Relationship Between Fibroblast Growth Factor 23 and Recurrence of Atrial Fibrillation After Catheter Ablation (REBECCA)
The Relationship Between Fibroblast Growth Factor 23 and the Recurrence of Atrial Fibrillation After Catheter Ablation: a Nested Case-Control Study
研究概览
详细说明
Atrial fibrillation, which can result in stroke and thromboembolism in an approximately 5-fold increased risk, has been a great burden to health care system with the aging of population. Catheter ablation is the most promising treatment of atrial fibrillation. However, the recurrence rates of AF after catheter ablation are high, ranging from 20%-60%. Therefore, non-invasive predictors for AF recurrence after catheter ablation is necessary to select the optimal patients for this procedure.
Fibroblast growth factor-23 (FGF-23) is a bone-derived hormone that plays a central role in phosphate homeostasis. Recent study showed that fibroblast growth factor 23 plays an important role in cardiac remodeling and is considered to be independently associated with the occurrence of atrial fibrillation. In this study, we are going to observe the relationship between the serum FGF-23 and the arrythmia recurrence after catheter ablation of AF.
This research is going to recruit 200 consecutive patients with a history of atrial fibrillation for 180-360 days who intend to undergo catheter ablation. The day before catheter ablation, serum FGF-23 level will be detected. Echocardiogram and left atrial CT scan will also be performed on the day before catheter ablation. All patients will be routinely follow up in the outpatient department by cardiologists every month for 1 year. If patients complain about palpitations, fatigue, or other symptoms related to arrhythmia, Holter monitoring will be performed. Patients will also be advised to see their doctor anytime they have these symptoms and to undergo a 12-lead ECG examination or 24-hour Holter monitoring. In asymptomatic patients, 24-hour Holter monitoring or 7-day cardiac event recording will be performed every three months after the procedure. The endpoint for follow-up is the recurrence of atrial fibrillation, which is considered to be any episode of AF/AFL/AT after a blank period of 3 months after the procedure of catheter ablation. Those who develop recurrence of AF during follow up will be assigned to recurrence group, and those who do not develop recurrence of AF during follow up will be assigned to non-recurrence group. Comparison of the serum FGF-23 level between the two groups will be carried out in order to investigate the relationship between serum FGF-23 level and the recurrence of AF.
研究类型
注册 (预期的)
联系人和位置
学习地点
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Beijing
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Beijing、Beijing、中国、100019
- Peking University Third Hospital
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Have a history of atrial fibrillation for 180 to 360 days
- Provide written informed consent, having understood the benefits and risks of participation in the trial
Exclusion Criteria:
- Significant structural heart disease (including symptomatic coronary heart disease; prosthetic mitral or tricuspid valve; congenital heart disease where abnormality or its correction prohibits or increases the risk of ablation)
- Atrial Fibrillation precipitated by other diseases (such as thyrotoxicosis)
- Severe dysfunction of liver or kidney
- Diabetes
- Malignant tumor
- Inability or refusal to provide written informed consent for the study
学习计划
研究是如何设计的?
设计细节
- 观测模型:病例对照
- 时间观点:预期
队列和干预
团体/队列 |
干预/治疗 |
---|---|
Recurrence Group
In the case control trial, patients who have any episode of atrial fibrillation/atrial flutter/atrial tachycardia after a blanking period of 3 months from the catheter ablation procedure will be assign to the recurrence group
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Patients with persistent or paroxysmal atrial fibrillation will go through catheter ablation
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Non-recurrence Group
In the case control trial, patients who do not have any episode of atrial fibrillation/atrial flutter/atrial tachycardia after a blanking period of 3 months from the catheter ablation procedure will be assign to the recurrence group
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Patients with persistent or paroxysmal atrial fibrillation will go through catheter ablation
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Incidence of the recurrence of atrial fibrillation
大体时间:after 3 months from the procedure of catheter ablation
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The recurrence of atrial fibrillation is considered to be any episode of AF/AFL/AT after a blank period of 3 months after the procedure of catheter ablation
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after 3 months from the procedure of catheter ablation
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Plasma fibroblast growth factor 23 levels
大体时间:after 3 months from the procedure of catheter ablation
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Fibroblast Growth Factor 23 plays an important role in cardiac remodeling and is considered to be independently associated with the occurrence of atrial fibrillation
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after 3 months from the procedure of catheter ablation
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CHA2DS2-VASc score
大体时间:after 3 months from the procedure of catheter ablation
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CHA2DS2-VASc score is used to measure the risk of thrombotic event in patient with atrial fibrillation
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after 3 months from the procedure of catheter ablation
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Cardiac CT evaluation
大体时间:after 3 months from the procedure of catheter ablation
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To evaluate the degree of fibrosis of the left and right atrium and pulmonary veins
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after 3 months from the procedure of catheter ablation
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合作者和调查者
调查人员
- 研究主任:Lei Li, MD、Peking University Third Hospital
出版物和有用的链接
研究记录日期
研究主要日期
学习开始
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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