- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01877486
PVI Using Cryoablation Alone in Paroxysmal AF Patients Converted From Persistent AF With Dofetilide (ABLATE)
Pulmonary Vein Isolation Using Cryoablation Alone in Paroxysmal Atrial Fibrillation Patients Converted From Persistent Atrial Fibrillation With Dofetilide
Study Overview
Status
Intervention / Treatment
Detailed Description
Pulmonary vein isolation is now considered a cornerstone of all atrial fibrillation (AF) ablation procedures. In patients with paroxysmal AF, pulmonary vein isolation alone is usually sufficient. The cryoballoon is now FDA approved to achieve PVI in patients with paroxysmal AF.
Although no ablation system is yet approved in patients with persistent AF, these patients are increasingly undergoing ablation. Many investigators feel that these patients have more atrial disease and thus PVI alone is insufficient in these patients. As a result, it is common for these patients to undergo additional ablation, which is often quite extensive and exposes patients to proarrhythmia. Commonly utilized strategies include linear lesions (left atrial roof; mitral isthmus line), ablation of complex fractionated atrial electrograms (CFAEs), left atrial appendage isolation and/or even right atrial ablation. For years, the investigators have been concerned about the adverse effects of this additional ablation. The investigators postulated that the "answer" is not more ablation but trying to "reverse remodel" patients with persistent AF back to a paroxysmal form, whereby PVI alone would again be justified and sufficient. The efficacy of such a strategy has previously been demonstrated.
In brief, the investigators start patients with persistent AF on dofetilide 3 months prior to scheduled ablation. In 96% of patients, AF either suppresses completely or is transformed into a paroxysmal pattern. The net effect is "reverse remodeling" of the left atria. The investigators have confirmed this by using a reduction in P wave duration as a surrogate of remodeling. At the ablation procedure, the investigators perform PVI alone.
Study Type
Contacts and Locations
Study Locations
-
-
New Jersey
-
Ridgewood, New Jersey, United States, 07450
- Valley Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Aged 18 to 80 years
- Able and willing to give written informed consent
- Paroxysmal AF, defined as recurrent AF ( ≥ 2 episodes in 1 month) that terminates within 7 days as assessed by ECG recordings
- Prior persistent AF, defined as sustained beyond seven days and up to one year, successfully converted to paroxysmal AF by dofetilide
Exclusion Criteria:
- Previous ablation for AF
- Left atrial size larger than 60mm (parasternal view on transthoracic echocardiogram)
- Patients who have AF episodes triggered by another uniform arrhythmia (e.g. atrial flutter or atrial tachycardia)
- Presence of severe valvular disease with the need for surgical correction
- AF deemed secondary to a transient or correctable abnormality including electrolyte imbalance, trauma, recent surgery, infection, toxic ingestion, and endocrinopathy
- Pregnant women or women of child bearing potential and not on reliable methods of birth control
- Second or third degree AV block, sinus pause > 3 seconds, resting heart rate< 30 bpm without permanent pacemaker
- History of drug-induced Torsades de Pointes or congenital long QT syndrome
- Uninterrupted AF for more than 12 months prior to randomization unless sinus rhythm maintained for ≥ 24 hours after cardioversion.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Cryoballoon ablation
After pre-treatment with dofetilide and conversion of persistent AF to sinus rhythm, performance of PVI using cryoballoon
|
Pulmonary vein isolation following dofetilide
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Freedom from atrial fibrillation/flutter
Time Frame: One year
|
As assessed by one week Holters and symptoms
|
One year
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UR Cryo PVI
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
Clinical Trials on Paroxysmal Atrial Fibrillation
-
Biosense Webster, Inc.Active, not recruitingRefractory Paroxysmal Atrial FibrillationChina
-
Boston Scientific CorporationCompletedParoxysmal Atrial Fibrillation (PAF)United States, Spain, Germany, Australia, United Kingdom, Sweden, Czechia, France, Portugal
-
Medtronic Cardiac Rhythm and Heart FailureCompletedParoxysmal Atrial Fibrillation (PAF)United States, Canada
-
Charite University, Berlin, GermanyGerman Federal Ministry of Education and ResearchTerminatedSymptomatic Paroxysmal Atrial FibrillationGermany
-
Hospital Clinic of BarcelonaCompletedDrug-refractory Paroxysmal Atrial FibrillationSpain
-
Biosense Webster, Inc.RecruitingDrug Refractory Paroxysmal Atrial FibrillationUnited States
-
Biosense Webster, Inc.CompletedDrug Refractory Symptomatic Paroxysmal Atrial FibrillationUnited States
-
Ablacon, Inc.RecruitingAtrial Fibrillation | Arrhythmias, Cardiac | Arrhythmia | Atrial Flutter | Atrial Fibrillation, Persistent | Atrial Tachycardia | Atrial Arrhythmia | Atrial Fibrillation Paroxysmal | Atrial Fibrillation, Paroxysmal or PersistentUnited States, Belgium, Netherlands, Czechia
-
Medtronic Cardiac Rhythm and Heart FailureMedtronic Atrial Fibrillation SolutionsCompletedSymptomatic Paroxysmal Atrial Fibrillation Without Clinically Significant Heart DiseasesNetherlands, Australia, France, Norway, Germany, Croatia, Italy, Argentina, Belgium
-
Beijing Anzhen HospitalJohnson & Johnson; Heart Health Research CenterNot yet recruitingParoxysmal Atrial Fibrillation | Persistent Atrial Fibrillation
Clinical Trials on Ablation
-
Oxford University Hospitals NHS TrustCompletedAtrial FibrillationUnited Kingdom
-
Ping LiangRecruitingHepatocellular Carcinoma | Surgery | Ablation | Prognosis | Contrast-enhanced UltrasoundChina
-
Karolinska University HospitalRecruiting
-
Covidien, GI SolutionsCompletedESOPHAGEAL SQUAMOUS CELL CARCINOMAChina
-
University of OklahomaCompleted
-
Shanghai Chest HospitalUnknown
-
Eastbourne General HospitalUnknownPersistent Atrial FibrillationUnited Kingdom
-
Texas Cardiac Arrhythmia Research FoundationCompletedMigraine | Atrial FibrillationUnited States
-
China National Center for Cardiovascular DiseasesNot yet recruitingConcomitant Hybrid Versus Catheter Ablation for Atrial Fibrillation With Hypertrophic CardiomyopathyAtrial Fibrillation | Cardiomyopathy, Hypertrophic | Radiofrequency AblationChina
-
Taipei Medical University HospitalRecruitingChronic Low Back Pain | Facet Joint SyndromeTaiwan