Stroke Clinical Trial
Official title:
Using a Personal Heart Rhythm Monitor (PHRM) to Diagnose Paroxsymal Atrial Fibrillation (PAF) in the Community; and the PREDICT-PAF Substudy - an Investigation of Biomarkers to Detect PAF.
This propsective study aims to compare the diagnostic yield of a Personal Heart Rhythm
Monitor (PHRM) with an automated cardiac event recorder (ACER) to detect paroxysmal Atrial
Fibrillation PAF). The investigators hypothesise that the PHRM, used intermittently for 3
months, will detect significantly more cases of PAF than the ACER, used continuously for one
week.
A case-control sub-study will identify individuals with confirmed PAF, and matched
individuals with no evidence of PAF, to identify potential serum biomarkers for PAF.
A further case-control study will assess markers of left atrial function in patients with
PAF and their matched controls.
Another case-control sub-study will determine the significance of frequent Atrial Premature
Beats (APBs) in the development of AF over a one year period.
Patients with suspected AF will be initially referred to a community-based, nurse-led
Arrhythmia clinic by their General Practitioners over a 15-month period.
All patients will be issued with a one week ACER (the 'R. Test 4 Evolution'), seen as the
'best-practice' investigation for this population group. Participants will also be issued
with a PHRM for three months. They will be instructed to take regular twice-daily, 30 second
recordings with additional recordings in the event of relevant symptoms. They will return
the ACER after one week and the PHRM after 3 months.
A subgroup of participants (target recruitment number = 100) will undergo transthoracic
echocardiography. A 40ml venous blood sample will also be taken. Another small subgroup
(target recruitment = 20) will be asked to continue twice-daily recordings using the PHRM
for a further nine months and will be issued with a repeat one week ACER at study
completion.
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