Tissue, Blood and Biomarkers to Predict Future Atrial Fibrillation

Study procedures:

The left atrial appendage (LAA) will be removed for research and intended prophylactic purposes, using a surgical stapler or surgical knife prior to the standard procedure. Epicardial mappings may be performed during cardiac surgery with a 48-multi-electrode. Patients will be followed with regular 24-hour Holter investigations.

This study will be an exploratory study with a required inclusion of 150 patients, based on the estimated event rate. Patients will be recruited by the investigators during pre-operative assessment.

Clinical data will be gathered at baseline and stored in a customized microsoft access entry database. Statistical analysis will be performed in collaboration with the Bioinformatics Laboratory from the Academic Medical Center.

Inclusion criteria

• Elective sternotomy for either coronary artery bypass surgery or aortic (valve) surgery or mitral valve surgery
• CHA2DS2 VASC score ≥ 2
• Sinus rhythm
• Age between 18 and 80 years
• Legally competent and willing and able to sign informed consent

Exclusion criteria

• Unable or unwilling to comply with study procedures
• Documented or reported history of atrial fibrillation, atrial flutter (duration > 5 minutes) or ventricular tachycardia
• Emergency or redo of CABG
• Emergency valvular surgery or pericarditis or endocarditis
• NYHA class IV heart failure symptoms or left ventricular ejection fraction < 35%
• Pregnancy or of childbearing potential without adequate contraception
• History of previous radiation therapy of the thorax
• Active malignancy
• Active inflammtion or auto-immune disease
• Surgery for congenital anomalies
• Circumstances that prevent follow-up (no permanent home or address, transient, etc.)