Stepwise Approach Versus Linear Ablation in Patients With Recurrence of Persistent Atrial Fibrillation (REDO-AF)
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Purpose
Catheter ablation of persistent atrial fibrillation (AF) remains a challenging procedure. Even in experienced centres, repeat interventions are necessary in up to 70 of patients to achieve sinus rhythm at a long-term follow-up.
While there is a consensus to perform pulmonary vein isolation (PVI) as a cornerstone for the ablation of paroxysmal and persistent AF ablation, different additional ablation strategies are used to achieve a modification of the substrate that perpetuates the arrhythmia: linear lesions (anterior and roof lines) or ablation of complex fractionated atrial electrograms (CFAE). In the stepwise approach PVI, CFAE ablation and/or LL are combined according to the presenting arrhythmia during procedure.
The aim of the study is to determine whether there is a difference in terms of freedom from arrhythmia between a stepwise approach and a linear ablation for repeat procedure in patient with recurrence of persistent atrial fibrillation.
| Condition | Intervention |
|---|---|
|
Atrial Fibrillation Recurrence |
Procedure: Ablation with stepwise approach Procedure: Linear ablation |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Stepwise Approach Versus Linear Ablation for Repeat Procedure in Patients With Recurrence of Persistent Atrial Fibrillation |
- Freedom from atrial arrhythmia [ Designated as safety issue: No ]Documented freedom from atrial arrhythmia (AF or AT) during follow-up.
- Procedural and safety data [ Designated as safety issue: Yes ]
- Duration of left atrial procedure, ablation time, fluoroscopy time.
- Complications
- Type of recurrent arrhythmia
- Number of reablation
| Estimated Enrollment: | 130 |
| Study Start Date: | October 2010 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | October 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Stepwise approach
Stepwise approach for repeat AF ablation
|
Procedure: Ablation with stepwise approach
Stepwise approach for repeat AF ablation
Procedure: Linear ablation
Linear ablation for AF ablation
|
|
Active Comparator: Linear ablation
Linear ablation for repeat procedure in patients with recurrent atrial fibrillation
|
Procedure: Ablation with stepwise approach
Stepwise approach for repeat AF ablation
Procedure: Linear ablation
Linear ablation for AF ablation
|
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with recurrence of symptomatic persistent atrial fibrillation after at least one ablation procedure,
- with the last ablation procedure at least 3 months ago.
- at least one unsuccessful attempt of antiarrhythmic drug
- oral anticoagulation for at least 4 weeks prior to ablation
Exclusion Criteria:
- LA thrombus
Contacts and Locations| Contact: Sonia Ammar, MD | +49891218 ext 2020 | ammar@dhm.mhn.de |
| Germany | |
| Deutsches Herzzentrum München | Recruiting |
| Munich, Germany, 80636 | |
| Principal Investigator: Sonia Ammar, MD | |
| Study Chair: | Isabel Deisenhofer, MD | Deutsches Herzzentrum München |
| Principal Investigator: | Sonia Ammar, MD | Deutsches Herzzentrum München |
More Information
No publications provided
| Responsible Party: | Isabel Deisenhofer, MD and Sonia Ammar, MD, Deutsches Herzzentrum München |
| ClinicalTrials.gov Identifier: | NCT01229475 History of Changes |
| Other Study ID Numbers: | GER-EP-003 |
| Study First Received: | October 26, 2010 |
| Last Updated: | February 28, 2013 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by Deutsches Herzzentrum Muenchen:
|
Atrial fibrillation recurrence repeat procedure linear ablation stepwise approach |
Additional relevant MeSH terms:
|
Atrial Fibrillation Recurrence Arrhythmias, Cardiac Heart Diseases |
Cardiovascular Diseases Pathologic Processes Disease Attributes |
ClinicalTrials.gov processed this record on May 23, 2013