About this trial
Postoperative atrial fibrillation (POAF) occurs in 20-40% of patients undergoing coronary artery bypass grafting (CABG) and is a marker of atrial vulnerability. It is strongly associated with AF recurrence, stroke, and cardiovascular mortality. It presents risk factors with atrial heart disease.
The latter refers to all structural, electrical, and mechanical alterations of the atrium that create a substrate conducive to AF.
Multiparametric cardiac MRI is currently the most comprehensive test for assessing atrial heart disease, thanks to its structural and functional analysis (atrial fibrosis, atrial strain, intracavitary 4D flow). However, to date, no prospective study has evaluated these parameters as predictors of AF recurrence after CAP. At the same time, an implantable Holter monitor will be used to enable detailed and continuous detection of recurrence episodes, overcoming the limitations of conventional monitoring strategies. By combining multiparametric imaging, histological analysis, and continuous monitoring for the first time, this study proposes a paradigm shift in the assessment of postoperative AF: moving from a descriptive and ad hoc approach to a mechanistic, integrative, and predictive approach.
Eligibility criteria
Qualifiers
Age ≥ 18 years
Indication for surgical myocardial revascularization by isolated coronary artery bypass grafting, to be performed in the cardiac surgery department of Saint-Étienne University Hospital.
Patient affiliated with or entitled to social security coverage
Patient who has received informed information about the study and has co-signed, with the investigator, a consent form to participate in the study
Disqualifiers
Contraindication related to cardiac MRI
Contraindication related to ILR implantation
Documented history of atrial fibrillation
Concomitant indication for valve surgery or other associated cardiac intervention
Trial design
Treatments tested in this trial
- 4D cardiac MRI with gadoteric acid
- Blood sample
- Implantable Loop Recorder (ILR)
- Right atrial biopsy