Catheter Ablation for Atrial Fibrillation and Heart Failure
Pulmonary Vein Isolation for Rhythm Control in Patients With Atrial Fibrillation and Left Ventricular Dysfunction: A Pilot Study
To compare heart function, symptoms, exercise capacity and quality of life in patients with Congestive Heart Failure (CHF) and Atrial Fibrillation (AF)before and after catheter ablation.
Hypothesis: Restoration and maintenance of sinus rhythm by catheter ablation, without the use of antiarrhythmic drugs, in AF and CHF improves heart failure status.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Contacts and Locations
Study Locations
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-
New Jersey
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Ridgewood, New Jersey, United States, 07450
- The Valley Hospital
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New York
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New York, New York, United States, 10025
- St.Luke's-Roosevelt Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age 18 years to 80 years
- Clinical diagnosis of CHF based on symptoms (Shortness of breath, fatigue, peripheral edema)
- Systolic left ventricular dysfunction with ejection fraction 40% or less
- NYHA Class I, II or III heart failure
- Paroxysmal AF(2 or more episodes in one month) that terminate within 7 days:or persistent AF (more than 7 days or less than 7 days but terminated with pharmacologic or electrical cardioversion).
- Willing and able to sign informed consent
Exclusion Criteria:
- Previous ablation
- Left atrial size greater than 60mm(parasternal view on transthoracic echocardiogram)
- AF episodes triggered by another uniform arrhythmia(e.g.atrial flutter or atrial tachycardia)
- Active alcohol or drug abuse, which may be causative of AF
- Severe valvular disease requiring surgical repair
- Myocardial infarction within 6 months of enrollment
- Abnormality that prevents catheter introduction
- Coronary surgical revascularization or other cardiac surgery within 6 months of enrollment
- Patients in whom heart transplant expected with 6 months
- AF deemed secondary to a transient or correctable cause (e.g.electrolyte imbalance ,trauma,recent surgery,,infection, toxic ingestion or endocrinopathy
- Pregnancy or women of child bearing potential & not on reliable method of birth control
- Contraindication to Warfarin therapy or other bleeding diathesis
- Participation in another clinical trial
- Inaccessable to follow-up
- Life expectancy of less than 24 months caused by reasons other than heart disease
- Renal failure requiring dialysis
- Decompensated CHF within 48 Hours of enrollment
- Second or third degree AV block or sinus pause greater than 3 seconds, resting heart rate less 30 bpm without a permanent pacemaker
- A history of drug induced Torsades de Pointes or congenital long QT syndrome
- Currently responding to antiarrhythmic drug therapy
- Uninterrupted AF for more than 12 months prior to randomization unless sinus rhythm maintained for 24 hours or longer.
- Unwilling or unable to sign informed consent
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Optimal Medical therapy
Subjects with Class I,IIor III congestive heart failure on optimal medical therapy.
Planned catheter ablation for paroxysmal or persistent atrial fibrillation.
Paroxysmal AF defined as recurrent AF(2 or more episodes in one month) that terminate within seven days.
Persistent AF defined as sustained beyond seven days, or lasting less than seven days but requiring pharmacologic or electrical cardioversion.
|
Subjects with clinical indication for PVI, either paroxysmal or persistent AF failing medical management with rate or rhythm control medications.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Improvement in LVESV by 15% or more from baseline at 6 months
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Quality of Life
Time Frame: 6 months
|
6 months
|
|
|
Remodeling as demonstrated by atrial & ventricular dimensions on echocardiogram
Time Frame: 6 months
|
6 months
|
|
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NYHA Class
Time Frame: 6 months
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6 months
|
|
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Six minute hall walk test
Time Frame: 6 months
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6 months
|
|
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Hospitalization for HF
Time Frame: one year
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Composite hospitalization for HF,thromboembolic complications, major bleeding or all cause mortality
|
one year
|
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Absence of Atrial fibrillation
Time Frame: one year
|
one year
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Suneet Mittal, MD, St. Luke's-Roosevelt Hospital Center
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 09-137
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