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Trial to Investigate the Efficacy of Olmesartan in Paroxysmal Atrial Fibrillation

Primary Purpose

Heart Disease, Arrhythmia, Atrial Fibrillation

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Olmesartan
Sponsored by
Atrial Fibrillation Network
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heart Disease focused on measuring atrial fibrillation, angiotensin II, angiotensin receptor antagonist, drug, controlled clinical trial

Eligibility Criteria

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

Inclusion Criteria: Documented paroxysmal atrial fibrillation: ECG documentation of atrial fibrillation at least in one ECG recorded during the last 2 months prior to randomization plus additional ECG recording of sinus rhythm at least 12 hours after the above mentioned ECG documentation. Age ≥ 18 Patient informed orally and in writing Written informed consent of the patient Exclusion Criteria: Strong clinical evidence for therapy with AT II/ACE inhibitors AT II/ACE inhibitor therapy within the last month Therapy with antiarrhythmic agents of class I or class III within the last month, therapy with amiodarone within the last 3 months Direct current (DC) cardioversion within the last 3 months Symptomatic bradycardia Implanted pacemaker or implanted cardioverter/defibrillator with any antitachycardiac algorithm in use Cardiac surgery or cardiac catheter ablation within the last 3 months Typical angina pectoris symptoms at rest or during exercise Known coronary artery disease with indication for intervention Valvular disease > II degree Left ventricular ejection fraction < 40% Diastolic blood pressure > 110mm Hg at rest Symptomatic arterial hypotension Known renal artery stenosis Serum creatinine > 1.8 mval/l Relevant hepatic or pulmonary disorders Hyperthyroidism manifested clinically and in laboratory Known drug intolerance for AT II inhibitors Females who are pregnant or breast feeding Females of childbearing potential who are not using a scientifically accepted method of contraception Participation in a clinical trial within the last 30 days Drug addiction or chronic alcohol abuse Legal incapacity, or other circumstances which would prevent the patient from understanding the aim, nature or extent of the clinical study Evidence of an uncooperative attitude

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Olmesartan

    Placebo

    Arm Description

    Olmesartan tablet, 1 in the morning

    Placebo tablets, 1 in the morning

    Outcomes

    Primary Outcome Measures

    Percentage of days with documented episodes of paroxysmal atrial fibrillation (number of days with paroxysmal atrial fibrillation/number of days with at least one readable Tele-ECG recording)

    Secondary Outcome Measures

    Time to first occurrence of a documented relapse of atrial fibrillation
    Time to first occurrence of a symptomatic documented episode of AF
    Time to persistent atrial fibrillation
    Time to prescription of the recovery-medication
    Number of hospitalizations for cardiovascular reasons (-> Endpoint review)
    Number of intermediate medical visits for cardiovascular reasons (-> Endpoint review) without hospitalization
    Number of cerebrovascular events
    Quality of life

    Full Information

    First Posted
    December 3, 2004
    Last Updated
    September 10, 2012
    Sponsor
    Atrial Fibrillation Network
    Collaborators
    Daiichi Sankyo, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00098137
    Brief Title
    Trial to Investigate the Efficacy of Olmesartan in Paroxysmal Atrial Fibrillation
    Official Title
    Angiotensin II-Antagonist in Paroxysmal Atrial Fibrillation Trial (ANTIPAF Trial)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2012
    Overall Recruitment Status
    Completed
    Study Start Date
    January 2005 (undefined)
    Primary Completion Date
    May 2009 (Actual)
    Study Completion Date
    May 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Atrial Fibrillation Network
    Collaborators
    Daiichi Sankyo, Inc.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Hypothesis: Blocking the angiotensin (AT) II type 1 receptor (Olmesartan) reduces the incidence of episodes of atrial fibrillation in patients with paroxysmal atrial fibrillation during 12 months by more than 25% compared to standard medication without angiotensin II type 1 receptor. A total of 422 subjects will be included in the two study groups. The treatment arm will receive 40mg Olmesartan per day, the remaining patients will receive placebo. Follow-up is 12 months. Daily Tele-ECG recordings will determine the cardiac rhythm and asymptomatic episodes of atrial fibrillation (AF) every day. Concomitant therapy with AV-nodal blocking drugs are allowed during the study. In case of severe AF-induced symptoms, an antiarrhythmic "recovery medication" (amiodarone) is allowed during follow-up.
    Detailed Description
    Double-blind, central randomization, two treatment groups, stratified by beta-blocker use. 211 patients in each treatment arm.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Heart Disease, Arrhythmia, Atrial Fibrillation
    Keywords
    atrial fibrillation, angiotensin II, angiotensin receptor antagonist, drug, controlled clinical trial

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    422 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Olmesartan
    Arm Type
    Experimental
    Arm Description
    Olmesartan tablet, 1 in the morning
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo tablets, 1 in the morning
    Intervention Type
    Drug
    Intervention Name(s)
    Olmesartan
    Primary Outcome Measure Information:
    Title
    Percentage of days with documented episodes of paroxysmal atrial fibrillation (number of days with paroxysmal atrial fibrillation/number of days with at least one readable Tele-ECG recording)
    Time Frame
    12 months follow-up
    Secondary Outcome Measure Information:
    Title
    Time to first occurrence of a documented relapse of atrial fibrillation
    Time Frame
    12 months follow up
    Title
    Time to first occurrence of a symptomatic documented episode of AF
    Time Frame
    12 months follow up
    Title
    Time to persistent atrial fibrillation
    Time Frame
    12 months follow up
    Title
    Time to prescription of the recovery-medication
    Time Frame
    12 months follow up
    Title
    Number of hospitalizations for cardiovascular reasons (-> Endpoint review)
    Time Frame
    12 months follow up
    Title
    Number of intermediate medical visits for cardiovascular reasons (-> Endpoint review) without hospitalization
    Time Frame
    12 months follow up
    Title
    Number of cerebrovascular events
    Time Frame
    12 months follow up
    Title
    Quality of life
    Time Frame
    12 months follow up

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Documented paroxysmal atrial fibrillation: ECG documentation of atrial fibrillation at least in one ECG recorded during the last 2 months prior to randomization plus additional ECG recording of sinus rhythm at least 12 hours after the above mentioned ECG documentation. Age ≥ 18 Patient informed orally and in writing Written informed consent of the patient Exclusion Criteria: Strong clinical evidence for therapy with AT II/ACE inhibitors AT II/ACE inhibitor therapy within the last month Therapy with antiarrhythmic agents of class I or class III within the last month, therapy with amiodarone within the last 3 months Direct current (DC) cardioversion within the last 3 months Symptomatic bradycardia Implanted pacemaker or implanted cardioverter/defibrillator with any antitachycardiac algorithm in use Cardiac surgery or cardiac catheter ablation within the last 3 months Typical angina pectoris symptoms at rest or during exercise Known coronary artery disease with indication for intervention Valvular disease > II degree Left ventricular ejection fraction < 40% Diastolic blood pressure > 110mm Hg at rest Symptomatic arterial hypotension Known renal artery stenosis Serum creatinine > 1.8 mval/l Relevant hepatic or pulmonary disorders Hyperthyroidism manifested clinically and in laboratory Known drug intolerance for AT II inhibitors Females who are pregnant or breast feeding Females of childbearing potential who are not using a scientifically accepted method of contraception Participation in a clinical trial within the last 30 days Drug addiction or chronic alcohol abuse Legal incapacity, or other circumstances which would prevent the patient from understanding the aim, nature or extent of the clinical study Evidence of an uncooperative attitude
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Thomas Meinertz, MD
    Organizational Affiliation
    University Hospital Hamburg
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Andreas Goette, MD
    Organizational Affiliation
    University Hospital Magdeburg
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    24351885
    Citation
    von Eisenhart Rothe AF, Goette A, Kirchhof P, Breithardt G, Limbourg T, Calvert M, Baumert J, Ladwig KH. Depression in paroxysmal and persistent atrial fibrillation patients: a cross-sectional comparison of patients enroled in two large clinical trials. Europace. 2014 Jun;16(6):812-9. doi: 10.1093/europace/eut361. Epub 2013 Dec 18.
    Results Reference
    derived
    PubMed Identifier
    24016511
    Citation
    von Eisenhart Rothe A, Bielitzer M, Meinertz T, Limbourg T, Ladwig KH, Goette A. Predictors of discordance between physicians' and patients' appraisals of health-related quality of life in atrial fibrillation patients: findings from the Angiotensin II Antagonist in Paroxysmal Atrial Fibrillation Trial. Am Heart J. 2013 Sep;166(3):589-96. doi: 10.1016/j.ahj.2013.05.020. Epub 2013 Jul 10.
    Results Reference
    derived
    PubMed Identifier
    22157519
    Citation
    Goette A, Schon N, Kirchhof P, Breithardt G, Fetsch T, Hausler KG, Klein HU, Steinbeck G, Wegscheider K, Meinertz T. Angiotensin II-antagonist in paroxysmal atrial fibrillation (ANTIPAF) trial. Circ Arrhythm Electrophysiol. 2012 Feb;5(1):43-51. doi: 10.1161/CIRCEP.111.965178. Epub 2011 Dec 7.
    Results Reference
    derived
    Links:
    URL
    http://www.kompetenznetz-vorhofflimmern.de
    Description
    Homepage of the German AF Network

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    Trial to Investigate the Efficacy of Olmesartan in Paroxysmal Atrial Fibrillation

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