Line Versus Spot Ablation in Persistent Atrial Fibrillation
Recruitment status was Recruiting
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Purpose
In this randomized study dealing with the ablative treatment of persistent atrial fibrillation, two ablation strategies are compared: a more anatomically guided linear ablation scheme versus an electrophysiological guided focal ablation strategy aiming at the electrical isolating of the pulmonary veins and ablating areas of fragmented intracardiac electrograms thought to maintain atrial fibrillation.
| Condition | Intervention | Phase |
|---|---|---|
|
Atrial Fibrillation |
Procedure: linear anatomically oriented ablations Procedure: focal electrophysiological oriented ablations |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Linear Anatomically Versus Focal Electrophysiologically Guided Substrate Ablation in Patients With Persistent Atrial Fibrillation |
- Sinus rhythm in follow-up [ Time Frame: Sinus rhythm in follow-up ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 116 |
| Study Start Date: | August 2004 |
| Estimated Study Completion Date: | November 2008 |
| Estimated Primary Completion Date: | May 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
linear lesions to ablate persistent atrial fibrillation
|
Procedure: linear anatomically oriented ablations
linear lesions to ablate persistent atrial fibrillation
|
|
Experimental: 2
focal electrophysiologically guided ablations to treat persistent atrial fibrillation
|
Procedure: focal electrophysiological oriented ablations
focal electrophysiologically guided ablations to treat persistent atrial fibrillation
|
Detailed Description:
This randomized study deals with two different ablative treatment strategies for persistent atrial fibrillation: a more anatomically guided linear ablation scheme with encircling of the ipsilateral pulmonary veins (PV), a left atrial roof line and an anterior line bridging the anterior mitral anulus to the ostium of the left superior PV versus an electrophysiological guided focal ablation strategy aiming at isolating, electrically, the PV and ablating areas of fragmented intracardiac electrograms thought to maintain atrial fibrillation.
Both ablation approaches contain isolation of the most common source of triggering foci, i.e., the pulmonary veins and additional modification of the substrate maintaining atrial fibrillation.
The study endpoint is a combined efficacy/safety analysis. Extensive follow-up with three-monthly 7 days holter ECG is provided.
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age between 18 and 80 years
- symptomatic persistent (> 7 days lasting) atrial fibrillation
- at least one unsuccessful cardioversion or atrial fibrillation relapse in the first 3 months after cardioversion despite antiarrhythmic drug therapy
- oral anticoagulation (> 4 weeks prior to ablation)
Exclusion Criteria:
- moderate to severe valvular heart disease
- congenital heart disease
- LV-EF < 35%
- reversible cause for atrial fibrillation (e.g., hyperthyreosis)
- prior left atrial ablation or Maze operation
- left atrial thrombus
Contacts and Locations| Contact: Heidi Estner, MD | 0049 89 1218 2020 | estner@dhm.mhn.de |
| Germany | |
| Deutsches Herzzentrum Muenchen | Recruiting |
| Munich, Germany, 80636 | |
| Contact: Heidi Estner, MD 0049 89 1218 2020 estner@dhm.mhn.de | |
| Principal Investigator: Heidi Estner, MD | |
| Study Chair: | Claus Schmitt, MD | Deutsches Herzzentrum Muenchen |
| Principal Investigator: | Heidi Estner, MD | Deutsches Herzzentrum Muenchen |
More Information
No publications provided
| Responsible Party: | Prof. A. Schömig, Deutsches Herzzentrum Munich |
| ClinicalTrials.gov Identifier: | NCT00196157 History of Changes |
| Other Study ID Numbers: | GE IDE No. C00604 |
| Study First Received: | September 12, 2005 |
| Last Updated: | May 28, 2009 |
| Health Authority: | Germany: Federal Institute for Drugs and Medical Devices |
Additional relevant MeSH terms:
|
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on May 16, 2013