Withdrawal Versus Continuation of Amiodarone in Successfully Treated Patients With Persistent Atrial Fibrillation (WISDOM)
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Purpose
Amiodarone is considered to be the most effective antiarrhythmic drug in the prevention of persistent atrial fibrillation. It can however cause many adverse events, both cardiac and non-cardiac. Long-term maintenance of sinus rhythm after cardioversion is difficult especially because of high recurrence rates during the first month after cardioversion. Duration of atrial fibrillation, type of underlying disease, left ventricular function, left atrial size and age are associated with maintaining sinus rhythm. Early recurrence of atrial fibrillation may be related to a highly arrhythmogenic period due to recovery from electrical remodelling. Late recurrences may be related to other triggers than recovery from electrical remodelling. In this study the investigators want to investigate the effect of amiodarone withdrawal on the occurrence of late relapses of persistent atrial fibrillation. Furthermore, the investigators want to investigate the effect of amiodarone withdrawal on the occurrence of amiodarone related adverse events as well as adverse events related to atrial fibrillation or underlying heart disease. The investigators also want to investigate which patients characteristics are and potential triggers have a prognostic value in the occurence of late relapses after amiodarone withdrawal.
| Condition | Intervention | Phase |
|---|---|---|
|
Persistent Atrial Fibrillation |
Drug: withdrawal or continuation of amiodarone therapy |
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: | Withdrawal of Amiodarone Treatment Versus Continuation in Successfully Treated Patients With Persistent Atrial Fibrillation. A Randomized Study. |
- occurrence of late relapse of persistent atrial fibrillation [ Time Frame: 2 years ] [ Designated as safety issue: No ]
- difference in occurrence of adverse events (amiodarone and atrial fibrillation/underlying heart disease related) between both strategies [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
| Enrollment: | 37 |
| Study Start Date: | August 2000 |
| Study Completion Date: | June 2009 |
| Primary Completion Date: | June 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: withdrawal amiodarone
withdrawal amiodarone afer at least 6 months of sinus rhythm maintenance on amiodarone therapy
|
Drug: withdrawal or continuation of amiodarone therapy
withdrawal or continuation of amiodarone therapy after at least 6 months sinus rhythm maintenance on amiodarone therapy
|
|
Active Comparator: continuation amiodarone
continuation of amiodarone after 6 months of sinus rhythm maintenance on amiodarone therapy
|
Drug: withdrawal or continuation of amiodarone therapy
withdrawal or continuation of amiodarone therapy after at least 6 months sinus rhythm maintenance on amiodarone therapy
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- history of persistent atrial fibrillation, necessitating at least one electrical cardioversion
- presence of sinus rhythm during the last 6 months, while on amiodarone treatment without adverse events related to amiodarone
- clinically stable
- age > 18 years
- written informed consent
Exclusion Criteria:
- sinus rhythm maintenance is preferable (because of atrial fibrillation related morbidity or any other reason)
- symptomatic heart failure NYHA III or IV
- unstable angina pectoris
- hemodynamically significant valvular disease
- concomitant treatment with other class I or III antiarrhythmic drug
- PCI,CABG, other cardiac surgery or major non-cardiac surgery within the last three months
- recent myocardial infarction (< 3 months)
- presence of any disease that is likely to shorten life expectancy to < 1 year
Contacts and Locations| Netherlands | |
| University Medical Center Groningen | |
| Groningen, Netherlands, 9700 RB | |
| Principal Investigator: | Isabelle C. Van Gelder, MD PhD | University Medical Centre Groningen |
More Information
No publications provided
| Responsible Party: | Prof Dr I.C. Van Gelder, University Medical Center Groningen |
| ClinicalTrials.gov Identifier: | NCT00845780 History of Changes |
| Other Study ID Numbers: | T377 |
| Study First Received: | February 17, 2009 |
| Last Updated: | June 23, 2009 |
| Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Keywords provided by University Medical Centre Groningen:
|
persistent atrial fibrillation amiodarone late recurrence atrial fibrillation adverse events |
Additional relevant MeSH terms:
|
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes Amiodarone Anti-Arrhythmia Agents |
Cardiovascular Agents Therapeutic Uses Pharmacologic Actions Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Vasodilator Agents |
ClinicalTrials.gov processed this record on May 21, 2013