Ablation vs Drug Therapy for Atrial Fibrillation - Pilot Trial (CABANA)
2012年12月3日 更新者:Mayo Clinic
Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation - Pilot Trial
The CABANA pilot study is designed to test the hypothesis that the treatment strategy of percutaneous left atrial catheter ablation for the purpose of the elimination of atrial fibrillation (AF) is superior to current state-of-the-art therapy with either rate control or anti-arrhythmic drugs for reducing AF recurrences at 1 year follow-up.
研究概览
地位
完全的
详细说明
The need for this trial arises out of 1) the rapidly increasing number of pts > 60 years of age with AF accompanied by symptoms and morbidity, 2) the failure of anti-arrhythmic drug therapy to maintain sinus rhythm and reduce mortality, 3) the rapidly increasing application of radio-frequency catheter ablation without appropriate evidence-based validation, and 4) the expanding impact of AF on health care costs.
研究类型
介入性
注册 (实际的)
60
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
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Alabama
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Birminham、Alabama、美国、35233
- Universtity of Alabama Hospital
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California
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Los Angeles、California、美国、90017
- Good Samaritan Hospital
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Illinois
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Maywood、Illinois、美国、60626
- Loyola University
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Iowa
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Des Moines、Iowa、美国、50314
- Mercy Medical Center
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Maryland
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Baltimore、Maryland、美国、21287
- Johns Hopkins Hospital
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Massachusetts
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Boston、Massachusetts、美国、02115
- Brigham and Womens Hospital
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Minnesota
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Rochester、Minnesota、美国、55902
- Mayo Clinic
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Ohio
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Columbus、Ohio、美国、43210
- Ohio State University Medical Center
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Pennsylvania
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Philadelphia、Pennsylvania、美国、19104
- University of Pennsylvania Health
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Utah
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Murray、Utah、美国、84157
- Intermountain Medical Center
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参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 90年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Have documented AF, which warrants active drug or ablative treatment
- Be eligible for both catheter ablation and at least 2 sequential anti-arrhythmic drugs and/or 3 sequential rate control drugs
- Be >65 yrs of age, or <65 yrs with one or more of the following risk factors for stroke: Hypertension, Diabetes, Congestive heart failure (including systolic or diastolic heart failure), Prior stroke or transient ischemic attack, Left atrium >4.5 cm, ejection fraction <35% by echocardiogram, radionuclide evaluation or contrast ventriculography
Exclusion Criteria:
- Previously failed 2 or more membrane active anti-arrhythmic drugs
- Efficacy failure of a full dose Amiodarone trial of >12 weeks duration
- Any amiodarone therapy in the past three months
- Reversible causes of AF including thyroid disorders, acute alcohol intoxication, recent major surgical procedures, or trauma
- Lone atrial fibrillation in the absence of risk factors for stroke in patients <65 years of age
- Recent cardiac events including myocardial infarction, percutaneous intervention, or valve or coronary bypass surgery in the preceding 3 months
- Hypertrophic obstructive cardiomyopathy
- Class IV angina or congestive heart failure
- Planned heart transplantation
- Other mandated anti-arrhythmic drug therapy
- Heritable arrhythmias or increased risk for "torsade de pointes" (a specific, rare variety of ventricular tachycardia) with class I or III drugs
- Prior left atrial catheter ablation with the intention to treat AF
- Patients with other arrhythmias requiring ablative therapy
- Prior surgical interventions for AF such as the MAZE procedure
- Prior atrioventricular nodal ablation
- Medical conditions limiting expected survival to <1 year
- Contraindication to warfarin anti-coagulation
- Women of childbearing potential
- Participation in any other clinical mortality trial
- Unable to give informed consent
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器:Pharmacologic Therapy
Pharmacologic Therapy Rate and/or Sinus Rhythm Control: Patients without other heart disease will receive beta or calcium channel blockers as first line rate control therapy.
Patients with underlying coronary artery disease will receive beta-blockers, patients with limited ventricular hypertrophy not warranting exclusion would receive either beta- or calcium channel blockers, while patients with heart failure would be expected to receive carvedilol or metoprolol.
Patients randomized to drug therapy may be started on a membrane active drug, in an approach consistent with the recommended Guidelines for Management of Subjects with AF.
Each patient will be placed on an anti-arrhythmic drug for an appropriate period and the patient cardioverted to sinus rhythm if necessary.
Patients will then be followed for a period of up to 3 months, during which dosage adjustment can be made or the drug replaced with a different anti-arrhythmic drug.
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Metoprolol 50-100mg
其他名称:
Atenolol 50-100mg,
其他名称:
Diltiazem 180-240mg
其他名称:
Verapamil 180-240mg
其他名称:
Digoxin 0.125mg
其他名称:
Propafenone 450mg
其他名称:
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有源比较器:Ablation Therapy
Left Atrial Catheter Ablation: The specific choice of ablation catheters will be left to the investigator from the following list: Lifewire TC XLS, Therapy Dual/Thermocouple, NAVI-STAR/NAVI-STAR DS, Celsius Braided Tip, NAVI-STAR Thermo-Cool, Freezor/FreezorMax, Stinger, Blazer II RF/RPM/SteeroCath /XP, Chilli Cooled.
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其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Number of Participants Experiencing Recurrence of Atrial Fibrillation by One Year Follow-up
大体时间:12 months after intervention
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Documentation of atrial fibrillation using a cardiac event recorder
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12 months after intervention
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
赞助
调查人员
- 首席研究员:Douglas L. Packer, M.D.、Mayo Clinic
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2006年9月1日
初级完成 (实际的)
2009年2月1日
研究完成 (实际的)
2010年6月1日
研究注册日期
首次提交
2007年12月14日
首先提交符合 QC 标准的
2007年12月20日
首次发布 (估计)
2007年12月21日
研究记录更新
最后更新发布 (估计)
2013年1月4日
上次提交的符合 QC 标准的更新
2012年12月3日
最后验证
2012年12月1日
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 06-003867
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
Rate Control的临床试验
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Devicare S.L.Clever Instruments S.L.; Fundacio Puigvert未知
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Indiana UniversityEunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)招聘中
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Gonzalez-Heydrich, Joseph, M.D.Boston Children's Hospital; Harvard University完全的
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University of Puerto RicoNational Institutes of Health (NIH)招聘中
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Ananda Basu, MDNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); DexCom, Inc.; Tandem...完全的