Reappraisal of Atrial Fibrillation: Interaction Between HyperCoagulability, Electrical Remodeling, and Vascular Destabilisation in the Progression of Atrial Fibrillation

NCT ID: NCT02726698

Last Updated: 2024-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

750 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-07-31

Study Completion Date

2024-10-31

Brief Summary

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The purpose of this study is to study clinical factors and (blood) biomarkers related to progression of Atrial Fibrillation (AF) in patients diagnosed with self-terminating AF with special reference to hypercoagulability. All patients will be continuously monitored for their atrial rhythm to assess AF progression, either through an implantable loop recorder (Reveal LinQ) or via the atrial lead of a cardiac implantable electronic device (CIED), both in combination with the CareLink home monitoring system. Remote monitoring and interrogation will be installed and used on a daily basis.

Detailed Description

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Conditions

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Atrial Fibrillation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* New onset or history of paroxysmal, self-terminating AF documented as:

* AF on ECG or Holter-recording or loop recorder
* Subclinical AF detected in implantable cardiac devices (atrial read \> 190 beats per minute, lasting \> 6 minutes).
* Prior history of self-terminating AF is allowed;
* Able and willing to sign informed consent for the registry;
* Able and willing to undergo implantation of an implantable loop recorder (in patients without a CIED);

* CHA2DS2-VASc score ≤5 (history of Congestive heart failure, Hypertension, Age ≥ 75 years (doubled), Diabetes mellitus,Stroke/transient ischemic attack (doubled), Vascular disease, Age 65-75 years, female Sex);
* No other indication for oral anticoagulation (e.g. mechanical valve prosthesis);
* Patient is willing to temporarily stop oral anticoagulation drugs (OAC).

Exclusion Criteria

* Non-self-terminating, persistent AF;
* Deemed unsuitable or not willing to undergo implantation of loop recorder (in patients without a CIED);
* Refusing to temporarily stop OAC for coagulation phenotyping (in patients already on OAC before inclusion in this study);
* On waiting list for pulmonary vein isolation or expected to be placed on waiting list within one year;
* Expected to start with amiodarone;
* Pregnancy;
* Life expectancy of less than 2.5 years.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Maastricht University Medical Center

OTHER

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role lead

Responsible Party

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I.C. Van Gelder

Prof.dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Harry JGM Crijns, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Maastricht University Medical Center

Isabelle C van Gelder, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

Locations

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Rijnstate Hospital

Arnhem, Gelderland, Netherlands

Site Status

Maastricht University Medical Center

Maastricht, Limburg, Netherlands

Site Status

Amsterdam University Medical Center - AMC

Amsterdam, , Netherlands

Site Status

Amsterdam University Medical Center - VU

Amsterdam, , Netherlands

Site Status

University Medical Center Groningen

Groningen, , Netherlands

Site Status

Martini Hospital

Groningen, , Netherlands

Site Status

Ommelander Ziekenhuis

Groningen, , Netherlands

Site Status

Laurentius Hospital

Roermond, , Netherlands

Site Status

Isala

Zwolle, , Netherlands

Site Status

Countries

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Netherlands

References

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Frausing MHJP, Rienstra M, Kronborg MB, De Melis M, Schotten U, Nielsen JC, Tieleman R, Crijns HJ, Van Gelder IC, Samuel M. Association between circulating biomarkers and atrial fibrillation burden in patients with paroxysmal atrial fibrillation: a subanalysis of the RACE V study. Open Heart. 2025 Sep 30;12(2):e003433. doi: 10.1136/openhrt-2025-003433.

Reference Type DERIVED
PMID: 41033708 (View on PubMed)

van Deutekom C, van de Lande ME, Rama R, Nguyen BO, Tieleman RG, Weberndorfer V, Hemels MEW, de Melis M, Schotten U, Linz D, Crijns HJGM, van Gelder IC, Rienstra M; RACE V Investigators. Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation-Data From the RACE V Study. J Am Heart Assoc. 2025 Mar 4;14(5):e034514. doi: 10.1161/JAHA.123.034514. Epub 2025 Feb 26.

Reference Type DERIVED
PMID: 40008502 (View on PubMed)

Koldenhof T, Van Gelder IC, van de Lande ME, Al-Jazairi MIH, Tieleman RG, Rienstra M. High heart rates during paroxysmal atrial fibrillation: continuous rhythm monitoring data of the RACE V study. Heart. 2024 Oct 10;110(21):1250-1253. doi: 10.1136/heartjnl-2024-324376.

Reference Type DERIVED
PMID: 39168591 (View on PubMed)

Frausing MHJP, Van De Lande M, Linz D, Crijns HJGM, Tieleman RG, Hemels MEW, De Melis M, Schotten U, Kronborg MB, Nielsen JC, Van Gelder I, Rienstra M. Healthcare utilisation and quality of life according to atrial fibrillation burden, episode frequency and duration. Heart. 2024 Jul 25;110(16):1030-1039. doi: 10.1136/heartjnl-2024-324016.

Reference Type DERIVED
PMID: 38944418 (View on PubMed)

van de Lande ME, Rama RS, Koldenhof T, Arita VA, Nguyen BO, van Deutekom C, Weberndorfer V, Crijns HJGM, Hemels MEW, Tieleman RG, de Melis M, Schotten U, Linz D, Van Gelder IC, Rienstra M; RACE V Investigators. Time of onset of atrial fibrillation and atrial fibrillation progression data from the RACE V study. Europace. 2023 May 19;25(5):euad058. doi: 10.1093/europace/euad058.

Reference Type DERIVED
PMID: 36967470 (View on PubMed)

Frausing MHJP, Van De Lande ME, Maass AH, Nguyen BO, Hemels MEW, Tieleman RG, Koldenhof T, De Melis M, Linz D, Schotten U, Weberndorfer V, Crijns HJGM, Van Gelder IC, Nielsen JC, Rienstra M. Brady- and tachyarrhythmias detected by continuous rhythm monitoring in paroxysmal atrial fibrillation. Heart. 2023 Aug 11;109(17):1286-1293. doi: 10.1136/heartjnl-2022-322253.

Reference Type DERIVED
PMID: 36948572 (View on PubMed)

Artola Arita V, Van De Lande ME, Khalilian Ekrami N, Nguyen BO, Van Melle JM, Geelhoed B, De With RR, Weberndorfer V, Erkuner O, Hillege H, Linz D, Ten Cate H, Spronk HMH, Koldenhof T, Tieleman RG, Schotten U, Crijns HJGM, Van Gelder IC, Rienstra M. Clinical utility of the 4S-AF scheme in predicting progression of atrial fibrillation: data from the RACE V study. Europace. 2023 Apr 15;25(4):1323-1331. doi: 10.1093/europace/euac268.

Reference Type DERIVED
PMID: 36857318 (View on PubMed)

Nguyen BO, Weberndorfer V, Crijns HJ, Geelhoed B, Ten Cate H, Spronk H, Kroon A, De With R, Al-Jazairi M, Maass AH, Blaauw Y, Tieleman RG, Hemels MEW, Luermans J, de Groot J, Allaart CP, Elvan A, De Melis M, Scheerder C, van Zonneveld AJ, Schotten U, Linz D, Van Gelder I, Rienstra M. Prevalence and determinants of atrial fibrillation progression in paroxysmal atrial fibrillation. Heart. 2022 Jul 20;109(3):186-94. doi: 10.1136/heartjnl-2022-321027. Online ahead of print.

Reference Type DERIVED
PMID: 35858774 (View on PubMed)

De With RR, Artola Arita V, Nguyen BO, Linz D, Ten Cate H, Spronk H, Schotten U, Jan van Zonneveld A, Erkuner O, Bayon MA, Schmidt AS, Luermans JGLM, Crijns HJGM, Van Gelder IC, Rienstra M. Different circulating biomarkers in women and men with paroxysmal atrial fibrillation: results from the AF-RISK and RACE V studies. Europace. 2022 Feb 2;24(2):193-201. doi: 10.1093/europace/euab179.

Reference Type DERIVED
PMID: 34329401 (View on PubMed)

De With RR, Erkuner O, Rienstra M, Nguyen BO, Korver FWJ, Linz D, Cate Ten H, Spronk H, Kroon AA, Maass AH, Blaauw Y, Tieleman RG, Hemels MEW, de Groot JR, Elvan A, de Melis M, Scheerder COS, Al-Jazairi MIH, Schotten U, Luermans JGLM, Crijns HJGM, Van Gelder IC; RACE V Investigators. Temporal patterns and short-term progression of paroxysmal atrial fibrillation: data from RACE V. Europace. 2020 Aug 1;22(8):1162-1172. doi: 10.1093/europace/euaa123.

Reference Type DERIVED
PMID: 32642768 (View on PubMed)

Other Identifiers

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NL53561.042.16

Identifier Type: -

Identifier Source: org_study_id