Atrial Fibrillation with Heart Failure with Preserved Ejection Fraction: Treatment Strategies-Catheter Ablation Vs. Anti-Atrial Arrhythmia Drugs
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 304
- 试验地点
- 1
- 主要终点
- The primary endpoint was a composite of all-cause death or rehospitalization for worsening HF.
研究概览
简要总结
A comparison of whether catheter ablation improves the prognosis (all-cause mortality and/or the composite endpoint of MACE) and reduces the recurrence rate of atrial fibrillation (AF) in patients with AF and heart failure with preserved ejection fraction (HFpEF), compared to anti-atrial arrhythmia drugs (AAD). This trial was randomly divided into two groups: the anti-AAD drug group and the catheter ablation group.
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
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥18 years.
- •The patient is willing and able to comply with the protocol and has provided written informed consent.
- •Paroxysmal or persistent atrial fibrillation (AF).(Persistent AF was defined as AF which is sustained beyond 7 days, or lasting less than seven days but necessitating pharmacologic or electric cardioversion. Included within the category of persistent AF is 'long-standing persistent AF', defined as continuous AF of >1-year duration. AF episodes had to be documented in the last 3 months prior to enrollment by ECG, Holter ECG, Loop Recorder, memory of the implanted device (ICD/CRT-D), or any other suitable device.)
- •Failure or intolerance of antiarrhythmic drug therapy or unwillingness to take antiarrhythmic drugs.
- •Diagnosed with Heart Failure with Preserved Ejection Fraction (HFpEF).((1) a history of hospitalization for HF with symptoms classified as New York Heart Association (NYHA) class II, III, or IV; (2) LVEF ≥ 50%; (3) at least one of the following cardiac structural abnormalities identified by echocardiography: left ventricular hypertrophy, left atrial enlargement, or diastolic dysfunction; and (4) elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), with a threshold of ≥400 pg/mL for pa-tients with SR at admission and ≥600 pg/mL for patients with AF at admis-sion.)
- •New York Heart Association class II, III, or IV.
排除标准
- •Previous left heart ablation procedure for AF.
- •Contraindication to chronic anticoagulation therapy or heparin.
- •Documented left atrial diameter >6 cm, optimally from the parasternal long-axis view.
- •Acute coronary syndrome, cardiac surgery, angioplasty, or cerebrovascular accident within 2 months prior to enrollment.
- •Planned cardiovascular intervention.
- •Listed for heart transplant.
- •Cardiac assist device implanted.
- •Life expectancy ≤ 12 months.
- •Mental or physical inability to participate in the study.
- •Requirement for dialysis due to terminal renal failure.
- •Woman currently pregnant or breastfeeding or not using reliable contraceptive measures during fertility age.
- •Enrollment in another investigational drug or device study, or participation in another telemonitoring concept.
研究组 & 干预措施
Ablation Group
Ablation Group: Received heart failure treatment combined with ablation
干预措施: Catheter ablation of atrial fibrillation (Procedure)
Drug Control Group
Received heart failure treatment combined with heart rate control.
结局指标
主要结局
The primary endpoint was a composite of all-cause death or rehospitalization for worsening HF.
时间窗: During regular follow-up visits at 3, 6, 12, 24months.
The primary endpoint was a composite of all-cause death or rehospitalization for worsening HF.
次要结局
- All-Cause Mortality(During regular follow-up visits at 3, 6, 12, 24months.)
- Worsening of Heart Failure Requiring Unplanned Hospitalization(During regular follow-up visits at 3, 6, 12, 24months.)
- Cardiovascular Mortality(During regular follow-up visits at 3, 6, 12, 24months.)
- Unplanned Hospitalization due to Cardiovascular Reason(During regular follow-up visits at 3, 6, 12, 24months.)
- All-Cause Hospitalization(During regular follow-up visits at 3, 6, 12, 24months.)
- Cerebrovascular Accident(During regular follow-up visits at 3, 6, 12, 24months.)
研究者
Xu Liu
Professor
Shanghai Chest Hospital
