be included Four patient categories will be included enabling to study patients with different stages of AF progression; 1. Patients without history of atrial fibrillation, without new onset atrial fibrillation detected by continuous rhythm monitoring after surgery (control group), 2. Patients without history of atrial fibrillation, with new onset atrial fibrillation detected by continuous rhythm monitoring, 3. Patients with self-terminating atrial fibrillation at inclusion, and 4. Patients with non-self-terminating atrial fibrillation at inclusion. At baseline in-depth phenotyping and genotyping will be performed. Continuous rhythm monitoring will also be performed in all patients. The combination of extensive phenotyping, genotyping and atrial fibrillation burden follow-up offers the unique opportunity to study the atrial tissue alterations and atrial gene expression changes in different stages of atrial fibrillation progression and to correlate these data to the phenotype of the patients.
Interventions
DEVICEImplantable loop recorder
Continuous rhythm monitoring Medtronic
Sponsors
Academisch Ziekenhuis Maastricht
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \> 18 years; * Undergoing first elective open chest cardiac surgery or surgical ablation for atrial fibrillation; * Able and willing to sign informed consent for the registry; * Able and willing to undergo implantation of implantable loop recorder (unless the patients has a pacemaker or implantable cardioverter-defibrillator (ICD) with atrial leads)
Exclusion criteria
* • Deemed unsuitable or not willing to undergo implantation of implantable loop recorder or attend follow-up visits. * Pregnancy. * Life expectancy of less than 2.5 years. * History of prior cardiac surgery or ablation for atrial fibrillation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Biochemical factors in atrial biopsies and blood samples | 2.5 year follow up | Biochemical factors in atrial biopsies and blood samples associated with atrial fibrillation and contributing to atrial fibrillation progression |
| Genetic factors in atrial biopsies and blood samples | 2.5 year follow up | Genetic factors in atrial biopsies and blood samples associated with atrial fibrillation and contributing to atrial fibrillation progression |
| Molecular factors in atrial biopsies and blood samples | 2.5 year follow up | Molecular factors in atrial biopsies and blood samples associated with atrial fibrillation and contributing to atrial fibrillation progression |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Major adverse cardiovascular and cerebrovascular events | 2.5 year follow up | Major adverse cardiovascular and cerebrovascular events (i.e. death, stroke, myocardial infarction) |
| First recurrent atrial fibrillation; | 2.5 year follow up | First recurrent atrial fibrillation |
| Atrial fibrillation burden | 2.5 year follow up | Atrial fibrillation burden |
| AF complexity | 2.5 year follow up | Electrical atrial fibrillation complexity or signs of atrial conduction disturbances measured from ECGs |
| AF progression | 2.5 year follow up | Self-terminating atrial fibrillation turning into non-self-terminating atrial fibrillation measured from ECGs and implantable loop recorders |
| Number of atrial fibrillation episodes | 2.5 year follow up | Number of atrial fibrillation episodes |
| Duration of atrial fibrillation episodes | 2.5 year follow up | Duration of atrial fibrillation episodes |
Countries
Netherlands
Contacts
Primary ContactMartijn Gilbers, Drs.
Outcome results
None listed