Atrial Dyssynchrony to Predict Arrhythmias in the Postoperative Setting of Cardiovascular Surgery.

NCT07388108 | Recruiting

• 1 other identifier: 003. 03/10/2023.
• Study Type: observational
• Target: 138
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to improve the prediction for developing arrhythmias in the postoperative period of cardiovascular surgery by using non-invasive echocardiographic techniques that are sensitive to detect inter and intra-atrial dyssynchrony. The main question it aims to answer is: Do patients with atrial dyssynchrony are at increased risk of developing arrhythmias in the postoperative period of cardiovascular surgery? Patients admitted to the protocol will undergo an echocardiogram with atrial strain before surgery to determine the presence or absence of intra- and inter-atrial dyssynchrony and will be followed during hospitalization to assess the occurrence of atrial fibrillation in the postoperative period.

Conditions

Atrial Fibrillation; Postoperative Complications

Keywords

Atrial fibrillation; Atrial strain; Cardiovascular surgery; Echocardiography

Outcome Measures

Primary Outcomes (1)

• Incidence of postoperatory atrial fibrillation

  Arrhythmic episodes of at least 30 seconds duration will be considered postoperative atrial fibrillation when detected on continuous monitoring or when detected on a ward ECG, if the patient reported symptoms or required medical intervention.

  From the end of surgery through hospital discharge, an average of 6 days.

Secondary Outcomes (1)

• Atrial Fibrillation at 28 and 365 Days

  From surgery through Day 28 and Day 365

Interventions

Atrial dyssynchrony DIAGNOSTIC_TEST

To determine interatrial dyssynchrony, an adaptation of the echocardiographic atrial strain will be made so that both atria can be evaluated simultaneously. This new evaluation, OMEGA (ω) will yield the time to maximum deformation of the lateral segments of the right atrium and the lateral segments of the left atrium. Additionally, total atrial deformation will be evaluated via bi-atrial strain analysis. We will then measure the maximum deformation time-from P-wave onset to the maximum negative strain deflection-to assess its relationship with atrial contraction strain.

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with a history of coronary artery disease, aortic stenosis or a combination of both pathologies, with indication for cardiovascular surgery according to the Guidelines for Cardiovascular Surgery of the European Society of Cardiology.

You may qualify if:

• Patients with criteria for non-mitral cardiovascular surgery, in sinus rhythm, and who gave informed consent to participate in the study.
• Absence of atrial fibrillation upon hospital admission for surgery.

You may not qualify if:

• Surgery of the mitral or tricuspid valve.
• History of previous atrial fibrillation.
• History of congenital heart disease or cardiac tumors.
• Emergency surgery of the heart
• Pour echocardiographic window

Sponsors & Collaborators

• School of Medicine. National University of Cuyo: lead

Study Sites (1)

Clínica de Cuyo

Mendoza, Mendozz, 5500, Argentina

RECRUITING

Related Publications (18)

• Sánchez FJ, Gonzalez VA, Farrando M, Baigorria Jayat AO, Segovia-Roldan M, García-Mendívil L, Ordovás L, Prado NJ, Pueyo E, Diez ER. Atrial Dyssynchrony Measured by Strain Echocardiography as a Marker of Proarrhythmic Remodeling and Oxidative Stress in Cardiac Surgery Patients. Oxid Med Cell Longev. 2020:8895078.

  BACKGROUND

• Badano, L.P.; Kolias, T.J.; Muraru, D.; Abraham, T.P.; Aurigemma, G.; Edvardsen, T.; D'Hooge, J.; Donal, E.; Fraser, A.G.; Marwick, T.; et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: A consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur. Heart J. Cardiovasc. Imaging 2018, 19, 591-600, doi:10.1093/ehjci/jey042.

  BACKGROUND

• Aksu, U.; Kalkan, K.; Gulcu, O.; Aksakal, E.; Öztürk, M.; Topcu, S. The role of the right atrium in development of postoperative atrial fibrillation: A speckle tracking echocardiography study. J. Clin. Ultrasound 2019, 47, 470-476, doi:10.1002/jcu.22736.

  BACKGROUND

• Müller, P.M.; Hars, C.; Schiedat, F.; Osche, L.I.B.; Gotzmann, M.; Strauch, J.; Dietrich, J.W.; Vogt, M.; Tannapfel, A.; Deneke, T.; et al. Correlation Between Total Atrial Conduction Time Estimated via Tissue Doppler Imaging ( PA-TDI Interval ), Structural Atrial Remodeling and New-Onset of Atrial Fibrillation. J. Cardiovasc. Electrophysiol. 2013, 24, 626-631, doi:10.1111/jce.12084

  BACKGROUND

• Merckx, K.L.; Vos, C.B. De; Palmans, A.; Habets, J.; Tieleman, R.G. Atrial Activation Time Determined by Transthoracic Doppler Tissue Imaging Can Be Used as an Estimate of the Total Duration of Atrial Electrical Activation. 940-944, doi:10.1016/j.echo.2005.03.022.

  BACKGROUND

• Xu, C.; Chen, K.; Yu, F.; Wang, Q.; Su, H.; Yang, D.; Xu, J.; Yan, J. Atrial Dyssynchrony: A New Predictor for Atrial High-Rate Episodes in Patients with Cardiac Resynchronization Therapy. Cardiol. 2019, 144, 18-26, doi:10.1159/000502541.

  BACKGROUND

• Ciuffo, L.; Tao, S.; Gucuk Ipek, E.; Zghaib, T.; Balouch, M.; Lima, J.A.C.; Nazarian, S.; Spragg, D.D.; Marine, J.E.; Berger, R.D.; et al. Intra-Atrial Dyssynchrony During Sinus Rhythm Predicts Recurrence After the First Catheter Ablation for Atrial Fibrillation. JACC Cardiovasc. Imaging 2019, 12, 310-319, doi:10.1016/j.jcmg.2017.11.028.

  BACKGROUND

• . Pathan, F.; D'Elia, N.; Nolan, M.T.; Marwick, T.H.; Negishi, K. Normal Ranges of Left Atrial Strain by Speckle-Tracking Echocardiography: A Systematic Review and Meta-Analysis. J. Am. Soc. Echocardiogr. 2017, 30, 59-70.e8, doi:10.1016/j.echo.2016.09.007.

  BACKGROUND

• Swartz, M.F.; Fink, G.W.; Sarwar, M.F.; Hicks, G.L.; Yu, Y.; Hu, R.; Lutz, C.J.; Taffet, S.M.; Jalife, J. Elevated pre-operative serum peptides for collagen i and III synthesis result in post-surgical atrial fibrillation. J. Am. Coll. Cardiol. 2012, 60, 1799-1806, doi:10.1016/j.jacc.2012.06.048.

  BACKGROUND

• Lacalzada-Almeida, J.; Izquierdo-Gómez, M.M.; Belleyo-Belkasem, C.; Barrio-Martínez, P.; GarcíaNiebla, J.; Elosua, R.; Jiménez-Sosa, A.; Escobar-Robledo, L.A.; Bayés de Luna, A. Interatrial block and atrial remodeling assessed using speckle tracking echocardiography. BMC Cardiovasc. Disord. 2018, 18, 1-9, doi:10.1186/s12872-018-0776-6.

  BACKGROUND

• Hatam, N.; Aljalloud, A.; Mischke, K.; Karfis, E.A.; Autschbach, R.; Hoffmann, R.; Goetzenich, A. Interatrial conduction disturbance in postoperative atrial fibrillation: A comparative study of P-wave dispersion and Doppler myocardial imaging in cardiac surgery. J. Cardiothorac. Surg. 2014, 9, 1-9, doi:10.1186/1749-8090-9-114

  BACKGROUND

• Osranek, M.; Kaniz, F.; Fatema, Q.; Al-Saileek, A.; Barnes, M.E.; Bailey, K.R. Left Atrial Volume Predicts the Risk of Atrial Fibrillation After Cardiac Surgery A Prospective Study. J. Am. Coll. Cardiol. 2006, 48, doi:10.1016/j.jacc.2006.03.054.

  BACKGROUND

• Liberale, L.; Montecucco, F.; Tardif, J.C.; Libby, P.; Camici, G.G. Inflamm-ageing: the role of inflammation in age- dependent cardiovascular disease. Eur. Heart J. 2020, 41, 2974-2982, doi:10.1093/eurheartj/ehz961.

  BACKGROUND

• . Zakkar, M.; Ascione, R.; James, A.F.; Angelini, G.D.; Suleiman, M.S. Inflammation, oxidative stress and postoperative atrial fibrillation in cardiac surgery. Pharmacol. Ther. 2015, 154, 13-20, doi:10.1016/j.pharmthera.2015.06.009.

  BACKGROUND

• Maesen, B.; Nijs, J.; Maessen, J.; Allessie, M.; Schotten, U. Post-operative atrial fibrillation: A maze of mechanisms. Europace 2012, 14, 159-174, doi:10.1093/europace/eur208.

  BACKGROUND

• Akintoye, E.; Sellke, F.; Marchioli, R.; Tavazzi, L.; Mozaffarian, D. Factors associated with postoperative atrial fibrillation and other adverse events after cardiac surgery. J. Thorac. Cardiovasc. Surg. 2018, 155, 242-251.e10, doi:10.1016/j.jtcvs.2017.07.063.

  BACKGROUND

• . Steinberg, B.A.; Zhao, Y.; He, X.; Hernandez, A.F.; Fullerton, D.A.; Thomas, K.L.; Mills, R.; Klaskala, W.; Peterson, E.D.; Piccini, J.P. Quality and Outcomes Management of Postoperative Atrial Fibrillation and Subsequent Outcomes in Contemporary Patients Undergoing Cardiac Surgery : Insights From the Society of Thoracic Surgeons CAPS-Care Atrial Fibrillation Registry. 2014, 13, 7-13, doi:10.1002/clc.22230.

  BACKGROUND

• Júnior, F.P.; Filho, G.F.T.; Sant'anna, J.R.M.; Py, P.M.; Prates, P.R.; Nesralla, I.A.; Kalil, R.A. Idade avançada e incidência de fibrilação atrial em pós-operatório de troca valvar aórtica. Brazilian J. Cardiovasc. Surg. 2014, 29, 45-50, doi:10.5935/1678-9741.20140010.

  BACKGROUND

MeSH Terms

Conditions

Atrial Fibrillation; Postoperative Complications

Condition Hierarchy (Ancestors)

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

Study Officials

• Emiliano Diez, PhD

  National University of Cuyo

  STUDY DIRECTOR

Central Study Contacts

Francisco Sánchez, PhD

CONTACT

+5492614135000; fsanchez@fcm.uncu.edu.ar

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD; PhD

Study Record Dates

• First Submitted: January 19, 2026
• First Posted: February 4, 2026
• Study Start: February 6, 2026
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): December 31, 2028
• Last Updated: February 10, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: The information will be available three months following the completion of patient enrollment and for a duration of five years thereafter.
• Access Criteria: Upon reasonable request.

Locations

AR (1)