Atrial fibrillation (AF) is a prevalent cardiac arrhythmia affecting millions globally, with projections indicating a doubling of cases by 2050. AF is linked to heightened cardiovascular risks like stroke and increased healthcare costs. Ablation, targeting the arrhythmia substrate, is a method to manage AF, yet recurrence rates remain high (20-45% in the first year). Studies highlight the impact of comorbidities, AF characteristics, ablation techniques, and myocardial remodeling markers on AF progression and ablation efficacy. However, there's no definitive guidance on selecting these factors for predicting treatment success. The aim of this study is to investigate predictors of successful AF ablation in the following areas: (a) clinical factors, (b) electrophysiological, (c) electrocardiographic, (d) ultrasound, (e) cardiac anatomy, (f) biomarkers.
AF is a multifactorial disease influenced by many possible mechanisms. This study will examine several different predictors of successful AF ablation: (a) clinical factors, (b) electrophysiological, (c) electrocardiographic, (d) ultrasound, (e) cardiac anatomy, (f) biomarkers. Analysis of these factors will help determine the optimal combination of predictors of successful ablation. This combination of prognostic factors can then be used to tailor therapeutic decisions specifically to individual patients and to improve patient selection for invasive treatment. Better patient selection and choice of ablation type can help increase success rates and avoid unnecessary procedures and their associated risks.
Study Type
OBSERVATIONAL
Enrollment
400
PPG-based remote heart rhythm/rate monitoring
ECG-based remote heart rhythm/rate monitoring
Transthoracic and transesophageal echocardiography examination
Liver ultrasound examination
Rotational angiography with three-dimensional reconstruction
Blood-derived biomarker analysis
Mobile health-based spirometry
Medical University of Warsaw
Warsaw, Poland
RECRUITINGLate AF recurrence
Late AF recurrence
Time frame: 3-12 months after ablation
Late recurrence of AF or atrial tachycardia or atrial flutter
Late recurrence of AF or atrial tachycardia or atrial flutter
Time frame: 3-12 months after ablation
Early recurrence of AF
Early recurrence of AF
Time frame: <3 months after ablation
Early recurrence of AF or atrial tachycardia or atrial flutter
Early recurrence of AF or atrial tachycardia or atrial flutter
Time frame: <3 months after ablation
Time to AF recurrence and the impact of early recurrence on late AF recurrence
Time to AF recurrence and the impact of early recurrence on late AF recurrence
Time frame: <3 and 3-12 months after ablation
The superiority of monitoring using mobile health devices over traditional heart rhythm monitoring
The superiority of monitoring using mobile health devices over traditional heart rhythm monitoring
Time frame: 3 months after ablation
Progression or regression of AF
Progression of AF (from paroxysmal to persistent or persistent to permanent) or regression of AF (from persistent to paroxysmal)
Time frame: 3-12 months after ablation
Modification of treatment, including antiarrhythmic treatment
Modification of treatment, including antiarrhythmic treatment
Time frame: 3-12 months after ablation
AF-related quality of life and symptoms
AF-related quality of life and symptoms
Time frame: Before, 3 and 12 months after ablation
Periprocedural complications
Periprocedural complications (e.g. cardiac tamponade, vascular complications, pseudoaneurysm, arteriovenous fistula, stroke, transient ischemic attack)
Time frame: Around ablation
Heart rate variability and rate
Heart rate variability and rate
Time frame: <3 months after ablation
Blood biomarker levels
Blood biomarker levels
Time frame: Before, 3 and 12 months after ablation
Ablation procedure parameters
Ablation procedure parameters (e.g. ablation time, procedure time, number of applications, amount of painkillers used)
Time frame: At ablation
Cardiac remodelling
Cardiac remodelling based on transthoracic and transesophageal echocardiography parameters
Time frame: Before, 3 and 12 months after ablation
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