DETECTion of PeriOperative Atrial Fibrillation After Noncardiac Surgery

Launched by POPULATION HEALTH RESEARCH INSTITUTE · Jul 19, 2024

Keywords

ClinConnect Summary

The DETECT trial is studying how common a heart condition called perioperative atrial fibrillation (POAF) is in patients who have just had noncardiac surgery. This condition can cause an irregular heartbeat, which can lead to complications if not detected early. In this study, participants will wear a small portable device that continuously monitors their heart activity for up to 14 days, starting within 72 hours after their surgery. This is important because identifying POAF early can help doctors manage it more effectively.

To be eligible for this trial, participants must have had noncardiac surgery within the last three days and meet certain health criteria. For example, patients aged 55 and older with specific heart-related concerns may qualify. Participants will be asked to give their consent to join the study and can expect to wear the monitoring device, which will help the research team gather important information about heart health after surgery. It’s a great opportunity for patients to contribute to research that could improve care for others in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• 1. Had undergone noncardiac surgery within the past 72 hours and requiring, or expected to require, at least one of the following:
• • an overnight hospital admission after surgery
• • day surgery that would result in a large enough physiological insult to be able to cause POAF. Procedures excluded include those that are conducted using local anesthesia alone, are less than 30 minutes in duration, and/or are judged to be of low physiologic insult by the local investigator.
• • 2. Have one of the following high-risk criteria;
• • age 55-64 years, and having either established cardiovascular disease, recent major vascular surgery, a CHA2DS2-VASc score ≥3, or an elevated postoperative troponin level;
• • age 65-74 years, and having either established cardiovascular disease, recent major vascular surgery, a CHA2DS2-VASc score ≥2, or an elevated postoperative troponin level; or
• • age ≥75 years;
• • 3. Provide written informed consent to participate.
• Exclusion Criteria:
• • 1. History of documented chronic (i.e., non-transient) AF before noncardiac surgery;
• • 2. Need for long-term systemic anticoagulation;
• • 3. Ongoing need for long-term dual antiplatelet treatment;
• • 4. Contraindication to oral anticoagulation;
• • 5. Severe renal insufficiency;
• • 6. Severe liver cirrhosis;
• • 7. Acute stroke in the past 14 days;
• • 8. Underwent cardiac surgery in the past 35 days;
• • 9. History of nontraumatic intracranial, intraocular, or spinal bleeding;
• • 10. Hemorrhagic disorder or bleeding diathesis;
• • 11. Known life expectancy \<1 year due to concomitant disease;
• • 12. Women who are pregnant, breastfeeding, or of childbearing potential not taking effective contraception;
• • 13. Expected to be non-compliant with follow-up and/or device use;
• • 14. Known contact allergy to monitoring device and/or its peripheral components;
• • 15. Previously enrolled in DETECT-POAF.