Catheter Ablation vs. Medical Therapy in Congested Hearts With AF (CATCH-AF)
Catheter Ablation vs. Medical Therapy in Congested Hearts With AF (CATCH-AF in Patients With Impaired LV Function): An Early Ablation Strategy Study Impact on Health Care Utilization
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Connecticut
-
Hartford, Connecticut, United States, 06102
- Hartford Hospital
-
-
Ohio
-
Akron, Ohio, United States, 44307
- Cleveland Clinic Akron General
-
Cleveland, Ohio, United States, 44195
- Cleveland Clinic
-
Columbus, Ohio, United States, 43210
- The Ohio State University Wexner Medical Center
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- Hospital of the University of Pennsylvania
-
-
Utah
-
Salt Lake City, Utah, United States, 84132
- University of Utah
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- must be 18 years of age or older
- Provide signed written Informed Consent
- symptomatic AF documented by EKG or heart rhythm monitoring within 12 months
- patients should be on optimal medical therapy for heart failure for 3 months prior to randomization. Adjustments to medications within this 3 month period are permitted.
- chronically impaired LV function defined as EF between 20%-45% within last 3 months
- all patients should be on an optimal therapy for impaired LV function
- ability to complete 6 minute walk test
- eligible for catheter ablation and anti-arrhythmic drugs
Exclusion Criteria:
- women of childbearing potential unless post- menopausal or surgically sterile
- patients hospitalized for heart failure within the 3 months prior to randomization
- reversible causes of AF such as pericarditis, thyroid disorders, acute alcohol intoxication, recent major surgical procedures or trauma
- recent reversible LV impairment that may be attributed to AF with rapid ventricular response and may improve with introduction of rate control
- valvular heart disease requiring surgical intervention
- Coronary Artery Disease (CAD) requiring surgical or percutaneous intervention
- early post-operative AF (within 3 months of surgery)
- previous MAZE or left atrial instrumentation (including ablation and left atrial appendage exclusion)
- history of Atrioventricular Node (AVN) ablation
- hypertrophic cardiomyopathy
- prolonged QT interval
- liver failure
- renal failure requiring dialysis
- social factors that would preclude follow up or make compliance difficult- history of drug, alcohol or substance abuse
- contraindications to the use of AADs and/or anticoagulation therapy
- Currently enrolled in, or discontinued within the last 30 days from a clinical trial involving an investigational product or non-approved use of a drug or device or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study.
- severe pulmonary disease
- documented intra-atrial thrombus, tumor, or structural abnormality which precludes catheter introduction
- unwilling to comply with protocol requirements or deemed by the investigator to be unfit for the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: AF catheter Ablation
Pulmonary Vein Isolation catheter ablation for treatment of AF.
AF catheter ablation is an FDA approved treatment for AF
|
During ablation, a doctor inserts a catheter through blood vessels into the heart.
The doctor looks at the electrical activity of the heart.
The catheter is used to determine which areas of the heart are causing AF.
After the area is identified, the doctor uses a special machine delivers energy through the catheter to tiny areas of the heart muscle that is causing AF.
This energy causes a scar in the tissue which "disconnects" the pathway of the AF.
Other Names:
|
|
Active Comparator: FDA approved anti arrhythmic drug
FDA approved anti arrhythmic drug for the treatment of AF will be based on treating physicians' preference in accordance to guidelines.
|
Anti arrhythmic drug medical treatment will be based on treating physicians discretion following standard clinical guidelines
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
First Hospitalization for Heart Failure, Recurrence of AF or Direct Current Cardioversion
Time Frame: 12 months
|
Time measured in days to first hospitalization for heart failure, recurrence of AF or Direct Current cardioversion after the treatment period (first 3 months post enrollment or post procedure during which repeat ablation can be performed and titration of AADs can be performed).
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in the Rand 36-Item Health Survey
Time Frame: 3 months through 15 months
|
change in the Rand 36-Item Health Survey reflective of change in patient's quality of life
|
3 months through 15 months
|
|
Change in Ejection Fraction (EF)
Time Frame: baseline through15 months
|
Change in Ejection Fraction heart failure measurement (percentage)
|
baseline through15 months
|
|
Total Number of Cardiovascular Hospitalization
Time Frame: 15 months
|
total number of cardiovascular hospitalization measured by hospitalization admissions
|
15 months
|
|
Time to Recurrence if AF Lasting Longer Than 30 Seconds
Time Frame: 15 months
|
time measured in days to recurrence of AF lasting longer than 30 seconds
|
15 months
|
|
Distance Walked in a 6-mile Walk Test
Time Frame: 3 months through 15 months
|
change in distance walked in 6 mile walk test
|
3 months through 15 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Oussama Wazni, MD, The Cleveland Clinic
Publications and helpful links
General Publications
- Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982 Apr 29;306(17):1018-22. doi: 10.1056/NEJM198204293061703.
- Van den Berg MP, Tuinenburg AE, Crijns HJ, Van Gelder IC, Gosselink AT, Lie KI. Heart failure and atrial fibrillation: current concepts and controversies. Heart. 1997 Apr;77(4):309-13. doi: 10.1136/hrt.77.4.309.
- Chen MS, Marrouche NF, Khaykin Y, Gillinov AM, Wazni O, Martin DO, Rossillo A, Verma A, Cummings J, Erciyes D, Saad E, Bhargava M, Bash D, Schweikert R, Burkhardt D, Williams-Andrews M, Perez-Lugones A, Abdul-Karim A, Saliba W, Natale A. Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. J Am Coll Cardiol. 2004 Mar 17;43(6):1004-9. doi: 10.1016/j.jacc.2003.09.056.
- Wyse DG. Some recent randomized clinical trials in the management of atrial fibrillation. J Interv Card Electrophysiol. 2003 Oct;9(2):223-8. doi: 10.1023/a:1026292609252.
- Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL, Josephson RA, Kellen JC, Klein RC, Krahn AD, Mickel M, Mitchell LB, Nelson JD, Rosenberg Y, Schron E, Shemanski L, Waldo AL, Wyse DG; AFFIRM Investigators. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation. 2004 Mar 30;109(12):1509-13. doi: 10.1161/01.CIR.0000121736.16643.11. Epub 2004 Mar 8.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
- Bio-858981
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.