Atrial Fibrillation Fingerprinting

What is the motivation for this research?
Atrial fibrillation (AF) is the most common age-related cardiac rhythm disorder accounting for about one-third of rhythm abnormalities related hospitalizations with annual costs in the European Union of 13 billion euro. Early recognition of AF is essential for prevention of disease progression from recurrent intermittent episodes to finally permanent AF. This progression is accompanied by a gradual increase in therapy failure till in the end-stage AF can, even with extensive therapy, not be treated. Persistence of AF is rooted in the presence of electropathology, which is defined as complex electrical conduction disorders caused by structural damage of atrial tissue. By exploiting electropathology, a novel diagnostic instrument will be developed to predict AF onset and early progression.

How will you perform this research?
Correlation between the bio-electrical AF Fingerprint, clinical characteristics and development of AF will be studied in patients planned for elective open-heart surgery by:

1. Epicardial mapping is performed in patients undergoing cardiac surgery to identify the patient-specific electrical profile.
2. The patient-specific biological profile is assessed by evaluating biomarker levels of blood samples (pre-procedural and during follow-up) and atrial appendage tissue samples.
3. Post procedural continuous rhythm monitoring is performed for arrhythmia detection.

What is the desirable outcome?
The main study parameters are clinical characteristics (e.g. gender, heart disease) and the AF Fingerprint, consisting of electrophysiological parameters (e.g. pattern of atrial activation, conduction block, epicardial breakthrough, fibrillation interval) and various biomarker levels/atrial tissue characteristics. These parameters will be used to develop a novel diagnostic instrument to predict AF onset and early progression.

• Technical University Delft
• Amsterdam UMC
• Medical Delta Cardiac Arrhythmia Lab
• Convergence project Deep Imaging

• Atrial Fibrillation FIngerPrinting; Spotting Bio-Electrical Markers to Early Recognize Atrial Fibrillation by the Use of a Bottom-Up Approach (AFFIP): Rationale and Design. Clin Cardiol. 2020 Jun;43(6):546-552. doi: 10.1002/clc.23370
• Anatomical hotspots of fractionated electrograms in the left and right atrium: do they exist? Europace. 2019 Jan 1;21(1):60-72. doi: 10.1093/europace/euy059
• Direction- and rate-dependent fractionation during atrial fibrillation persistence: Unmasking cardiac anisotropy? J Cardiovasc Electrophysiol. 2020 Jun 1;31(8):2206-2209. doi: 10.1111/jce.14597
• Classification of sinus rhythm single potential morphology in patients with mitral valve disease. Europace. 2020 Oct 1;22(10):1509-1519. doi: 10.1093/europace/euaa130
• Sinus Rhythm Voltage Fingerprinting in Patients with Mitral Valve Disease using a High-Density Epicardial Mapping Approach. Europace. 2020 (in press). doi: 10.1093/europace/euaa336

• Dr. Y.J.H.J. Taverne
• Prof. Dr. Ir. W. Serdijn
• Prof. Dr. Ir. A. van der Veen
• Dr. M.C. Roos
• Ir. P. Knops
• M. van Schie, MSc

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  Prof. dr N.M.S. (Natasja) de Groot, PhD

  Cardiologist-Electrophysiologist, chief Research Unit Translational Electrophysiology

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  R.W. (Rudi) Hendriks, Professor, PhD

  Principal Investigator, Head of the Pulmonary Medicine Research Laboratory