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Updated: Jan 18, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
PREventive left atrial appenDage resection for the predICtion of fuTure atrial fibrillation: design of the PREDICT AF
Nicoline W E van den Berg1, Jolien Neefs1, Wouter R Berger1
1Department of Cardiology and Experimental Cardiology, Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam.
Insights
The PREDICT AF study aims to discover biomarkers for predicting atrial fibrillation after cardiac surgery. By analyzing tissue and blood, it seeks to identify patients at risk for better prevention strategies.
Area of Science:
- Cardiology
- Biomarker Discovery
- Cardiac Surgery
Background:
- Atrial fibrillation is a common arrhythmia with significant patient and healthcare costs.
- Postoperative atrial fibrillation (POAF) and new-onset atrial fibrillation (AF) are risks for cardiac surgery patients, potentially leading to stroke.
- Current methods for identifying at-risk patients are insufficient, and the underlying pathological changes are not well understood.
Purpose of the Study:
- To design and implement the PREDICT AF study, the first to correlate tissue pathophysiology and blood biomarkers with clinical data for predicting AF in cardiothoracic surgery patients.
- To identify novel biomarkers, including microRNAs and protein biomarkers, that can predict the occurrence of POAF and new-onset AF.
Main Methods:
- The study will enroll 150 patients undergoing cardiac surgery with a CHA2DS2-VASc score of at least 2.
- Left atrial appendage tissue and blood samples will be collected pre-surgery and at 6 and 12 months post-surgery.
- Atrial fibrillation will be objectively assessed using 24-hour Holters and ECGs at multiple time points post-surgery.
Main Results:
- Biomarker discovery through analysis of tissue and blood samples (microRNAs, protein biomarkers).
- Correlation of identified biomarkers with clinical profiles and follow-up data.
- Identification of predictive markers for POAF and new-onset AF.
Conclusions:
- The PREDICT AF trial design facilitates the discovery of reliable biomarkers for predicting POAF and new-onset AF.
- Combining tissue and plasma biomarkers with clinical follow-up offers a comprehensive approach to AF prediction.
- Findings will aid in developing targeted prevention strategies for AF in cardiac surgery patients.
Background:
Atrial fibrillation is the most common cardiac arrhythmia, posing a heavy burden on patients' wellbeing and healthcare budgets. Patients undergoing cardiac surgery are at risk of developing postoperative atrial fibrillation (POAF), new-onset atrial fibrillation and subsequent atrial fibrillation-related complications, including stroke. Sufficient clinical identification of patients at risk fails while the pathological substrate changes that precede atrial fibrillation remain unknown. Here, we describe the PREDICT AF study design, which will be the first study to associate tissue pathophysiology and blood biomarkers with clinical profiling and follow-up of cardiothoracic surgery patients for the prediction of future atrial fibrillation.
Methods:
PREDICT AF will include 150 patients without atrial fibrillation and a CHA2DS2-VASc score of at least 2 undergoing cardiac surgery. The left atrial appendage will be excised during surgery and blood samples will be collected before surgery and at 6 and 12 months' follow-up. Tissue and blood analysis will be used for the discovery of biomarkers including microRNAs and protein biomarkers. The primary study endpoint is atrial fibrillation, which will be objectified by 24 h Holters and ECGs after 30 days for POAF and after 6, 12 and 24 months for new-onset atrial fibrillation. Secondary endpoints include the dynamic changes of blood biomarkers over time and other atrial arrhythmias. PREDICT AF participants may benefit from extensive postoperative care with clinical phenotyping, rhythm monitoring and primary prevention of stroke.
Conclusion:
We here describe the PREDICT AF trial design, which will enable the discovery of biomarkers that truly predict POAF and new-onset atrial fibrillation by combining tissue and plasma-derived biomarkers with comprehensive clinical follow-up data.
Trial Registration:
Retrospectively registered NCT03130985 27 April 2017.
