title: QUest for the Arrhythmogenic Substrate of Atrial fibRillation in Patients Undergoing Cardiac Surgery (QUASAR Study): Rationale and Design.
abstract: The heterogeneous presentation and progression of atrial fibrillation (AF) implicate the existence of different pathophysiological processes. Individualized diagnosis and therapy of the arrhythmogenic substrate underlying AF may be required to improve treatment outcomes. Therefore, this single-center study aims to identify the arrhythmogenic areas underlying AF by intra-operative, high-resolution, multi-site epicardial mapping in 600 patients with different heart diseases. Participants are divided into 12 groups according to the underlying heart diseases and presence of prior AF episodes. Mapping is performed with a 192-electrode array for 5-10 s during sinus rhythm and (induced) AF of the entire atrial surface. Local activation times are converted into activation and wave maps from which various electrophysiological parameters are derived. Postoperative cardiac rhythm registrations and a 5-year follow-up will show the incidence of postoperative and persistent AF. This project provides the first step in the development of a tool for individual AF diagnosis and treatment.
authors.affiliation: Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, Thorax Center, PO Box 2040, s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Lisette J M E
authors.initials: LJME
authors.lastname: van der Does
authors.affiliation: Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, Thorax Center, PO Box 2040, s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Ameeta
authors.initials: A
authors.lastname: Yaksh
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Charles
authors.initials: C
authors.lastname: Kik
authors.affiliation: Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, Thorax Center, PO Box 2040, s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Knops
authors.affiliation: Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, Thorax Center, PO Box 2040, s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Eva A H
authors.initials: EAH
authors.lastname: Lanters
authors.affiliation: Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, Thorax Center, PO Box 2040, s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Christophe P
authors.initials: CP
authors.lastname: Teuwen
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Frans B S
authors.initials: FBS
authors.lastname: Oei
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Pieter C
authors.initials: PC
authors.lastname: van de Woestijne
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bekkers
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ad J J C
authors.initials: AJJC
authors.lastname: Bogers
authors.affiliation: Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
authors.forename: Maurits A
authors.initials: MA
authors.lastname: Allessie
authors.affiliation: Translational Electrophysiology, Department of Cardiology, Erasmus Medical Center, Thorax Center, PO Box 2040, s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. nmsdegroot@yahoo.com.
authors.forename: Natasja M S
authors.initials: NMS
authors.lastname: de Groot
mesh_terms: D000200:Action Potentials; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016275:Atrial Function; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects; D022062:Electrophysiologic Techniques, Cardiac; D056149:Epicardial Mapping; D006329:Heart Conduction System / Q000503:physiopathology*; D006330:Heart Defects, Congenital / Q000601:surgery; D006339:Heart Rate; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D009426:Netherlands; D011237:Predictive Value of Tests; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; Cardiac surgery; Electrophysiology; Epicardial mapping; Study design