Atrial Fibrillation Clinical Trial
Official title:
The Relationship Between Fibroblast Growth Factor 23 and the Recurrence of Atrial Fibrillation After Catheter Ablation: a Nested Case-Control Study
To investigate whether fibroblast growth factor 23 can be used to predict recurrence after catheter ablation for atrial fibrillation and to provide an objective basis for the clinical selection of the optimal patients for catheter ablation.
Atrial fibrillation, which can result in stroke and thromboembolism in an approximately
5-fold increased risk, has been a great burden to health care system with the aging of
population. Catheter ablation is the most promising treatment of atrial fibrillation.
However, the recurrence rates of AF after catheter ablation are high, ranging from 20%-60%.
Therefore, non-invasive predictors for AF recurrence after catheter ablation is necessary to
select the optimal patients for this procedure.
Fibroblast growth factor-23 (FGF-23) is a bone-derived hormone that plays a central role in
phosphate homeostasis. Recent study showed that fibroblast growth factor 23 plays an
important role in cardiac remodeling and is considered to be independently associated with
the occurrence of atrial fibrillation. In this study, we are going to observe the
relationship between the serum FGF-23 and the arrythmia recurrence after catheter ablation
of AF.
This research is going to recruit 200 consecutive patients with a history of atrial
fibrillation for 180-360 days who intend to undergo catheter ablation. The day before
catheter ablation, serum FGF-23 level will be detected. Echocardiogram and left atrial CT
scan will also be performed on the day before catheter ablation. All patients will be
routinely follow up in the outpatient department by cardiologists every month for 1 year. If
patients complain about palpitations, fatigue, or other symptoms related to arrhythmia,
Holter monitoring will be performed. Patients will also be advised to see their doctor
anytime they have these symptoms and to undergo a 12-lead ECG examination or 24-hour Holter
monitoring. In asymptomatic patients, 24-hour Holter monitoring or 7-day cardiac event
recording will be performed every three months after the procedure. The endpoint for
follow-up is the recurrence of atrial fibrillation, which is considered to be any episode of
AF/AFL/AT after a blank period of 3 months after the procedure of catheter ablation. Those
who develop recurrence of AF during follow up will be assigned to recurrence group, and
those who do not develop recurrence of AF during follow up will be assigned to
non-recurrence group. Comparison of the serum FGF-23 level between the two groups will be
carried out in order to investigate the relationship between serum FGF-23 level and the
recurrence of AF.
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Observational Model: Case Control, Time Perspective: Prospective
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