Improving the assessment of heart function in patients with atrial fibrillation (INDEX-AF)

Accurate assessment of ventricular function is essential for the optimal management of patients, however in patients with atrial fibrillation (AF) this is challenging.

My previous work has shown that measuring on a beat with preceding and pre-preceding cardiac cycles of similar length (index-beat) is more reproducible and time-efficient than conventional averaging of multiple consecutive beats.

This fellowship will aim to understand the validity of index-beat measurements against invasive reference standards, correlation with clinical outcomes, and its practicality in cardiology departments.

Measurements of ventricular function will be used to compare the index-beat approach with invasively-derived dP/dt and pulmonary capillary wedge pressure, in a prospective cohort of 50 patients with AF undergoing routine left heart angiography.

To understand the predictive ability of an index-beat versus multi-beat averaging for cardiovascular events, I will utilise existing anonymised clinical data from 595 patients, to correlate with cardiovascular events.

Finally the feasibility of index-beat in routine practice will be tested in 60 outpatients attending three different hospitals.

This fellowship will establish me as a leader in the field of AF and cardiovascular imaging, by defining methods to accurately assess heart function in patients with AF, leading to improved prognosis and quality of life.