Study Comparing Pulmonary Vein Isolation With the Cryoballoon, Radiofrequency Energy, or Both in the Treatment of Atrial Fibrillation (AF) (Cryo Vs RFA)
Recruitment status was Recruiting
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Purpose
The purpose of this study is to perform a prospective, randomised study investigating the safety and efficacy of cryoballoon catheter ablation compared with radiofrequency ablation, or both together in the treatment of paroxysmal AF.
The hypotheses for this study are (1) that cryothermal energy is as effective and safe as using radiofrequency energy in the treatment of paroxysmal AF and is associated with a better long term outcome, and (2) that use of both cryothermy and RF in combination is as effective and safe as using either radiofrequency energy or cryothermy alone and is associated with a better long term outcome.
| Condition | Intervention | Phase |
|---|---|---|
|
Atrial Fibrillation |
Procedure: Atrial fibrillation ablation |
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: | A Randomised Study Comparing Pulmonary Vein Isolation Using the Occluding Cryoballoon, Conventional Radiofrequency Energy, or Both in the Treatment of Atrial Fibrillation (AF). |
- Freedom from AF after a single procedure at 6 months. [ Time Frame: 6 months ] [ Designated as safety issue: No ]Freedom from AF or any other atrial tachyarrhythmia lasting > 30 seconds (symptomatic or not) at 6 months following a single ablation procedure.
- Complication rates, costs, fluoroscopy times, radiation exposure, and long term success. MRI substudy: sensitivity & specificity for determining ablation lesions. Platelet substudy: Platelet activation post ablation compared to baseline. [ Time Frame: 0-12 months post procedure ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 246 |
| Study Start Date: | September 2008 |
| Estimated Primary Completion Date: | September 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Cryoballoon |
Procedure: Atrial fibrillation ablation
Comparison of three different techniques for pulmonary vein isolation
|
| Active Comparator: Radiofrequency |
Procedure: Atrial fibrillation ablation
Comparison of three different techniques for pulmonary vein isolation
|
| Active Comparator: Cryoballoon + Radiofrequency together |
Procedure: Atrial fibrillation ablation
Comparison of three different techniques for pulmonary vein isolation
|
Detailed Description:
Pulmonary vein isolation is an important treatment for patients with atrial fibrillation (AF), particularly those in whom antiarrhythmic drugs are ineffective or cannot be tolerated. One method involves the use of radiofrequency energy and 3-D mapping system to produce a series of lesions (small burn areas) within the heart. Another method involves passing a balloon (called a cryoballoon) into the heart and freezing the parts of the heart muscle that the veins drain into. Both methods appear to be effective from known data. However, it is not known if use of either method alone or both together is the most effective. We aim to perform a prospective, randomized clinical trial comparing these three strategies.
Substudy 1: Use of cardiac MRI to evaluate ablation lesions. Some patients will also be asked to undergo an MRI scan of the heart before the ablation procedure, and again at three months and one year following the procedure. This will allow us to examine the potential role for MRI in imaging scar tissue formed by the ablation, and help us understand the time course of scar formation and changes to that part of the heart following the ablation.
Substudy 2: Platelet reactivity and activation in AF, and the impact of curative ablation. Blood and urine samples will be taken pre- and 3 months post ablation to see if platelet reactivity and activation are affected by AF compared to established normal ranges, and whether curative ablation impacts on this.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with documented paroxysmal AF on at least 2 occasions and accepted for catheter ablation.
Exclusion Criteria
- Significant valvular disease
- Previous left atrial ablation
Contacts and Locations| Contact: Richard J Schilling, FRCP MD | 02076018639 | victoria.baker@bartsandthelondon.nhs.uk |
| United Kingdom | |
| Barts and the London NHS Trust | Recruiting |
| London, United Kingdom, EC1A 7BE | |
| Contact: Richard J Schilling, FRCP MD 02076018639 victoria.baker@bartsandthelondon.nhs.uk | |
| Principal Investigator: Richard J Schilling, FRCP MD | |
More Information
No publications provided
| Responsible Party: | Professor Richard Schilling, Barts & The London NHS Trust |
| ClinicalTrials.gov Identifier: | NCT01038115 History of Changes |
| Other Study ID Numbers: | 005841 |
| Study First Received: | December 21, 2009 |
| Last Updated: | March 21, 2011 |
| Health Authority: | United Kingdom: Research Ethics Committee |
Keywords provided by Barts & The London NHS Trust:
|
Catheter Ablation |
Additional relevant MeSH terms:
|
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on May 19, 2013