Short summary

Atrial fibrillation (AF) causes up to 1/4 of all strokes, which can be prevented by anticoagulant treatment. AF might occur subclinically, which is difficult to detect. Patients with high age, hypertension and diabetes mellitus are at high risk of developing AF and subsequently stroke. This project will detect subclinical AF in high-risk patients in order to initiate timely anticoagulant treatment and thus prevent stroke. We hypothesize that subclinical AF is under-detected in this group of patients . We also investigate, whether echocardiographic parametres and specific biomarkers are correlated to the occurrence of AF and are able to contribute to the risk assessment for these patients and subsequent decision concerning monitoring.

Rationale

Description of the cohort

One hundred consecutive patients are included in a cardiology clinic. They are screened primarily from diabetic outpatient clinics. There is an expected dropout at 20 %.

Eligible patients are 65 years or older at the time of inclusion with known diabetes mellitus (either treated peroral or with insulin) and known hypertension (with a minimum of treatment of 2-drugs antihypertensiva).

Patients with significant cardiovascular disease, severe chronic kidney disease, documented atrial fibrillation, implanted cardioverter defibrillator (ICD) or pacemaker, ongoing anticoagulant treatment, and thyreotoxicosis are excluded.

Data and biological material

Screening of the patients is done using electronic patient records. Included patients are clinically examined including ECG, blood pressure and standard blood tests. All patients receive an implantable loop recorder, undergo a 72-hour Holter monitoring and are examined with advanced echocardiogram. Additional blood samples are taken for investigation of specifik biomarkers.

Collaborating researchers and departments

Department of Cardiology, Odense University Hospital

• Associate Professor Axel Brandes, MD, DMSc, FESC
• Jordi Sanchez Dahl, MD, PhD

Department of Clinical Biochemistry and Pharmacology, Odense University Hospital

• Mads Nybo, MD, PhD

Department of Cardiology, Hospital of Southern Jutland

• Lene Svenstrup Christensen, MD, PhD
• Michael Gilså Hansen, MD