Reappraisal of Atrial Fibrillation: Interaction Between HyperCoagulability, Electrical Remodeling, and Vascular Destabilisation in the Progression of Atrial Fibrillation

Inclusion criteria

• New onset or history of paroxysmal, self-terminating AF documented as:

• AF on ECG or Holter-recording or loop recorder
• Subclinical AF detected in implantable cardiac devices (atrial read > 190 beats per minute, lasting > 6 minutes).
• Prior history of self-terminating AF is allowed;
• Able and willing to sign informed consent for the registry;
• Able and willing to undergo implantation of an implantable loop recorder (in patients without a CIED);
• In patients already on oral anticoagulation drugs, the following inclusion criteria need to be met (to allow for safe temporary interruption of anti-thrombotic treatment for coagulation phenotyping):

• CHA2DS2-VASc score ≤5 (history of Congestive heart failure, Hypertension, Age ≥ 75 years (doubled), Diabetes mellitus,Stroke/transient ischemic attack (doubled), Vascular disease, Age 65-75 years, female Sex);
• No other indication for oral anticoagulation (e.g. mechanical valve prosthesis);
• Patient is willing to temporarily stop oral anticoagulation drugs (OAC).

Exclusion criteria

• Non-self-terminating, persistent AF;
• Deemed unsuitable or not willing to undergo implantation of loop recorder (in patients without a CIED);
• Refusing to temporarily stop OAC for coagulation phenotyping (in patients already on OAC before inclusion in this study);
• On waiting list for pulmonary vein isolation or expected to be placed on waiting list within one year;
• Expected to start with amiodarone;
• Pregnancy;
• Life expectancy of less than 2.5 years.