Risk factors, quality of life and prognostic outcomes associated with specific types of atrial fibrillation; the Tromsø Study

Project period: 1 September 2019 – 31 August 2023

The primary investigator: Hilde Espnes, MD, PhD student at the Department of Community Medicine, UiT The Arctic University of Norway

The project leader and main supervisor: Ekaterina Sharashova, MD, PhD, posdoctoral researcher at the Department of Community Medicine, UiT The Arctic University of Norway

Co-supervisors:

Maja-Lisa Løchen, MD, PhD, professor at Department of Community Medicine, UiT The Arctic University of Norway, and a senior consultant cardiology at UNN Tromsø

Tom Wilsgaard, PhD, professor at Department of Community Medicine, UiT The Arctic University of Norway, and a researcher at Centre for Quality and Development, UNN Tromsø

Jocasta Ball, PhD, a senior research officer and early career fellow at Baker Heart and Diabetes Institute in Melbourne, Australia

Project is about:

The main aim of this project is to explore atrial fibrillation types in relation to underlying risk factors, quality of life and prognosis.

Aims:

  • To explore risk factors and comorbidities associated with paroxysmal/persistent versus permanent atrial fibrillation in men and women from the population-based Tromsø Study.
  • To investigate whether atrial fibrillation types are associated with the risk of subsequent stroke and mortality in men and women from the Tromsø Study.
  • To explore quality of life and psychological profile of patients with paroxysmal/persistent versus permanent atrial fibrillation using the Tromsø Study data.

Project summary:

The types of atrial fibrillation  – whether it is paroxysmal (lasting ≤7 days and usually self‐terminating), persistent (lasting >7 days, usually requiring termination with cardioversion and/or medication) or permanent (for which a rhythm control strategy is not pursued) – is associated with different degree of functional and structural changes in the atria. There is some evidence that atrial fibrillation types may modify the response to treatment and influence the risk of stroke although according to the ESC guidelines from 2016 this evidence is weak. Moreover there is lack of knowledge about risk factors, comorbidities, psychological condition and quality of life related to different atrial fibrillation types. This project will use data from the population-based Tromsø Study surveys conducted in 1986-87, 1994-95, 2001-02, 2007-08, and 2015-16. All the participants will be followed up for atrial fibrillation, stroke and death throughout 2016. Using ECG and medical records all atrial fibrillation cases are validated and classified as paroxysmal/persistent (48.2%), permanent (45.9%) or unclassified (6.4%). Large sample size, prospective cohort design of the study, wide range of potential risk factors (including changes in risk factors level over time), information on psychological conditions and quality of life as well as thoroughly diagnosed atrial fibrillation of different types will allow to cover the existing knowledge gaps.

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