- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06417242
Predicting Outcomes in Atrial Fibrillation and Heart Failure (PrOAF-HF)
Study Overview
Status
Conditions
Detailed Description
Heart failure is a chronic disease affecting half a million patients in the UK. Up to 40% of patients with heart failure also suffer from atrial fibrillation. A subgroup of patients with atrial fibrillation and heart failure have tachycardia induced cardiomyopathy and benefit from significant improvement of the left ventricular function with restoration of sinus rhythm. Currently those patients can only be identified based on their response to treatment. Investigators aim to improve the treatment of AF-HF patients. The group will develop a robust modelling framework for simulating the hearts of AF-HF patients' hearts to predict patients' response to therapy and infer patient history. This modelling framework will enable integration of predictive simulations into clinical study design where the inferred initiating disease and predicted patient response to therapy are tested for selecting either rate or rhythm control in AF-HF patients.
The primary objective is to test if rhythm control delivered through catheter ablation in patients where either the index disease is unclear or where AF was diagnosed prior to the onset of HF improves LVEF more than in patients where HF was diagnosed first with no evidence of AF.
The secondary objectives are to examine whether the ability to terminate AF during pulmonary vein isolation is influenced by the identified index disease and to determine whether the identified index disease affects AF recurrence rate at 6 months and/or burden post ablation. This study will also identify whether the index disease affects pressure measurements as predictors of change in ejection fraction, hospitalisation, and death rates during the follow up period.
This will be a non-interventional cohort study. Routinely acquired clinical data collected during pre-procedure work up will be accessed for research purposes including: 24-48 hour ambulatory (Holter) monitoring, electrocardiograph (ECG) in AF and in sinus rhythm if available; echocardiography, and clinical history and examination details.
Additionally, an atrial cardiac magnetic resonance imaging (MRI) scan will be performed including assessment of atrial structure, function, fibrosis and epicardial fat burden. Symptom questionnaires will be performed During the ablation procedure, additional time will be taken to perform electrophysiological assessment in all four chambers of the heart.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Magdalena Klis, MD
- Phone Number: 56308 02071887188
- Email: magda.klis@kcl.ac.uk
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Symptomatic persistent AF
- LVEF ≤40% prior to commencement of treatment
- NYHA class ≥2
- Patient must have been commenced on guideline directed medical therapy (GDMT)
- Patient planning to proceed to radiofrequency atrial fibrillation ablation
- Age 18-80 years
- Able and willing to provide written informed consent
Exclusion Criteria:
- Any clinical contra-indication to ablation
- Any disease limiting life expectancy to <1 year
- Potential participant currently pregnant or breast feeding
- Contraindication to MRI
- Paroxysmal or permanent AF
- Unable to understand verbal or written explanations given in English
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
---|
HF index disease
Patients with no history of atrial fibrillation at the time of first diagnosis of heart failure
|
Unclear index disease
Patients in whom the index disease is unknown or in whom atrial fibrillation is the index disease
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in LVEF
Time Frame: 6 months post ablation
|
Change in left ventricular ejection fraction measured on echocardiography
|
6 months post ablation
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Immediate change in LVEF
Time Frame: Immediately post procedure
|
Change in left ventricular ejection fraction on echocardiography
|
Immediately post procedure
|
AF recurrence
Time Frame: 6 months post ablation
|
Presence of AF
|
6 months post ablation
|
Termination of AF during the procedure
Time Frame: Intraprocedural
|
Termination of AF during the ablation procedure
|
Intraprocedural
|
Hospitalization
Time Frame: 6 months
|
Hospitalization for any reason
|
6 months
|
Death
Time Frame: 6 months
|
Death of any cause and cardiovascular death
|
6 months
|
Pressure measurements as predictors of change in LVEF
Time Frame: Intraprocedural measurements - change in LVEF as above
|
Invasive measurements of all four chambers pressure changes during the ablation
|
Intraprocedural measurements - change in LVEF as above
|
Change in atrial fibrillation burden
Time Frame: 6 months post ablation
|
Change in atrial fibrillation burden assessed on a continuous Holter monitor
|
6 months post ablation
|
Change in symptoms
Time Frame: 6 months post ablation
|
Change in quality of lide questionnaire scores
|
6 months post ablation
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 318987
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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