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- Essai clinique NCT01945229
Thumb-ECG Ambulant Screening for Atrial Fibrillation in Patients Treated for Hyperthyroidism (TAMBOURINE) (TAMBOURINE)
Background: Atrial fibrillation is a common heart rhythm disturbance affecting some 1-2% of the western population. It may cause symptoms such as irregular heartbeats, shortness of breath, and fatigue. It may also be asymptomatic (ie "silent atrial fibrillation). In some cases, atrial fibrillation is permanent whereas in others it is sporadic. Regardless of symptoms, there is an increased risk of stroke in some patients with this condition. Novel technologies are being developed to increase detection of silent atrial fibrillation, in order to find patients who might benefit from treatment with oral anticoagulants (blood-thinning medications) in order to reduce the risk of stroke. One of these technologies is thumb-ECG, a simple way for a patient to have his or her heart rhythm reliably analyzed at home.
Hyperthyroidism (sometimes referred to as "toxic goiter") is defined as an excessive production of thyroid hormone. It is known that hyperthyroidism may cause atrial fibrillation in about 8% of cases.
Objective: To provide thumb-ECG-monitors to hyperthyroid patients before and after treating their hormonal disturbance, in order to find episodes of silent atrial fibrillation.
Design: Prospective observational study.
Hypotheses:
- Primary hypothesis: Silent atrial fibrillation is at least as common as overt atrial fibrillation in hyperthyroid patients.
- Secondary hypothesis nr 1: Atrial fibrillation continues to be more prevalent compared to the normal population even after hyperthyroidism is treated.
- Secondary hypothesis nr 2: The majority of patients with hyperthyroidism and atrial fibrillation are at increased risk of stroke and should be considered for treatment with oral anticoagulants.
Aperçu de l'étude
Statut
Les conditions
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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Gothemburg, Suède, 41345
- Medicine Clinic, Sahlgrenska University Hospital
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Stockholm, Suède, 17176
- Endocrinology Clinik, Karolinska University Hospital
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Stockholm, Suède, 18288
- Medicine Clinic, Danderyds Hospital
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- Patient is deemed suitable for treatment with radioiodine or antithyroid drugs
- Patient has a thyreotropin (TSH) value below 0,1 mIU/L, measured less than 2 weeks before inclusion
- Patient has a CHADS-VASc-score of 1 point or higher (excluding if 1 point is for female sex only)
- Patient gives written consent to participate in study
Exclusion Criteria:
- Patient has a previously known diagnosis of atrial fibrillation
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
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Hyperthyroid patients
Patients with hyperthyroidism admitted for treatment with radioiodine or antithyroid drugs
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Prevalence of asymptomatic (silent) atrial fibrillation in hyperthyroid patients
Délai: Upon inclusion and 2 weeks onwards
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Upon inclusion, each patient will receive a thumb-ECG-monitor to take home.
He/she will register his/her heart rhythm twice daily, and can also register at will upon symptoms.
This will continue for 2 weeks, after which the monitor is returned.
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Upon inclusion and 2 weeks onwards
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Prevalence of asymptomatic (silent) atrial fibrillation in patients treated for hyperthyroidism.
Délai: Between 12 and 14 weeks after inclusion
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When a patient comes back to the policlinic after hyperthyroidism treatment (typically 3 months later), the same procedure is performed as upon inclusion.
Thumb-ECG-monitoring is performed during a 2-week period.
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Between 12 and 14 weeks after inclusion
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Prevalence of risk factors for stroke in patients with atrial fibrillation
Délai: Momentary (day 1, upon inclusion)
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Risk factors for stroke in atrial fibrillation according to the CHADS-VASc-scoring system.
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Momentary (day 1, upon inclusion)
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Mårten Rosenqvist, Prof, Karolinska Institutet
Publications et liens utiles
Publications générales
- Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med. 2004 Aug 9-23;164(15):1675-8. doi: 10.1001/archinte.164.15.1675. Erratum In: Arch Intern Med. 2005 Feb 14;165(3):307.
- Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P; ESC Committee for Practice Guidelines (CPG). 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012 Nov;33(21):2719-47. doi: 10.1093/eurheartj/ehs253. Epub 2012 Aug 24. No abstract available. Erratum In: Eur Heart J. 2013 Mar;34(10):790. Eur Heart J. 2013 Sep;34(36):2850-1.
- Osman F, Franklyn JA, Holder RL, Sheppard MC, Gammage MD. Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case-control study. J Am Coll Cardiol. 2007 Jan 2;49(1):71-81. doi: 10.1016/j.jacc.2006.08.042. Epub 2006 Dec 13.
- Metso S, Auvinen A, Salmi J, Huhtala H, Jaatinen P. Increased long-term cardiovascular morbidity among patients treated with radioactive iodine for hyperthyroidism. Clin Endocrinol (Oxf). 2008 Mar;68(3):450-7. doi: 10.1111/j.1365-2265.2007.03064.x. Epub 2007 Oct 17.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 3/9 B
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