NCT01570361终止4 期
Atrial Fibrillation Progression Trial
适应症
干预措施
相关药物
试验速览
- 阶段
- 4 期
- 状态
- 终止
- 入组人数
- 255
- 主要终点
- Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Years
研究概览
简要总结
The objective of this study is to determine whether early radiofrequency (RF) ablation treatment, using the CARTO® 3 or CARTO® XP System, and THERMOCOOL® Catheter Family (including THERMOCOOL® SF or THERMOCOOL® SMARTTOUCH™) in subjects with paroxysmal atrial fibrillation (PAF), delays progression of atrial fibrillation (AF) compared with drug therapy (either rate or rhythm control) using current AF management guidelines.
详细描述
Eligible PAF subjects with recurrent AF for 2 years who have failed no more than 2 prescribed drugs (with either anti-arrhythmic or rate control drug) are randomized into one of two study arms (catheter ablation or drug therapy).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with recurrent paroxysmal atrial fibrillation (AF) for at least 2 years, with ≥ 2 episodes over the last 6 months; (per Amendment v3, 09APR2013, previous "6 episodes" )
- •HATCH Score of at least ≥1 and ≤
- •Eligible for catheter ablation and for anti-arrhythmic or rate control medications, after having failed at least 1 but no more than 2 prescribed drugs (either anti-arrhythmic or rate control drug).
- •Age 60 years or older.
- •Left atrium (LA) diameter ≤ 55mm by TTE.
- •Left ventricle (LV) ejection fraction ≥50% when in sinus rhythm or LV ejection fraction ≥35% when in atrial fibrillation.
- •NOTE: For patients entering the study in AF with an ejection fraction ≥35% and <50%; the ejection fraction should be re-checked when in sinus rhythm. In case the ejection fraction is >50% the subject can continue in the study.
- •Patient signed the Informed Consent Form and is able and willing to comply with protocol requirements, including all baseline and follow-up testing.
排除标准
- •Patients awaiting cardiac transplantation or other cardiac surgery.
- •Acute illness (ongoing) or active systemic infection or sepsis which in the opinion of the investigator, may adversely affect the safety and/or effectiveness of the participant of the study.
- •Reversible causes of atrial fibrillation, e.g. but not limited to thyroid disorders, acute alcohol intoxication, recent major surgical procedures or trauma, etc.
- •Recent cardiac events including myocardial infarction (MI), percutaneous coronary intervention (PCI), or valve or bypass surgery in the preceding 3 months.
- •Heart failure decompensation.
- •Previously diagnosed with persistent/permanent atrial fibrillation/ atrial flutter.
- •Previously required cardioversion >48 hours after onset of atrial fibrillation/ atrial flutter.
- •Subject having previous transischemic attack (TIA) or stroke (cerebrovascular accident) one year prior to patient enrolment and/or no sufficient recovery.
- •Pulmonary embolism or recent atrial embolism/thrombosis.
- •Hypertrophic obstructive cardiomyopathy.
- •Class IV angina or Class IV congestive heart failure (CHF) (including past or planned heart transplantation).
- •Mandated anti-arrhythmic drug therapy for disease conditions other than atrial fibrillation.
- •Heritable arrhythmias or increased risk for torsade de pointes with class I or III Drugs.
- •Prior left atrial catheter ablation with the intention of treating atrial fibrillation; prior surgical interventions for AF such as the MAZE procedure.
- •Prior AV nodal ablation.
- •Patients presenting contra-indications for the study catheter(s), as indicated in the respective Instructions For Use.
- •Contraindication to warfarin, other anticoagulation therapy, or all anti-platelet medications.
- •Medical conditions limiting expected survival to <3 years.
- •Concurrent participation in any other clinical study.
- •Prior history of non-adherence to prescribed drug regimens.
- •Women of child bearing potential whom are pregnant, lactating, or planning to become pregnant during the course of the trial
- •NOTE: Prior ablation of the cavo-tricuspid isthmus is not a reason to exclude, if the patient develops subsequent recurrent atrial fibrillation.
- •NOTE: For patients randomized to the PVI group (Test Group), a Transesophageal Echocardiography (TEE) should be performed (as per standard of care), within 48 hours pre-procedure, to exclude atrial thrombus or other structural contraindications for an ablation procedure.
研究组 & 干预措施
Catheter Ablation
Experimental
Radiofrequency catheter ablation treatment in subjects with Paroxysmal Atrial Fibrillation (PAF)
干预措施: Catheter Ablation (Device)
Drug Treatment
Active Comparator
Drug therapy (either rate or rhythm control) using current AF management guidelines
干预措施: Drug Treatment (Drug)
结局指标
主要结局
Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Years
时间窗: 3 years
Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
次要结局
- Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 2 Years(2 years)
- Number of Repeat Ablations(3 years)
- Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Year(3 year)
- Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 1 Year(1 year)
- Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 1 Year(1 year)
- Number of Participants in Sinus Rhythm at Each Visit Throughout the Follow-up(3 months, 6 months, 1 year, 2 years, 3 years)
- Number of Participants With Recurrent AF/AT at Each Visit Throughout the Follow-up(3 months, 6 months, 1 year, 2 year and 3 years)
- Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 2 Years(2 Years)
- Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Years by Number of Repeat Ablations(3 years)
- Number of New Antiarrhythmic Drugs(3 years)
研究者
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