Progression of Atrial Fibrillation in the Young

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to investigate the presence and magnitude of structural changes of the heart and their long-term development in young patients with atrial Fibrillation (AF), studied by echocardiographic measurements and plasma biomarkers and their association to AF burden, studied using long-term ECG

Detailed Description
-----------------
100 patients with symptomatic Atrial Fibrillation diagnosis are included. Diagnosis is set either at the index visit or within 12 months before inclusion. . The follow up period is 5 years. Patients presenting with AF in connection with acute infection, acute cardiac ischemia, surgery or thyroid disease are excluded. Further, AF patients with cardiomyopathies, known genetic diseases and congenital cardiac abnormalities are also excluded. At inclusion patients undergo an in-depth interview regarding comorbidities, medication, previous treatments related to the AF diagnosis. In addition, baseline data for weight and height are collected. In connection to inclusion the patients are asked leave venous bloodwork (Na, K, Creatinine, plasma Glucose and NTproB-Type Natriuretic Peptide). An echocardiographic exam is performed according to a prespecified protocol with special emphasis on the left atrial function and anatomy. This is followed by a continuous ECG recording for 14 days using BioTel ePatch. The ECG patch is later returned to a core facility by mail. The patients´ are followed for five years and are asked to leave bloodwork and perform a 14-day ECG recording yearly. After these exams, a follow up phone call is placed to the patient aimed at documenting clinical progress related to symptoms, treatment and interventions. After 5 years follow up patients undergo a follow up echocardiographic exam in addition to yearly bloodwork and ECG recording. The patients´ clinical symptoms are treated at the clinician´s discretion according to current guidelines.

Official Title
-----------------
Progression of Atrial Fibrillation in the Young

Conditions
-----------------
Atrial Fibrillation

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Atrial fibrillation Diagnosis of atrial fibrillation within one year of inclusion Exclusion Criteria: Duration of atrial fibrillation over one year. Acute stressor for atrial fibrillation such as: acute ischemic heart disease or infection

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Development of atrial fibrillation burden | Change in burden of atrial fibrillation expressed as proportion of arrhythmia present on long-term ECG yearly | change from baseline at 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Development of humoral measures of hemodynamic status | Change in levels of plasma-N-terminal pro brain natriuretic peptide yearly (ng) | Change from baseline at 5 years | 
| Development of atrial electrocardiographic status | Change in number of supraventricular ectopic beats per 24 h on long-term ECG Yearly | Change from baseline at 5 years | 
| Development of supraventricular ectopies | Change in numbers of supraventricular tachycardia runs of at least 20 beats per 24 h on long-term ECG yearly | Change from baseline at 5 years | 
| Development of atrial fibrillation incident | Change in numbers of atrial fibrillation episodes per 24 h on long-term ECG yearly | Change from baseline at 5 years | 
| Development of echocardiographic status | Change in the left atrial volume indexed (ml/m2) | Change from baseline at 5 years | 
| Development of left atrial systolic function by echocardiography | Change in left atrial strain (%) | Change from baseline at 5 years | 
| Development of left atrial volume by echocardiography | Change in left ventricular volume indexed (ml/m2) | Change from baseline at 5 years | 
| Development of left ventricular systolic function by echocardiographic | Change in left ventricular ejection fraction (%) | Change from baseline at 5 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
atrial fibrillation, progression, left atrial function