FIRE AND ICE II Trial Pilot
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|ClinicalTrials.gov Identifier: NCT03706677|
Recruitment Status : Recruiting
First Posted : October 16, 2018
Last Update Posted : September 3, 2020
|Condition or disease||Intervention/treatment||Phase|
|Persistent Atrial Fibrillation Atrial Arrhythmia||Device: Cryoballoon (Arctic Front Advance Cryoballoon) Device: Radiofrequency Catheter (ThermoCool Smarttouch)||Not Applicable|
60 patients with persistent AF will be randomized 1:1 between Cryoballoon ablation and Radiofrequency ablation in the FIRE AND ICE II Trial Pilot at 5 clinical sites in Europe.
The data collected within the pilot phase will be reviewed and a decision on extending the trial with an extended number of patients and sites as main phase will be taken.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||60 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||Randomization 1:1 between Cryoballoon ablation and Radiofrequency ablation|
|Masking:||Triple (Participant, Investigator, Outcomes Assessor)|
|Masking Description:||Single-blinded; participants will be blinded to the treatment group. Investigators will be blinded on study specific diagnostics used in the trial; Endpoint Review Committee will be blinded to the treatment group.|
|Official Title:||FIRE AND ICE II Trial Pilot|
|Actual Study Start Date :||April 5, 2019|
|Estimated Primary Completion Date :||April 30, 2022|
|Estimated Study Completion Date :||April 30, 2024|
Active Comparator: CRYO group
Within the CRYO arm the ablation will be performed using the Arctic Front Advance Cardiac CryoAblation Catheter, including next generation systems as applicable and approved by Medtronic for the trial.
Intervention performed: Cryoballoon ablation; Cryoballoon (Arctic Front Advance Cryoballoon)
Device: Cryoballoon (Arctic Front Advance Cryoballoon)
Ablation using a Cryoballoon catheter (Arctic Front Advance Cryoballoon Cardiac Ablation Catheter)
Active Comparator: RF group
Within the RF arm the ablation will be performed using a catheter out of the ThermoCool Smarttouch catheter family, including next generation contact force systems as applicable.
Intervention performed: Radiofrequency ablation; Radiofrequency Catheter (ThermoCool Smarttouch)
Device: Radiofrequency Catheter (ThermoCool Smarttouch)
Ablation using a Radiofrequency ablation catheter (ThermoCool Smarttouch catheter)
- Primary Efficacy Objective (not powered within pilot) (time to clinical treatment failure) [ Time Frame: 12 Month ]To demonstrate that Cryo ablation is non-inferior to radiofrequency (RF) ablation with respect to time to clinical treatment failure, defined as recurrence of atrial arrhythmias or intervention for AF (a blanking period of three months will be maintained after the index procedure). The first documented recurrence of an episode of atrial arrhythmia after the blanking period lasting at least 30 seconds will be counted for the primary efficacy objective, as well as any intervention for AF with initiation after the blanking period.
- Safety Objective (freedom from device and procedure related serious adverse events (SAEs)) [ Time Frame: 12 Month ]To demonstrate that Cryo ablation is non-inferior to RF ablation with respect to freedom from device and procedure related serious adverse events (SAEs). The first device or procedure related serious adverse event with onset after start of the index ablation therapy will be used for the safety objective analysis.
- Assess acute procedural success (PVI) [ Time Frame: 3 Month ]Acute procedural success is defined as successful electrical isolation of the pulmonary veins after the ablation procedure as assessed via a diagnostic catheter.
- Assess quality of life: EQ-5D-5L [ Time Frame: 12 Month and 36 Month ]The EQ-5D-5L and AFEQT questionnaires are administered at screening / baseline and at scheduled follow-up (FU) visits. The EQ-5D-5L questionnaire includes 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) assessed with descriptive questions, and a general health score assessed on a Visual Analogue Scale (VAS). For the EQ-5D-5L an index will be derived by comparing the responses to a value set. The index and the health score will each be summarized with mean and standard deviation for randomized arms by visit. The AFEQT questionnaire is a 20-item questionnaire that supports a 4-item symptoms score, an 8-item daily activity score, a 6-item treatment concerns score, and a 2-item treatment satisfaction scale. These are combined into a single AFEQT score. The sub-scores and summary score will be summarized by subject visit and post-procedure assessments, as well as compared between randomized arms using a mixed regression model.
- Evaluate post-procedural interventions for atrial arrhythmias [ Time Frame: 12 Month and 36 Month ]Post-procedural interventions for atrial arrhythmias will be collected and reported.
- Evaluate incidence rate of post-procedure events [ Time Frame: 12 Month and 36 Month ]Serious, device-related, and procedure-related adverse events, all-cause and cardio-vascular-related (CV) hospitalizations, all-cause and CV-related mortality, transient ischemic attack and stroke, phrenic nerve palsy, AF-related symptoms and prescription of antiarrhythmic medication will be reported separately.
- Characterize AF burden seen on Reveal LINQ [ Time Frame: 12 Month and 36 Month ]For subjects in the pilot phase, AF burden will be determined before and after the index ablation from the Cardiac Compass of the Reveal LINQ device.
- Characterize AF burden data seen on Reveal LINQ in subjects with any post-procedural intervention for AF [ Time Frame: 12 Month and 36 Month ]For subjects in the pilot phase, post-ablation AF burden from the Cardiac Compass of the Reveal LINQ device will be characterized who had a post-procedural intervention for AF.
- Comparison of the lesion area as measured by cardiac MRI at Month 3 [ Time Frame: 3 Month ]For subjects in the pilot phase, the MRI Core Lab will determine the area of the atrial lesion created by the PVI procedure. Lesion area will be compared between arms of the trial.
- Evaluate the relation between outcome and AF burden in the 4 weeks before ablation (Reveal LINQ will be assessed) [ Time Frame: 3 Month ]For subjects in the pilot phase, the relation between freedom from AF as assessed for the first primary objective, and the average AF burden from the 4 weeks before the ablation procedure as measured by the Reveal LINQ will be assessed
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03706677
|Contact: Ralf Meyer, Dr||0049175581 ext 0431||Ralf.Meyer@medtronic.com|
|Contact: Petra Kremer||0049174212 ext firstname.lastname@example.org|
|Clinique Pasteur Toulouse||Recruiting|
|Toulouse, Cedex 3, France, 31076|
|Contact: Serge Boveda, Prof. Dr.|
|Herz-Zentrum Bad Krozingen||Recruiting|
|Bad Krozingen, Germany, 79189|
|Contact: Thomas Arentz, Prof. Dr.|
|Cardioangiologisches Centrum Bethanien CCB||Recruiting|
|Frankfurt am Main, Germany, 60431|
|Contact: KR Julian Chun, PD Dr.|
|Asklepios St. Georg||Recruiting|
|Hamburg, Germany, 20099|
|Contact: Stephan Willems, Prof. Dr.|
|Universitätsklinikum Schleswig-Holstein / Campus Lübeck||Recruiting|
|Lübeck, Germany, 23538|
|Contact: Roland Tilz, Prof. Dr.|
|Principal Investigator:||Karl-Heinz Kuck, Prof. Dr.||Asklepios St. Georg, Hamburg|