Excessive Supraventricular Activity and Atrial Fibrillation
- Conditions
- Atrial FibrillationSupraventricular Beat, PrematurePremature Supraventricular BeatsPremature Atrial ComplexExtrasystole, AtrialAtrial Flutter
- Interventions
- Diagnostic Test: Holter recordingDiagnostic Test: Echocardiography (Echo)Diagnostic Test: Blood sampleDiagnostic Test: 24 hour ambulatory blood pressure monitoring And Arteriograph
- Registration Number
- NCT04593498
- Lead Sponsor
- Karolinska Institutet
- Brief Summary
The aim of the proposed study is to determine if individuals with excessive supraventricular ectopic activity (ESVEA) on Holter recording should be subjected to prolonged screening with Event loop recorder in order to detect previously undiagnosed Atrial fibrillation / flutter. Other biomarkers such as plasma biomarkers, high-end echocardiography and assessment of blood pressure and atrial stiffness will be studied and compared in ESVEA and control group as well as progression of atrial cardiomyopathy in ESVEA patients.
- Detailed Description
Excessive supraventricular ectopic activities (ESVEA) are a common finding on long-term ECG recordings and have a connection to atrial cardiomyopathy, incident AF, stroke and mortality.
Holter recording from 2022 preformed at Danderyd hospital will be screened in order to identify 125 recordings with ESVEA, defined as at least 30 atrial ectopic beats/hour or a supraventricular run of at least 20 consecutive beats. Participants fulfilling eligibility criteria will be offered prolonged AF screening with continuous holter recording during 14 days. A matched control group (125 participants) without ESVEA will also be screened using same method.
Cardiovascular data from medical records will be collected in order to obtain information regarding co-morbidities and being able to assess CHA2DS2-VASC score. Participants will be asked to fill in a questionnaire.
Samples of blood will be collected at index time, after 21± 3 months for further analysis with the aim of identifying biomarkers for atrial fibrillation. During these two time periods echocardiography, 24 hour ambulatory blood pressure monitoring and assessment af artery stiffness with Arteriograph will also be preformed.
The study population will after 21± 3 months be subjected to renewed screening with Holter in order to examine the persistence of excessive supraventricular activity.
Four years after the completion of screening visits, data from patient records and information thorough telephone interview and/or data from Swedish Patient Register, Swedish Dispensed Drug Register will be collected
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 250
Patients with at least 30 supraventricular extra systole (SVES)/h or a supraventricular run of at least 20 beats on a Holter recording.
Age < 70 years, >89 years Atrial fibrillation / flutter Lifelong treatment with oral anticoagulant Patients with implantable cardiac device Congestive heart failure (CHF) with Ejection fraction (EF) ≤ 30% Severe valvular heart disease
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Non-ESVEA Echocardiography (Echo) Participants not meeting inclusion criteria ESVEA Holter recording ESVEA (Excessive supraventricular ectopic activity): Participants with at least 30 supraventricular extra systole (SVES)/h or a supraventricular run of at least 20 beats. ESVEA Echocardiography (Echo) ESVEA (Excessive supraventricular ectopic activity): Participants with at least 30 supraventricular extra systole (SVES)/h or a supraventricular run of at least 20 beats. ESVEA 24 hour ambulatory blood pressure monitoring And Arteriograph ESVEA (Excessive supraventricular ectopic activity): Participants with at least 30 supraventricular extra systole (SVES)/h or a supraventricular run of at least 20 beats. Non-ESVEA 24 hour ambulatory blood pressure monitoring And Arteriograph Participants not meeting inclusion criteria ESVEA Blood sample ESVEA (Excessive supraventricular ectopic activity): Participants with at least 30 supraventricular extra systole (SVES)/h or a supraventricular run of at least 20 beats. Non-ESVEA Holter recording Participants not meeting inclusion criteria Non-ESVEA Blood sample Participants not meeting inclusion criteria
- Primary Outcome Measures
Name Time Method atrial fibrillation yield in extended ECG screening among patients with ESVEA on Holter recording as compared to patients without ESVEA. 10-14 days Proportion of patients with at least one episode of atrial fibrillation with a duration of at least 30 seconds among patients with ESVEA on Holter recording as compared to patients without ESVEA.
- Secondary Outcome Measures
Name Time Method the clinical development of atrial fibrillation subtype in patients diagnosed with atrial fibrillation. 2 years Presence of paroxysmal or permanent atrial fibrillation on follow-up.
Temporal development of ESVEA and atrial cardiomyopathy on repeated Holter recordings. 2 years Comparison of burden of supraventricular extrasystolic beats and number of episodes and duration of longest episode of supraventricular tachycardia.
Temporal development of several blood biomarkers with a possible relation to atrial cardiomyopathy in patients with and without ESVEA. 2 years Explorative sequential analysis of several blood biomarkers using PEA:
Artrial stiffness in relation to ESVEA and/or AF. 2 yeras Comparison of artrial stiffness and blood pressure
association between plasma biomarkers and the development of atrial fibrillation in patients with ESVEA. 2 years Comparison of biomarker profile in patients diagnosed with atrial fibrillation and patients not diagnosed with atrial fibrillation.
Association between ESVEA, atrial fibrillation and other relevant comorbidities such as stroke, heart failure and major bleeding as well as mortality. 4 years or longer Long-term data on incident stroke, heart failure, major bleedning and mortality compared between ESVEA- and non-ESVEA groups.
echocardiographic parameters in relation to ESVEA and/or AF. 2 years Comparison of echocardiographic parameters with focus on atrial dimension and function compared between ESVEA and non-ESVEA group.
Trial Locations
- Locations (1)
Danderyd Hospital
🇸🇪Stockholm, Sweden