Reappraisal of Atrial Fibrillation: Interaction between hyperCoagulability, Electrical remodeling, and Vascular Destabilisation in the Progression of AF


RACE V (Reappraisal of Atrial Fibrillation: Interaction between hyperCoagulability, Electrical remodeling, and Vascular Destabilisation in the Progression of AF) is a multicenter, observational exploratory registry, which purpose is to elucidate the pathophysiological mechanisms of atrial fibrillation progression and to evaluate the role of LinQ/ CareLink guided tailored therapy in patients with atrial fibrillation.

This registry concerns the extensive phenotyping in patients with paroxysmal self-terminating atrial fibrillation, in conjunction with continuous atrial rhythm monitoring, to elucidate the role of hypercoagulability and other potential mechanisms in atrial fibrillation progression and to identify patients at risk for atrial fibrillation progression. In addition, the feasibility of implementing changes in therapy in patients with selfterminating atrial fibrillation using the LinQ/ Carelink system will be studied.

A total of 750 patients with self-terminating, paroxysmal atrial fibrillation are included. Inclusion of patients is entering the final phase.

Phenotyping is done by collection of clinical parameters, and by vascular assessment, CT-heart, echocardiography, DNA and circulating biomarkers collection – with special interest in hypercoagulability. Patients will receive continuous rhythm monitoring by either a Medtronic Reveal LINQ or a Medtronic ICD/pacemaker until end of study.

The RACE V consortium consists of a large group of researchers from 3 University Hospitals, and is led by Groningen and Maastricht. The RACE V registry is carried out in twelve hospitals in The Netherlands. With our ongoing investigation we have already started to identify new data involving progression and temporal patters of atrial fibrillation with the continuous monitoring method which allows us to follow our patient’s heart rhythm alterations 24/7 for years.

Circulating biomarker analyses obtained at the time of actual atrial fibrillation or sinus rhythm, and scene of actual atrial fibrillation in the left atrium makes it possible to study the link between different progression patterns to our patient’s phenotypes, as well as approach pathophysiological mechanisms related to the arrhythmia.

We are always open to meeting new people who are interested in joining our team and who share the same interest on investigation as we do. We welcome professionals who would like to work on atrial fibrillation related research, as there is always the possibility of working within the team as a doctoral or postdoctoral candidate .


People involved

Principal investigators

Isabelle van Gelder


Michiel Rienstra


Yuri Blaauw


Alexander Maass


Marieke Velt

MD/PhD Student

Vicente Artola Arita

PhD Student

Neda Khalilian Ekrami

PhD Student

Bao-Oanh Nguyen


Press & publications

A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation.

1. Van Gelder IC, .. Crijns HJGM. New Engl J Med. 2002

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Lenient versus strict rate control in patients with atrial fibrillation.

Van Gelder IC, Groenveld HF, Crijns HJ, …RACE II Investigators. New Engl J Med. 2010

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Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial.

Rienstra M, Hobbelt AH, Alings M, Tijssen JGP, Smit MD, Brügemann J, Geelhoed B, Tieleman RG, Hillege HL, Tukkie R, Van Veldhuisen DJ, Crijns HJGM, Van Gelder IC; RACE 3 Investigators. Eur Heart J. 2018

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Nurse-led vs. usual-care for atrial fibrillation.

E P J Petra Wijtvliet, Robert G Tieleman, Isabelle C van Gelder, Nikki A H A Pluymaekers, Michiel Rienstra, Richard J Folkeringa, Patrick Bronzwaer, Arif Elvan, Jan Elders, Raymond Tukkie, Justin G L M Luermans, A D I Thea Van Asselt, Sander M J Van Kuijk, Jan G Tijssen, Harry J G M Crijns, RACE 4 Investigators. European Heart Journal. 2020

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Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation.

N.A.H.A. Pluymaekers, E.A.M.P. Dudink, J.G.L.M. Luermans, J.G. Meeder, T. Lenderink, J. Widdershoven, J.J.J. Bucx, M. Rienstra, O. Kamp, J.M. Van Opstal, M. Alings, A. Oomen, C.J. Kirchhof, V.F. Van Dijk, H. Ramanna, A. Liem, L.R. Dekker, B.A.B. Essers, J.G.P. Tijssen, I.C. Van Gelder, and H.J.G.M. Crijns, for the RACE 7 ACWAS Investigators. N Engl J Med. 2019

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