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D001281: Atrial Fibrillation

Developed by Shray Alag, The Harker School
Sections: Correlations, Clinical Trials, and HPO

Correlations computed by analyzing all clinical trials.

Navigate: Clinical Trials and HPO


Correlated Drug Terms (4)


Name (Synonyms) Correlation
drug2355 PT-X and IMT Wiki 0.71
drug540 CAP-1002 Allogeneic Cardiosphere-Derived Cells Wiki 0.71
drug479 Blood samples (collection of 5 mL of blood in a dry tube) Wiki 0.71
Name (Synonyms) Correlation
drug2115 Nasopharyngeal swabs Wiki 0.50

Correlated MeSH Terms (4)


Name (Synonyms) Correlation
D016171 Torsades de Pointes NIH 0.71
D001919 Bradycardia NIH 0.71
D054537 Atrioventricular Block NIH 0.71
Name (Synonyms) Correlation
D001145 Arrhythmias, Cardiac NIH 0.35

Correlated HPO Terms (5)


Name (Synonyms) Correlation
HP:0004757 Paroxysmal atrial fibrillation HPO 1.00
HP:0001678 Atrioventricular block HPO 0.71
HP:0001664 Torsade de pointes HPO 0.71
Name (Synonyms) Correlation
HP:0001662 Bradycardia HPO 0.71
HP:0011675 Arrhythmia HPO 0.35

Clinical Trials

Navigate: Correlations   HPO

There are 2 clinical trials


1 COVIDAR - International Registry on Arrhythmias in COVID-19

BACKGROUND AND RATIONALE: There is very limited literature available on the arrhythmia occurrence in the context of an infection by the SARS-CoV2 virus. On the other hand, treatment strategies against the SARS-CoV2 virus may carry a risk of QTc prolongation and pro-arrhythmia/sudden death which may be amplified by concomitant use of other QTc-prolonging drugs and/or ion disbalances. COVIDAR is an international initiative to monitor the occurrence of arrhythmic events in the context of the SARS-CoV2 infection, to identify potential modifiable predisposing factors to reduce their incidence and to inform the best arrhythmia management options in this patient population. MAIN OBJECTIVE: To describe the incidence and type of arrhythmic events in the context of the SARS-CoV2 infection. STUDY DESIGN: patient registry (observational). Patients will not undergo any additional investigations. Only data that is generated during routine clinical care will be collected. STUDY POPULATION: Patients admitted to the hospital highly suspected of or with confirmed COVID-19.

NCT04437901
Conditions
  1. COVID
  2. Arrhythmia
  3. Torsades de Pointe Caused by Drug
  4. Qt Interval, Variation in
  5. Atrioventricular Block
  6. Atrial Fibrillation
  7. Bradyarrhythmia
  8. Ventricular Arrythmia
MeSH:Atrial Fibrillation Arrhythmias, Cardiac Atrioventricular Block Bradycardia Torsades de Pointes
HPO:Arrhythmia Atrial fibrillation Atrioventricular block Bradycardia Paroxysmal atrial fibrillation Torsade de pointes

Primary Outcomes

Description: Any arrhythmic event occurring in COVID-19 patients during hospital admission: Monomorphic ventricular tachycardia Polymorphic ventricular tachycardia/Torsades de pointes (non-sustained) Ventricular fibrillation AV-block Severe bradycardia, symptomatic and/or requiring treatment New-onset atrial fibrillation Other

Measure: Arrhythmia

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Secondary Outcomes

Description: Categorical variable collecting the patient's underlying rhythm at baseline, on treatment and in case of arrhythmic adverse events): sinus rhythm, atrial fibrillation/flutter, other

Measure: Electrocardiographic changes - Underlying rhythm

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Collected as a categorical (normal, 1st-, 2nd- or 3rd degree AV block) and a continuous (PR duration in ms) at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Electrocardiographic changes - Atrioventricular conduction

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Collected as a continuous variable (ms) at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Electrocardiographic changes - QRS duration

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Collected as a categorical variable (not present, type 1 or type 2) at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Electrocardiographic changes - presence of Brugada QRS pattern

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Collected as a continuous variable (ms) at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Electrocardiographic changes - QTc duration

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Kalium, magnesium and calcium collected as continuous variables at baseline, on treatment and in case of arrhythmic adverse events). Will be reported as a categorical variable (presence/absence) of electrolyte misbalance

Measure: Laboratory abnormalities - electrolyte misbalance

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Cardiac CK, troponin T and/or troponin I (where available) collected as a continuous variable at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Laboratory abnormalities - cardiac biomarkers

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Creatinine clearance at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Laboratory abnormalities - renal function

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Description: Liver enzymes collected at at baseline, on treatment and in case of arrhythmic adverse events)

Measure: Laboratory abnormalities - liver function

Time: From date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months
2 Physiotherapist Led Exercise Within Cardiac Rehabilitation and Inspiratory Muscle Training and Patients With Paroxysmal Atrial Fibrillation - a Randomized Controlled Trial

Paroxysmal atrial fibrillation (AF) induce, in the affected patient, a prominent negative effect on health-related quality of life (HR-QoL) and physical fitness. The health care utilisation is high and the patient does never know when the next attack of atrial fibrillation occurs. Therefore, is physical exertion often avoided due to fear of new attacks. Further, are shortness of breath and fatigue often present despite of prescribed modern drugs. Paroxysmal AF per se enhance markedly the risk to develop stroke and heart failure, which both are syndromes that cause further negative effect on the patient´s HR-QoL and physical fitness. Altogether, cause the symptoms in paroxysmal AF a vicious spiral where both VO2max and muscle function deteriorate. The problems with shortness of breath might be due to dysfunction in respiratory muscles. Physiotherapy led exercise within cardiac rehabilitation (PT-X) in combination with inspiratory muscle training (IMT) has shown positive effects in patients with permanent atrial fibrillation. However, to our knowledge, not yet investigated in patients with paroxysmal AF. Aim: Primary to investigate, in a multicentre randomised controlled trial, if PT-X in combination with IMT can impact HR-QoL in patients with paroxysmal AF. Secondary to investigate the effect of PT-X in combination with IMT regarding symptoms, physical fitness, physical activity and the number of atrial fibrillation attacks and health care costs compared to the control group, asked to live their usual life, during the study period. Expected outcome: PTX in combination with IMT can improve HR-QoL, respiratory muscle function, level of symptoms, physical fitness and physical activity in patients with paroxysmal AF. In addition, a reduced number of atrial fibrillation attacks could decrease the direct cost of health care.

NCT04600713
Conditions
  1. Atrial Fibrillation Paroxysmal
Interventions
  1. Other: PT-X and IMT
MeSH:Atrial Fibrillation
HPO:Atrial fibrillation Paroxysmal atrial fibrillation

Primary Outcomes

Description: The Swedish version of short form 36 (SF-36) will be used for self-reported HR-QoL.

Measure: Health-related quality of life

Time: Change from baseline at 12 weeks

Secondary Outcomes

Description: Venous blood samples will be obtained according to the European accreditation system.

Measure: N-terminal pro-B type natriuretic peptide (NT-proBNP)

Time: At baseline

Description: Venous blood samples will be obtained investigated with a laboratory method Enzyme- Linked Immunosorbent Assey (ELISA) where antibodies Ig A, Ig G, Ig M will be detected. Due to the fact that the reliability for the laboratory tests to detect antibodies for SARS-CoV-2 is still changing the final decision regarding on which test to use will be made at the start of the study.

Measure: Antibodies for SARS-CoV-2

Time: At baseline

Description: will be measured with MicroRPM (Micro Medical/Care Fusion, Kent, United Kingdom). The respiratory pressure measures inspiratory and expiratory muscle strength.

Measure: Inspiratory and expiratory muscle strength

Time: Change from baseline at 12 weeks

Description: will be measured by a symptom-limited ergometer cycle test based on World Health Organization (WHO) protocol. The workload begins at 25 W or 50 W depending on the anamnesis. The Watts increase every 4.5 min by 25 W until the patient's rates perceived exertion (RPE) 17 (Very Heavy) on the Borg scale. Unless the patient shows any symptoms or signs that demands an earlier stop at the test. Heart rate and blood pressure are assessed at rest and during the test. If the patient do not surpass the last 4.5 minute the watt will be estimated according to Strandells formula.

Measure: Exercise capacity

Time: Change from baseline at 12 weeks

Description: will be measured by a muscle endurance test, including the following: A unilateral isoinertial shoulder flexion test assessed with the patient sitting on a stool with their back touching the wall holding a dumbbell in their hand, 2 kg for women and 3 kg for men. The tested arm is elevated to 90º flexion and the arm not tested is placed in the patient's knee. A pace of 40 beats per min is kept by a digital metronome. Bilateral isometric shoulder abduction is assessed with the patient holding a 1 kg dumbbell in each hand using the same body position as above. The patient is asked to elevate both arms to 90°of shoulder abduction and to maintain this position as long as possible (measured in s). Unilateral isoinertial heel-lift is assessed with the patients performing as many unilateral heel-lifts as possible, with a straight knee, on a 10° tilted wedge, with shoes on. A pace of 60 beats per minutes is kept is kept by a metronome.

Measure: Muscle function

Time: Change from baseline at 12 weeks

Description: will be measured by an accelerometer (Actigraph® GT3x+, Actigraph, Pensacola, Florida, USA). The accelerometer will be worn throughout the whole day during seven days except when taking a bath or a shower. The accelerometer has showed to be valid and reliable in the adult population.

Measure: Physical activity

Time: Change from baseline at 12 weeks

Description: will be measured by short form International Physical Activity Questionnaire (IPAQ). IPAQ measures physical activity during seven days and total time spent sitting a day. IPAQ is validity and reliability tested in several countries.

Measure: Self reported physical activity

Time: Change from baseline at 12 weeks

Description: will be measured by the Hospital Axiently and Depression Scale (HADS ).

Measure: Self-reported anxiently and depression

Time: Change from baseline at 12 weeks

Description: will be measured with a handheld ECG monitor Zenicor-EKG ® (Zenicor Medical Systems AB, Stockholm, Sverige). Zenicor ® has high specificity and sensitivity for detection of sinus rhythm compared to a 24- Holter ECG. Self- reported AF attacks will be logged in a diary.

Measure: Handheld ECG heart rhythm

Time: Through the study completion, an avarage of 12 weeks

Description: are calculated as total costs per patient and the patients medical journal in hospital and primary care.

Measure: Direct hospital costs related to AF

Time: Through the study completion, an avarage of 12 weeks

Other Outcomes

Description: Will be investigated will be examined during sinus rhythm with a two -dimensional, Doppler echocardiography (Vidid 7 and Vivid E9, GE Medical systems, Horten, Norway).

Measure: Ejection fraction

Time: At baseline

Description: Will be investigated will be examined during sinus rhythm with a two -dimensional, Doppler echocardiography (Vidid 7 and Vivid E9, GE Medical systems, Horten, Norway).

Measure: Left ventricular function

Time: At baseline

Description: Will be investigated will be examined during sinus rhythm with a two -dimensional, Doppler echocardiography (Vidid 7 and Vivid E9, GE Medical systems, Horten, Norway).

Measure: Diastolic function

Time: At baseline

Description: Will be investigated will be examined during sinus rhythm with a two -dimensional, Doppler echocardiography (Vidid 7 and Vivid E9, GE Medical systems, Horten, Norway).

Measure: Valvular screening

Time: At baseline

HPO Nodes


Reports

Data processed on December 13, 2020.

An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.

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