Identifying autonomic drivers for human Atrial Fibrillation
Research type
Research Study
Full title
Feasibility of identifying autonomic drivers for human Atrial Fibrillation
IRAS ID
265850
Contact name
P Kanagaratnam
Contact email
Sponsor organisation
Imperial College London
ISRCTN Number
ISRCTN11762670
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Atrial fibrillation (AF) is a common heart rhythm problem which can significantly affect a patient’s quality of life. We know that it is caused by extra heart beats (ectopics) that come from structures called the pulmonary veins (PV). These attach to the top chambers of the heart, called the atria. We have been studying what might cause these extra heart beats and have been able to find sites in the left atrium that can be stimulated to trigger them. These sites are collections of nerve cells called Ganglionated Plexi (GP). In a small study in patients with intermittent AF, burning (ablation) of these sites prevented both the occurrence of these ectopics in the PV and recurrence of AF in more than half of patients 1 year after treatment. Our data demonstrates that GP are found throughout the heart muscle with the highest number around the connection of the pulmonary veins into the atria. It is likely these particular GP have a key role in triggering and maintaining AF. We have investigated this by demonstrating that ablating them results in 55% of patients being free from AF at 1 year of follow up. This was the same as that achieved in patients receiving standard treatment alone but significantly less ablation was required in our procedure. We think that a similar cause of AF exists in patients with permanent AF and so plan to investigate this.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
20/SC/0081
Date of REC Opinion
21 Feb 2020
REC opinion
Favourable Opinion