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cliNIcal sCEnarios and Pathophysiology of Atrial Fibrillation

Not yet recruiting
Conditions
Atrial Fibrillation
Registration Number
NCT04320134
Lead Sponsor
Policlinico Casilino ASL RMB
Brief Summary

Atrial fibrillation (AF) remains the most common sustained cardiac arrhythmia with prevalence and incidence continuously increasing worldwide. Current guidelines propose an etiological, symptom-based classification of the arrhythmia and mainly focused on its duration with consequent rhythm or rate-control strategies. Moreover, risk scores for atherothrombotic systemic or hemorrhagic events related to atrial fibrillation are principally based on patients cardiovascular history and risk factors.

This approach do not consider relevant pathophysiological aspects that may play a pivotal role in triggering or perpetuating the arrhythmia, especially at its first occurrence. At this point, a crucial step would be deeply investigating AF clinical and pathophysiological features to guide a tailored diagnostical and therapeutic approach. Indeed, early recognition and proper characterization of triggers, substrates, autonomic system imbalance and modulating factors (drugs, electrolytes, etc) are of the utmost importance for AF care and management.

Therefore, this large scale prospective observational study aims to evaluate clinical and pathophysiological features of patients with symptomatic and asymptomatic atrial fibrillation in different scenarios to understand possible distinctive characteristics warranting a personalized approach to the arrhythmia.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
5000
Inclusion Criteria
  • Patients with electrocardiographic diagnosis of Atrial Fibrillation (New Onset, Paroxysmal, Persistent, Long Standing Persistent and Permanent) admitted to the Emergency Room and/or Cardiology Department /ambulatory care center of our Hospital
  • Age >18 years old
  • Patients who can give their written informed consent.
Exclusion Criteria
  • Age <18 years old
  • Patients who cannot give their written informed consent.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Rate of Atrial Fibrillation recurrences5 years

frequency distribution

Number of participants with Major Adverse Cardiac Events (MACE)5 years

frequency distribution

Rate of bleeding events5 years

frequency distribution of minor, major and fatal bleedings

Rate of thromboembolic events5 years

frequency distribution

Secondary Outcome Measures
NameTimeMethod
Rate of participants socio-demographic characteristicsbaseline and 5 years

Frequency distribution: age, gender, race, occupation, life-style, diet, physical activity, alcohol consumption

Rate of participants with comorbiditiesbaseline and 5 years

Frequency distribution: hypertension, heart failure, diabetes mellitus, kidney failure, dyslipidemia, lung diseases, thyroid disorders, gastrointestinal and liver disorders, hematological diseases, neoplasms, autoimmune disorders

Rate of participants with Heart diseasesbaseline and 5 years

frequency distribution: vascular diseases, valvular problems, cardiomyopathies, arrhythmias, family/genetic history of cardiovascular disease

Rate of patients with Atrial Fibrillation secondary to triggers and/or autonomic system imbalance and/or modifiable factorsbaseline and 5 years

Frequency distribution of patients in which atrial fibrillation was clearly related to adrenergic tone imbalance and/or vagal tone imbalance and/or secondary to modifiable factors

Describe imaging parameters (echocardiogram and cardiac magnetic resonance)baseline and 5 years

Left ventricle, right ventricle, right and left atrium and valves: morphologies, volumes, dimensions and function

Concentration of laboratory biomarkersbaseline and 5 years

Complete Blood cell count with differential; Interleukin-1, Interleukin-6, High sensitivity C Reactive protein

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