Pulmonary Vein (PV) Isolation Versus Box Isolation for the Treatment of Atrial Fibrillation
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Purpose
Curative catheter ablation has been established as an effective therapeutic option for atrial fibrillation (AF) that is resistant to pharmacologic rhythm or rate control. However, standard ablative approaches targeting the pulmonary veins (PVs) are associated with a success rate as low as 40%. In a recent study, Kumagai et al. described a new approach of catheter ablation of AF isolating the posterior left atrium including all PVs (called Box Isolation). In Kumagai's study, 46 patients with symptomatic AF underwent box isolation. At 6 months follow up, 43 of 46 patients (93%) were arrhythmia free without antiarrhythmic drugs, with a single procedure success rate of 87% (40/46). This study provided new evidence supporting the hypothesis that the posterior wall is of high importance for the maintenance of AF. The aim of the investigators study is to determine the efficacy of two different approaches of catheter ablation (Standard PV Isolation vs. Box isolation) for the treatment of chronic AF.
| Condition | Intervention |
|---|---|
|
Atrial Fibrillation Radiofrequency Ablation |
Procedure: usual PV ablation Procedure: Box isolation of pulmonary veins |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | PV Isolation Versus Box Isolation for the Treatment of Atrial Fibrillation |
- freedom from atrial fibrillation [ Time Frame: 3 months following ablation ] [ Designated as safety issue: No ]
- safety of Box isolation [ Time Frame: 3 months following procedure ] [ Designated as safety issue: Yes ]
| Enrollment: | 30 |
| Study Start Date: | June 2007 |
| Study Completion Date: | February 2009 |
| Primary Completion Date: | February 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: usual ablation
Wide-area circumferential ablation of the pulmonary veins
|
Procedure: usual PV ablation
usual PV ablation, per above
|
|
Experimental: Box isolation of the pulmonary veins
Single Box lesion set encompassing all four pulmonary veins and the posterior wall of the left atrium.
|
Procedure: Box isolation of pulmonary veins
as above
|
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients undergoing clinically indicated pulmonary vein ablation for atrial fibrillation.
Exclusion Criteria:
- Unable to understand consent form. Not scheduled for clinically indicated pulmonary vein ablation
Contacts and Locations
More Information
No publications provided by Johns Hopkins University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Charles Henrikson, MD, Johns Hopkins University |
| ClinicalTrials.gov Identifier: | NCT01091597 History of Changes |
| Other Study ID Numbers: | NA_00008424 |
| Study First Received: | March 23, 2010 |
| Last Updated: | March 23, 2010 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on May 16, 2013