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Ablating Atrial Tachycardias Occuring During Ablation of Complex Fractionated Electrograms in Persistent AF (ATTAC CFAE)

Primary Purpose

Atrial Fibrillation, Ablation, Atrial Flutter

Status
Completed
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
Ablation
Cardioversion
Sponsored by
Deutsches Herzzentrum Muenchen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atrial Fibrillation focused on measuring Atrial fibrillation, ablation, atrial flutter

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients (>=18 und < 80 years) with symptomatic persistent AF (AF episode enduring at least 7 days) but are successfully convertable in sinus rhythm (SR).
  • At least one unsuccessful attempt of antiarrhythmic drug (betablocker or class I oder III).
  • Oral anticoagulation with phenprocoumone or warfarine for at least 4 weeks prior to ablation with weekly documented INR > 2..
  • Withdrawal of antiarrhythmic drugs at least 3 half times prior to ablation except amiodarone.
  • Atrial tachycardia occurring during ablation of CFAE (defined as CL > 200 msec und stable activation sequence).

Exclusion Criteria:

-

Sites / Locations

  • Klinikum Karlsruhe
  • Deutsches Herzzentrum München

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Ablation

Cardioversion

Arm Description

Ablation of atrial tachycardia

Cardioversion of atrial tachycardia

Outcomes

Primary Outcome Measures

Freedom from atrial tachyarrhythmia
Documented freedom from atrial tachyarrhythmia (AF or AT) during follow-up after first ablation.

Secondary Outcome Measures

Procedural and safety data
Duration of left atrial procedure, time of ablation, time of radiation and radiation dose from randomization until the end of the procedure. In case of recurrence, characteristic of predominant tachyarrhythmia (AF or AT). Safety parameters (pericardial tamponade, thrombembolic complications). Number of re-ablations.

Full Information

First Posted
October 26, 2010
Last Updated
April 10, 2017
Sponsor
Deutsches Herzzentrum Muenchen
Collaborators
Klinik für Kardiologie, Klinikum Karlsruhe, Prof. Dr. C. Schmitt
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1. Study Identification

Unique Protocol Identification Number
NCT01229033
Brief Title
Ablating Atrial Tachycardias Occuring During Ablation of Complex Fractionated Electrograms in Persistent AF
Acronym
ATTAC CFAE
Official Title
Ablating Atrial Tachycardias Occuring During Ablation of Complex Fractionated Electrograms in Persistent AF - ATTAC CFAE Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
January 2010 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
January 2014 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Deutsches Herzzentrum Muenchen
Collaborators
Klinik für Kardiologie, Klinikum Karlsruhe, Prof. Dr. C. Schmitt

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Catheter ablation has proven to be an effective treatment option in patients suffering from symptomatic persistent atrial fibrillation (AF). Catheter ablation consists of two major steps: (1) Isolation of pulmonary veins to abolish the trigger of atrial fibrillation and (2) modification of left atrial and eventually right atrial substrate by ablation of complex fractionated atrial electrograms (CFAE). CFAE are mainly found at the ostia of the pulmonary veins, around the left atrial appendage, at the mitral annulus and the septum. When ablating CFAE 40-65% of the patients show a regularization of AF to an atrial tachycardia (AT) that can be macro- or micro-reentrant (localized re-entry). Until now the significance of the AT is unclear. In the following study we examine the hypothesis that an ablation of AT occuring during CFAE ablation (group 1) significantly improves outcome defined as freedom of atrial arrhythmia (AF or AT) compared to patients that are cardioverted when AF has regularized to AT (group 2).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atrial Fibrillation, Ablation, Atrial Flutter
Keywords
Atrial fibrillation, ablation, atrial flutter

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
186 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Ablation
Arm Type
Active Comparator
Arm Description
Ablation of atrial tachycardia
Arm Title
Cardioversion
Arm Type
Active Comparator
Arm Description
Cardioversion of atrial tachycardia
Intervention Type
Procedure
Intervention Name(s)
Ablation
Intervention Description
Ablation of atrial tachycardia
Intervention Type
Procedure
Intervention Name(s)
Cardioversion
Intervention Description
Cardioversion of atrial tachycardia
Primary Outcome Measure Information:
Title
Freedom from atrial tachyarrhythmia
Description
Documented freedom from atrial tachyarrhythmia (AF or AT) during follow-up after first ablation.
Secondary Outcome Measure Information:
Title
Procedural and safety data
Description
Duration of left atrial procedure, time of ablation, time of radiation and radiation dose from randomization until the end of the procedure. In case of recurrence, characteristic of predominant tachyarrhythmia (AF or AT). Safety parameters (pericardial tamponade, thrombembolic complications). Number of re-ablations.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients (>=18 und < 80 years) with symptomatic persistent AF (AF episode enduring at least 7 days) but are successfully convertable in sinus rhythm (SR). At least one unsuccessful attempt of antiarrhythmic drug (betablocker or class I oder III). Oral anticoagulation with phenprocoumone or warfarine for at least 4 weeks prior to ablation with weekly documented INR > 2.. Withdrawal of antiarrhythmic drugs at least 3 half times prior to ablation except amiodarone. Atrial tachycardia occurring during ablation of CFAE (defined as CL > 200 msec und stable activation sequence). Exclusion Criteria: -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Isabel Deisenhofer, MD
Organizational Affiliation
Deutsches Herzzentrum München
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Clemens Jilek, MD
Organizational Affiliation
Deutsches Herzzentrum München
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinikum Karlsruhe
City
Karlsruhe
ZIP/Postal Code
76133
Country
Germany
Facility Name
Deutsches Herzzentrum München
City
München
ZIP/Postal Code
80636
Country
Germany

12. IPD Sharing Statement

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Ablating Atrial Tachycardias Occuring During Ablation of Complex Fractionated Electrograms in Persistent AF

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