- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01260220
Randomized Trial of Segmental Versus Circumferential Antral Ablation in Paroxysmal Atrial Fibrillation (CABLE)
August 25, 2017 updated by: Lawson Health Research Institute
An isolation-limited segmental antral approach to pulmonary vein isolation is as effective in achieving long-term freedom from atrial fibrillation as the standard anatomic, circumferential antral ablation.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This is a randomized controlled non-inferiority designed trial.
Follow up:
Patients will stop their anti-arrhythmic drugs 2 months post procedure. Follow-ups will involve clinical assessment, holter and/or loop recorders at 3, 6, 9, and 12 month intervals.
Study Type
Interventional
Enrollment (Actual)
120
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Ontario
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London, Ontario, Canada, N6A 5A5
- London Health Science Centre
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Paroxysmal Atrial Fibrillation (PAF) for at least 6 months with at least 1 symptomatic episode during the previous 6 moths
- Patient must be felt to be candidates for Atrial Fibrillation (AF) ablation based on AF that is symptomatic and refractory or intolerant to at least one class 1 or 3 anti-arrhythmic agent
- Documentation of at least one episode of AF on 12 lead ECG, TTM or Holter monitor within 12 months of randomization in the trial
- Patient must be on continuous anti-coagulation with warfarin (INR 2-3) or fractionated subcutaneous heparin for >4 weeks prior to the ablation or they have undergone a recent (less than 48 hours before planned ablation) transoesphageal echocardiogram to exclude left atrial thrombus.
- Patient must provide written informed consent to participate in the clinical trial
Exclusion Criteria:
- Contraindications to oral anticoagulants
- History of any previous ablation for AF
- Intracardiac thrombus
- AF due to reversible causes
- Pregnancy
- atriotomy scar (typically, MV or TV repair/replacement, ASD surgery, transplants)(CABG are okay)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Circumferential
Completing a complete circle of RF lesions around the left and right pulmonary veins
|
The goal is to complete ablation in all segments around the pulmonary veins until a circle of ablation lesions is created in the antrum with at least 30 seconds of ablation, 25W on the posterior surface, 30W on the anterior surface at each site, and change in the local electrogram.
Entry and Exit block will be confirmed in each vein.
The left superior pulmonary vein and left inferior pulmonary vein will be isolated with one circle, and the right superior and right inferior pulmonary veins will be isolated with one circle.
|
Experimental: Segmental
Isolating the left and right pulmonary veins through RF lesions with a segmental antral approach.
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If the patient is in atrial fibrillation, ablation will begin in the segment with the highest frequency signals in the pulmonary vein antrum.
If the patient is in sinus rhythm, mapping and ablation will occur during coronary sinus pacing.
Segments with the earliest signals in the Lasso catheter will be targeted, and reassessed after each ablation lesion.
This will continue in a segmental fashion on the antrum until pulmonary vein isolation is achieved.
Lasso should be moved between veins between lesions to assess the earliest electrogram.
Entry and exit block will be confirmed at each vein.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Freedom from atrial fibrillation
Time Frame: six months
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Symptomatic atrial fibrillation recurrence (without anti-arrhythmic med's)
|
six months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Procedure time
Time Frame: (4-6) hours From the time patient is draped to the time electrophysiology catheters are removed from the body (same day in the electrophysiology lab)
|
How long did the procedure take?
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(4-6) hours From the time patient is draped to the time electrophysiology catheters are removed from the body (same day in the electrophysiology lab)
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Ablation Time
Time Frame: (4-6 hours) Measured during the procedure.
|
A cumulative measurement of the duration of ablation used during the pulmonary vein isolation procedure.
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(4-6 hours) Measured during the procedure.
|
Fluoroscopy Time
Time Frame: (4-6 Hours) Measured during the procedure.
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A cumulative measurement of flouroscopy time during the pulmonary vein isolation procedure.
|
(4-6 Hours) Measured during the procedure.
|
complications
Time Frame: 6 months
|
Did the patient experience any complication during the actual pulmonary vein isolation procedure or complication during follow-up related to the procedure?
|
6 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Lorne J Gula, MD, Western University, Canada
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 12, 2009
Primary Completion (Actual)
December 31, 2015
Study Completion (Actual)
December 31, 2015
Study Registration Dates
First Submitted
June 8, 2010
First Submitted That Met QC Criteria
December 13, 2010
First Posted (Estimate)
December 15, 2010
Study Record Updates
Last Update Posted (Actual)
August 28, 2017
Last Update Submitted That Met QC Criteria
August 25, 2017
Last Verified
August 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- R-09-489
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.
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