In this pilot and feasibility study, the investigators will enroll patients with frequent symptomatic episodes of atrial fibrillation (AF) in a cross-over study testing two different classes of anti arrhythmic drugs (AADs). This pilot and feasibility study will provide preliminary data for a larger study in which the investigators will test the hypothesis that a common AF genetic risk allele modulates response to different AADs.
Name: Flecainide
Description: flecainide up to 150mg twice daily for the control of atrial fibrillationType: Drugflecainide 1st sotalol 1st
Name: Sotalol
Description: sotalol up to 120mg twice daily for the control of atrial fibrillationType: Drugflecainide 1st sotalol 1st
Allocation: Randomized
Crossover Assignment
There are 4 SNPs
However, a SNP at the 4q25 locus (rs10033464) was significantly associated with successful symptom control (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.42-6.21,
Blood processing, DNA extraction, and genotyping: Blood samples will be drawn into ethylenediamenetetraacetic acid (EDTA) tubes and immediately refrigerated at 4° C. Plasma will be separated by centrifugation and stored at -80° C. DNA will be extracted from the buffy coat using a commercially available kit (Qiagen Puregene, Valencia, California) and stored at -20° C. Study participants will be genotyped for three common chr4q25 SNPs (rs2200733, rs17570669, and rs3853445) using Sanger sequencing.
Then we will create a second model that replaces the separate chr4q25 SNP terms for a combined chr4q25 risk score calculated by adding the beta-coefficients for the genotypes at rs2200733, rs17570669, and rs3853445 found in the first model.
Blood processing, DNA extraction, and genotyping: Blood samples will be drawn into ethylenediamenetetraacetic acid (EDTA) tubes and immediately refrigerated at 4° C. Plasma will be separated by centrifugation and stored at -80° C. DNA will be extracted from the buffy coat using a commercially available kit (Qiagen Puregene, Valencia, California) and stored at -20° C. Study participants will be genotyped for three common chr4q25 SNPs (rs2200733, rs17570669, and rs3853445) using Sanger sequencing.
Then we will create a second model that replaces the separate chr4q25 SNP terms for a combined chr4q25 risk score calculated by adding the beta-coefficients for the genotypes at rs2200733, rs17570669, and rs3853445 found in the first model.
Blood processing, DNA extraction, and genotyping: Blood samples will be drawn into ethylenediamenetetraacetic acid (EDTA) tubes and immediately refrigerated at 4° C. Plasma will be separated by centrifugation and stored at -80° C. DNA will be extracted from the buffy coat using a commercially available kit (Qiagen Puregene, Valencia, California) and stored at -20° C. Study participants will be genotyped for three common chr4q25 SNPs (rs2200733, rs17570669, and rs3853445) using Sanger sequencing.
Then we will create a second model that replaces the separate chr4q25 SNP terms for a combined chr4q25 risk score calculated by adding the beta-coefficients for the genotypes at rs2200733, rs17570669, and rs3853445 found in the first model.