Atrial Fibrillation Clinical Trial
Official title:
Multimodality Prediction of Success of Atrial Fibrillation Rhythm Control Strategy
In this study the investigators aim to build a model to predict the maintenance of sinus
rhythm (SR) after successful direct current cardioversion (DCC) incorporating standard
predictors such as echocardiographic parameters, clinical parameter and 12-lead ECG
parameters and new parameters, including 17-lead ECG, Oesophageal-ECG and single nucleotide
polymorphisms (SNPs). Using this novel integrated prediction model will help in the
identification of patients who will maintain SR after cardioversion. Another innovative
aspect of our study is the use of daily rhythm monitoring using a versatile device
(MyDiagnostick®). The clinical impact this study will have is that it helps the cardiologist
to make a patient tailored strategy in the treatment of AF as advocated by the guidelines and
to prevent exposing patients not likely to maintain SR to the potentially harmful side-effect
of a rhythm-control strategy.
Primary objectives To show that a model incorporating the novel predictors 17-lead ECG,
Oesophageal-ECG and SNPs is superior to existing models in predicting maintenance of sinus
rhythm after successful DCC in patients with persistent AF.
Secondary objectives To assess the predictive value of new predictors (the Oesophageal-ECG,
17-lead ECG and SNPs) for maintenance of SR after successful DCC separately.
To assess the predictive value of new predictors (the Oesophageal-ECG, 17-lead ECG and SNPs)
for time to recurrence of AF.
To assess the predictive value of predictors with respect to complete failure of
cardioversion.
To assess the predictive value of predictors with respect to cardiovascular morbidity.
Hypothesis The investigators hypothesise that a model incorporating the novel predictors the
17-leads ECG, Oesophageal-ECG and SNPs performs significantly better than existing models
using only clinical, echocardiographic and ECG parameters on a standard 12-lead ECG in
predicting maintenance of SR after successful DCC. In addition the investigators hypothesise
that Oesophageal-ECG is the best single predictor for maintenance of SR after successful DCC.
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