- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03607123
Atrial Fibrillation With Sinus Node Dysfunction: Intensive Device Follow-up (SAFE PAF-SND)
July 23, 2018 updated by: Minglong Chen, The First Affiliated Hospital with Nanjing Medical University
Stepwise Atrial Fibrillation supprEssion Treatment in Patients With Paroxysmal Atrial Fibrillation and Sinus Node Dysfunction: Intensive Device Follow-up
The study will try to access the efficacy of atrial pacing, medication and radiofrequency ablation in treating patients with paroxysmal atrial fibrillation and sinus node dysfunction; to identify the response to these treatments in patients with "functional" and organic sinus node dysfunction respectively; to explore the necessity of pacemaker implantation in patients with "functional" sinus node dysfunction.
Patients who meet the inclusion criteria will receive pacemaker implantation followed by trial pacing, medication and radiofrequency ablation of AF.
Device data will be analyzed to answer the question.
And after follow-up of 1 year, lower rate of pacemaker will be set as 40 bpm for patients without AF.
The proportion of pacing and patients' tolerance will be analyzed.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Study Type
Observational
Enrollment (Anticipated)
200
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
-
-
Jiangsu
-
Nanjing, Jiangsu, China, 201129
- The First Affiliated Hospital of Nanjing Medical University
-
-
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 to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
Patients who meet the Eligibility Criteria will be enrolled.
The anticipated number of patients is 200.
Description
Inclusion Criteria:
- Age from 18 - 80 years
- Longest RR interval ≥ 3 seconds in sinus rhythm or when atrial arrhythmia (atrial fibrillation/atrial arrhythmia/atrial flutter) is converted to sinus rhythm (documented by either holter monitor or electrogram).
- Meet the indications of permanent pacemaker implantation in patients with SND according to the 2012 ACCF/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities.
- Evidence of paroxysmal atrial fibrillation ( two or more symptomatic episodes within 6 months)
- Willing to sigh informed consent
Exclusion Criteria:
- Type II second-degree or three-degree atrioventricular block (in sinus rhythm)
- Intrinsic PR interval ≥ 300 ms in sinus rhythm
- Persistent AF(including long-standing persistent AF)
- Severe structural heart disease(e.g. ischemic heart disease that requires revascularization, rheumatic heart disease that requires valve replacement, cardiomyopathy except hypertensive myocardial hypertrophy)
- Work high above the ground or heavy physical labour
- Malignant ventricular arrhythmias
- New York Heart Association (NYHA) class III or IV
- AF secondary to electrolyte imbalance, thyroid dysfunction, vasovagal reaction or other reversible or non-cardiac causes
- Previous procedures dealing with AF (including radiofrequency ablation and surgical operation)
- Cardiac implantable electronic device implantation history
- Severe hepatic and renal dysfunction(serum creatinine above the upper normal limit of the center, or chronic renal dysfunction ; ALT or AST more than 2 times the upper normal limit of the center, or bilirubin more than 2 times the upper normal limit of the center, or hepatic cirrhosis)
- Contraindication to propafenone/amiodarone/dronedarone(except bradycardia)
- Contraindication to oral anticoagulants
- Women who are pregnant
- Presence of malignant tumor
- Severe coagulation disorder (without any anticoagulation treatment)
- The investigators do not think the patient is eligible for this study
- Patient is unwilling to cooperate with the study procedures
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
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Baseline
After implantation of pacemaker, the pacing mode and the lower rate of pacemaker will be set as VDD and 50/45 bpm respectively, to get the baseline burden of atrial fibrillation without atrial pacing.
Except for beta-blockers digoxin, and CCB to control heart rate, anti-arrhythmic drugs (AAD) will not be prescribed.
Patients who can not tolerate will drop out.
After follow-up of at least 3 month, patients with AF lasting longer than one minute detected by pacemaker will go to next group / stage (Atrial Pacing, Step1).
|
Different programing parameters will be set in different group/stage
|
Atrial Pacing (Step 1)
After Baseline and after follow-up of at least 3 month, patients with AF lasting longer than one minute detected by pacemaker will come to this group /stage (Atrial Pacing).
At this stage, the pacing mode and the lower rate of pacemaker will be set as DDD and 70/60 bpm respectively, to perform relatively high-rate atrial pacing.
Except for beta-blockers digoxin, and CCB to control heart rate, anti-arrhythmic drugs (AAD) will not be prescribed.
After follow-up of at least 3 month, patients with AF lasting longer than one minute detected by pacemaker will go to next group/stage (AAD, Step1).
|
Different programing parameters will be set in different group/stage
|
AAD (Step 2)
After Step 1, and after follow-up of at least 3 month, patients with AF lasting longer than one minute detected by pacemaker will come to this group/stage.
Anti-arrhythmic drugs including propafenone, amiodarone and dronedarone will be prescribed.
After follow-up of at least 6 month, patients with AF lasting longer than one minute detected by pacemaker will go to next group/stage (RFCA, Step3).
|
AF ablation can only be performed in Step 3
|
RFCA (Step 3)
After Step 2, and after follow-up of at least 6 month, patients with AF lasting longer than one minute detected by pacemaker will come to this group/stage (RFCA, Step3).
Patients will receive catheter ablation of AF, up to patients' willingness.
After follow-up of at least 12 month, patients without AF lasting longer than one minute detected by pacemaker will go to next group/stage (SAFE PAF-SND II).
|
AF ablation can only be performed in Step 3
Anti arryhthmic drugs can be prescribed in Step 2, Step3 and SAFE PAF-SND
|
SAFE PAF-SND II
After RFCA, and after follow-up of at least 12 month, patients without AF lasting longer than one minute detected by pacemaker will come to this group/stage (SAFE PAF-SND II).
At this stage, the pacing mode and the lower rate of pacemaker will be set as VDD and 40 bpm respectively.
If the patient can not tolerate, the the pacing mode and the lower rate of pacemaker will be set as DDD/DDDR and 60 bpm.
If the patient has no symptom related to bradycardia, he/she will be followed up until the end of this study.
|
Different programing parameters will be set in different group/stage
AF ablation can only be performed in Step 3
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
proportion of ventricular pacing
Time Frame: through study completion, an average of 2 years
|
through study completion, an average of 2 years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
symptom related to bradycardia
Time Frame: through study completion, an average of 2 years
|
through study completion, an average of 2 years
|
AF burden
Time Frame: through study completion, an average of 2 years
|
through study completion, an average of 2 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
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)
July 4, 2018
Primary Completion (Anticipated)
July 4, 2022
Study Completion (Anticipated)
July 4, 2022
Study Registration Dates
First Submitted
July 8, 2018
First Submitted That Met QC Criteria
July 23, 2018
First Posted (Actual)
July 31, 2018
Study Record Updates
Last Update Posted (Actual)
July 31, 2018
Last Update Submitted That Met QC Criteria
July 23, 2018
Last Verified
July 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2017-SR-235.A2
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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 Atrial Fibrillation
-
Ablacon, Inc.CompletedArrhythmias, Cardiac | Atrial Fibrillation, Persistent | Persistent Atrial Fibrillation | Longstanding Persistent Atrial FibrillationGermany
-
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
-
Barts & The London NHS TrustAtriCure, Inc.Not yet recruitingAtrial Fibrillation, Persistent | Persistent Atrial Fibrillation | Atrial Arrhythmia | Atrium; FibrillationUnited Kingdom
-
AtriCure, Inc.Active, not recruitingPersistent Atrial Fibrillation | Atrial Fibrillation (AF) | Longstanding Persistent Atrial FibrillationUnited States
-
Maastricht University Medical CenterRWTH Aachen UniversityUnknownAtrial Fibrillation (Paroxysmal) | Atrial Fibrillation Recurrent | Atrial Fibrillation Common Gene VariantsNetherlands
-
Adagio MedicalRecruitingAtrial Fibrillation | Atrial Flutter | Paroxysmal Atrial Fibrillation | Persistent Atrial FibrillationNetherlands, Germany, Belgium
-
Vivek ReddyEnrolling by invitationAtrial Fibrillation and Flutter | Atrial Flutter Typical | Atrial Fibrillation, Paroxysmal or PersistentUnited States
-
Fundació Institut de Recerca de l'Hospital de la...RecruitingAtrial Arrhythmia | Atrial Fibrillation and Flutter | Atrial Fibrillation RecurrentSpain
-
St. George's Hospital, LondonRecruitingAtrial Fibrillation | Atrial Fibrillation, Persistent | Persistent Atrial Fibrillation | Atrial ArrhythmiaUnited Kingdom
-
R-PharmFSBI "National Medical Research Center of Cardiology named after academician...CompletedAtrial Flutter | Paroxysmal Atrial Fibrillation | Persistent Atrial FibrillationRussian Federation
Clinical Trials on programing of pacemaker
-
Alfonso FasanoBoston Scientific CorporationNot yet recruiting
-
Ajou University School of MedicineRecruitingObesity | Arrhythmias, Cardiac | Cardiovascular Morbidity | Pacemaker ComplicationKorea, Republic of
-
Biotronik SE & Co. KGTerminatedHeart Block | Bradycardia | Sick Sinus SyndromeUnited Kingdom
-
Region GävleborgUnknown
-
Academisch Medisch Centrum - Universiteit van Amsterdam...MedtronicUnknownPulmonary Hypertension | Chronic Thromboembolic Pulmonary Hypertension | Right Ventricular FailureNetherlands
-
Abbott Medical DevicesTerminated
-
Imperial College LondonBritish Heart FoundationRecruitingBradycardia | Left Bundle Branch Area Pacing | His Bundle Pacing | Right Ventricular Pacing | PacingUnited Kingdom
-
Arun RaoMedtronicCompletedSinus Node DysfunctionUnited States
-
Massachusetts General HospitalMedtronicRecruiting