title: HALT & REVERSE: Hsf1 activators lower cardiomyocyt damage; towards a novel approach to REVERSE atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation is a progressive arrhythmia, the exact mechanism underlying the progressive nature of recurrent AF episodes is still unknown. Recently, it was found that key players of the protein quality control system of the cardiomyocyte, i.e. Heat Shock Proteins, protect against atrial fibrillation progression by attenuating atrial electrical and structural remodeling (electropathology). HALT & REVERSE aims to investigate the correlation between electropathology, as defined by endo- or epicardial mapping, Heat Shock Protein levels and development or recurrence of atrial fibrillation following pulmonary vein isolation, or electrical cardioversion or cardiothoracic surgery.
  
  
  METHODS
  This study is a prospective observational study. Three separate study groups are defined: (1) cardiothoracic surgery, (2) pulmonary vein isolation and (3) electrical cardioversion. An intra-operative high-resolution epicardial (group 1) or endocardial (group 2) mapping procedure of the atria is performed to study atrial electropathology. Blood samples for Heat Shock Protein determination are obtained at baseline and during the follow-up period at 3 months (group 2), 6 months (groups 1 and 2) and 1 year (group 1 and 2). Tissue samples of the right and left atrial appendages in patients in group 1 are analysed for Heat Shock Protein levels and for tissue characteristics. Early post procedural atrial fibrillation is detected by continuous rhythm monitoring, whereas late post procedural atrial fibrillation is documented by either electrocardiogram or 24-h Holter registration.
  
  
  CONCLUSIONS
  HALT & REVERSE aims to identify the correlation between Heat Shock Protein levels and degree of electropathology. The study outcome will contribute to novel diagnostic tools for the early recognition of clinical atrial fibrillation.
  
  
  BACKGROUND
  Rotterdam Medical Ethical Committee MEC-2014-393, Dutch Trial Registration NTR4658.
authors.affiliation: Department of Cardiology, Ba 579, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands. e.lanters@erasmusmc.nl.
authors.forename: Eva A H
authors.initials: EA
authors.lastname: Lanters
authors.affiliation: Department of Clinical Pharmacy and Pharmacology, EB71, University Institute for Drug Exploration (GUIDE), University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30 001, 9700, RB, Groningen, The Netherlands. d.m.s.van.marion@umcg.nl.
authors.forename: Denise M S
authors.initials: DM
authors.lastname: van Marion
authors.affiliation: Department of Cardiothoracic Surgery, Bd 557, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands. c.kik@erasmusc.nl.
authors.forename: Charles
authors.initials: C
authors.lastname: Kik
authors.affiliation: Nyken Therapeutics B.V., L.J. Zielstraweg 2, 9713, GX, Groningen, The Netherlands. hermansteen@nyken.com.
authors.forename: Herman
authors.initials: H
authors.lastname: Steen
authors.affiliation: Department of Cardiothoracic Surgery, Bd 557, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands. a.j.j.c.bogers@erasmusmc.nl.
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
authors.affiliation: Department of Cardiology, Ba 579, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands. m.allessie@maastrichtuniversity.nl.
authors.forename: Maurits A
authors.initials: MA
authors.lastname: Allessie
authors.affiliation: Department of Clinical Pharmacy and Pharmacology, EB71, University Institute for Drug Exploration (GUIDE), University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30 001, 9700, RB, Groningen, The Netherlands. b.j.j.m.brundel@umcg.nl.|Department of Physiology, Institute for Cardiovascular Research, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands. b.j.j.m.brundel@umcg.nl.
authors.forename: Bianca J J M
authors.initials: BJ
authors.lastname: Brundel
authors.affiliation: Department of Cardiology, Ba 579, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands. n.m.s.degroot@erasmusmc.nl.
authors.forename: Natasja M S
authors.initials: NM
authors.lastname: de Groot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000517:prevention & control* / Q000601:surgery / Q000628:therapy*; D002315:Cardiopulmonary Bypass; D004268:DNA-Binding Proteins / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology; D000076249:Heat Shock Transcription Factors; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D032383:Myocytes, Cardiac / Q000378:metabolism*; D010496:Pericardium / Q000473:pathology; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology; D012008:Recurrence; D012107:Research Design; D014157:Transcription Factors / Q000097:blood*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004268:DNA-Binding Proteins; C000619706:HSF1 protein, human; D000076249:Heat Shock Transcription Factors; D014157:Transcription Factors