Assessment of Atrial Fibrillation in Emergency Department

NCT03836339 | Completed DMC

• 1 other identifier: 2018ACFA10-11
• Study Type: observational
• Target: 1,369
• Locations: 1 country
• Sites: 1

Brief Summary

Atrial Fibrillation (AF) is the most common disorder of the rhythm disturbance, especially in older adults. The incidence and prevalence of AF increases significantly with age: less than one new case per 1000/year before age 40 to 20/1000 per year after the age of eighty. AF represents 1% of emergency department (ED) visits a third of which are inaugural or recurrent. The causes are varied from cardiac (ischemic cardiac disease, valvular, high blood pressure, heart failure, pericarditis, myocarditis) to extra cardiac etiologies (pulmonary embolism, thyroid disorders, thyrotoxicosis, alcohol, shock, chest trauma, electrolyte disorders, dehydration). While the diagnosis is given quickly by reading the electrocardiogram (ECG), its management both in terms of therapeutic strategy that of choice of care pathway is complex as evidenced by the diversity of possibilities and the difference in practice. Specific recommendations have been published by the French Society of Emergency Medicine in 2015. Our study aims to investigate guidelines implementation in French ED, especially the contribution of diagnostic tests and initiated treatments. Therapeutic strategies are evaluated with a follow up at 3 months, 6 months and 1 year, reporting cardiovascular events and long-term treatment.

Conditions

Atrial Fibrillation

Keywords

emergency department; pathway of care; assessment; anticoagulants

Outcome Measures

Primary Outcomes (13)

• atrial fibrillation type

  Number of idiopathic AF, AF secondary to acute heart failure, pulmonary embolism, COPD decompensation, pneumopathy, dysthyroidism, or any other precipitating factor.

  At admission

• Troponin value

  incidence of positive troponin

  At admission

• Brain Natriuretic Peptide (BNP/proBNP) value

  incidence of BNP elevation

  At admission

• Renal Clearance

  Renal clerance(Cl) measuring (by Cockroft formula : Cl(Male) = 1,23 x Weight (kg) x (140 - Age)/Creatinine, Cl(Female) = 1,04 x Weight (kg) x (140 - Age)/Creatinine)

  At admission

• cardiac echography

  number of cardiac echography performed in ED

  At admission

• antiarythmic drugs

  list antiarythmic drugs administration (Class IA, IB, IC, II, III or IV of Vaughan Williams classification, digitalis or adenosin)

  at admission

• antiarythmic drugs

  list antiarythmic drugs administration (Class IA, IB, IC, II, III or IV of Vaughan Williams classification, digitalis or adenosin)

  at 3 months

• antiarythmic drugs

  list antiarythmic drugs administration (Class IA, IB, IC, II, III or IV of Vaughan Williams classification, digitalis or adenosin)

  at 6 months

• antiarythmic drugs

  list antiarythmic drugs administration (Class IA, IB, IC, II, III or IV of Vaughan Williams classification, digitalis or adenosin)

  at 1 year

• anticoagulant strategy

  anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant) administration

  at admission

• anticoagulant strategy

  anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant) administration

  at 3 months, 6 months and 1 year

• anticoagulant strategy

  anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant) administration

  at 6 months and 1 year

• anticoagulant strategy

  anticoagulant therapy (vitamin K antagonist or direct oral anticoagulant) administration

  at 1 year

Secondary Outcomes (19)

• mortality

  at 24 hours after admission

• mortality

  at 3 months

• mortality

  at 6 months

• mortality

  at 1 year

• atrial fibrillation incidence

  at 3 months

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients over 18 years admitted to the emergency department with an AF diagnosis on ECG

You may qualify if:

• Atrial fibrillation diagnosis on ECG

You may not qualify if:

• Refusal of the patient to participate

Sponsors & Collaborators

• RESCUe - RESeau Cardiologie Urgence / RESUVal - RESeau des Urgences de la vallée du Rhône: lead
• French Cardiology Society: collaborator
• French Society of Emergency Medicine: collaborator
• Bayer: collaborator
• Boehringer Ingelheim: collaborator

Study Sites (1)

Lucien Hussel Hospital

Vienne, 38209, France

Location

MeSH Terms

Conditions

Atrial Fibrillation; Emergencies

Condition Hierarchy (Ancestors)

Arrhythmias, Cardiac; Heart Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Disease Attributes

Study Officials

• Stephane Manzo-Silberman, MD

  French Cardiology Society

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Year
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 27, 2019
• First Posted: February 11, 2019
• Study Start: October 1, 2018
• Primary Completion: December 31, 2019
• Study Completion: December 31, 2019
• Last Updated: May 14, 2021

Record last verified: 2021-05

Locations

FR (1)