Atrial fibrillation is the most common cardiac arrhythmia. There are 360,000 people in the Netherlands who are known to have atrial fibrillation; in addition, it is estimated that there are about 80,000 people who do not know about it themselves. Atrial fibrillation can lead to complications such as stroke, heart failure and death. As a person becomes more affected by atrial fibrillation, the risk of these complications increases. Therefore, it is important to prevent this progression.
Many people are diagnosed when the arrhythmia has existed for some time. It is important to recognize it early, preferably before it develops. This is because when doctors determine that someone has atrial fibrillation, the atrium has often been diseased for some time, making proper treatment increasingly difficult. The researchers now want to find out exactly what happens in the atria and what the early signals of a diseased atrium (‘atrial cardiomyopathy’) are. This not only helps to detect these signals early in patients, but also offers possibilities for early and sometimes possibly more personalized treatment.
Addressing these underlying risk factors and disease processes is an important goal of the new research. The underlying mechanisms for the onset and progression of atrial fibrillation are complex and not yet fully understood. These mechanisms may be important for the treatment of atrial fibrillation. Although it is not yet known exactly how the atrium becomes diseased, it is already known that high blood pressure, obesity, heart failure and diabetes are important risk factors. The research will therefore identify the various underlying mechanisms of atrial fibrillation, both in men and women.
Three new treatment strategies are being investigated led by the UMCG. One trial is investigating whether worsening atrial fibrillation and associated hospitalizations can be prevented by treating people with diseased atria (‘atrial cardiomyopathy’) and low burden of atrial fibrillation very early with catheter ablation. Another trial is investigating treatment with a weight-reducing drug; this may allow the underlying cause of atrial fibrillation to be properly treated and prevent atrial fibrillation progression. A third study is looking at how diseased atria (‘atrial cardiomyopathy’) can best and most easily be measured and monitored in daily practice.
The EmbRACE network is a national collaboration between UMCs, general hospitals and universities from Groningen, Maastricht, Amsterdam, Utrecht, Leiden, Rotterdam, Arnhem and Eindhoven. The network is led by professors Michiel Rienstra of the Department of Cardiology at the University Medical Center Groningen and Ulrich Schotten of the Department of Physiology at the University of Maastricht. Cardiologists, general practitioners, researchers and patients are all involved in the network to improve the well-being of patients with atrial fibrillation. Preclinical and clinical research are hereby combined by starting with tissue and digital research, in order to later apply these outcomes in studies in which patients with atrial fibrillation will participate. The study will last for 5 years.
