Atrial Fibrillation Clinical Trial
Official title:
READ-POAF Pilot Study. The Use of the Reveal XT as Device for Postoperative Atrial Fibrillation Detection After Cardiac Surgery
Postoperative atrial fibrillation after coronary artery bypass grafting will be monitored up
to 1 year after the procedure by implanting a Reveal XT internal loop recorder two weeks
before the surgery. Frequency, burden, and possible risk factors will be described.
During the operation direct contact epicardial mapping will be performed and tissue samples
will be collected to identify an electrophysiological and a structural substrate for
development of AF.
Background of the study:
Postoperative atrial fibrillation (POAF) after cardiac surgery is a common (1 in 4)
complication and associated with morbidity and mortality. Not all episodes of AF are noticed
and detected, especially after discharge. several studies have shown high mortality in POAF
patients, suggesting a progression in AF frequency.
Objective of the study:
To investigate the real incidence and burden of POAF. Afterwards a risk stratification of
POAF is made. To identify a structural and electrophysiological substrate for the
development of POAF and new onset AF during follow up.
Study design:
140 patients will receive a Reveal device. After 3 and 12 months data will be subtracted
from the device. 100 of these patient will undergo additional mapping and tissue biopsies
during operation.
Study population:
All patients undergoing cardiac surgery without a history of AF and without a pacemaker will
be invited to participate in the study.
Primary study parameters/outcome of the study:
Incidence of POAF until 3 months after CABG.
Secondary study parameters/outcome of the study:
Incidence of POAF until 12 months after CABG. Determine risk factors for early and late
POAF. Detect pre-operative (unnoticed) episodes of AF.
Determine a substrate for development of AF.
Nature and extent of the burden and risks associated with participation, benefit and group
relatedness:
There is a small risk of minor complications (hemorrhage and infection of the pocket).The
device can be explanted easily if necessary. Ther is a burden of the im- and explantation of
the device (local anesthesia, approx. 20 minutes). Patient will have to visit the
out-hospital clinic twice.
The operation will be prolonged by 30 minutes due to mapping.
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Observational Model: Cohort, Time Perspective: Prospective
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