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Paroxysmal Atrial FibrillationNCT02637453

Addition of Six Short Lines on Pulmonary Vein Isolation

A study testing PVI and CPVI+6L in people with Paroxysmal Atrial Fibrillation, run by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

We randomly assigned 390 patients with symptomatic, paroxysmal AF to undergo catheter ablation with PVI (PVI group) alone or combined with 6 additional ablation lines extended outside the PVI circumferences at 1, 3 and 6 o'clock of left PV and 6, 9 and 11 o'clock of right PV (PVI+6L group). Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Paroxysmal Atrial Fibrillation
What is being tested?
PVI and CPVI+6L
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
390 participants
Where
1 siteChina
Study dates
4 Jan 2017to 10 Jan 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients between the ages of 18 and 80 years undergoing their first ablation of atrial fibrillation.
  • Diagnosed with symptomatic paroxysmal atrial fibrillation, defined as an documented episode of atrial fibrillation that lasts more than 30 seconds and terminates in less than 7 days.
  • Resistant or intolerant to at least one class I, II, or III antiarrhythmic drugs.
  • Patients deemed candidates for radiofrequency ablation of atrial fibrillation.
  • Able and willing to comply with pre-, post-, and follow-up requirements.

Who cannot join

  • Left atrial thrombus by pre-procedural imaging.
  • Uncontrolled heart failure: New York Heart Association Class III or IV, or left ventricular ejection fraction< 40%
  • Myocardial infarction, unstable angina, coronary stenting within the previous 90 days.
  • Stroke or any thrombo-embolic events within the previous 90 days.
  • Expecting cardiac transplantation or other cardiac surgery within 180 days.
  • History of catheter ablation of atrial fibrillation, atrial flutter or atrial tachycardia.
Show all 16Show fewer
  • History of blood clotting or bleeding abnormalities.
  • Contraindication to anticoagulation.
  • History of cardiac surgery.
  • Uncontrolled maligment tumor.
  • Patients in dialysis or creatinine > 221 μmol/L.
  • Patients with alanine aminotransferase > 150 U/L or aspartate aminotransferase > 76 U/L
  • Acute illness or active infection at time of index procedure or leukocytosis for which antibiotics have been or will be prescribed.
  • Life expectancy less than 1 year.
  • Women who are pregnant or who plan to become pregnant during the study.
  • Other significant congenital anomaly or medical problem that in the opinion of the investigator would preclude enrollment

Trial locations and contacts

1 site in 1 country.

China1 site
  • Xinhua Hospital, Shanghai Jiao Tong University School of Medicne

    Shanghai, Shanghai Municipality, 200092

Other trials in China

About this study

Official title: Addition of Six Short Ablation Lines on Pulmonary Vein Isolation Circumferences Reduces Recurrence Rate of Paroxysmal Atrial Fibrillation

We randomly assigned 390 patients with symptomatic, paroxysmal AF to undergo catheter ablation with PVI (PVI group) alone or combined with 6 additional ablation lines extended outside the PVI circumferences at 1, 3 and 6 o'clock of left PV and 6, 9 and 11 o'clock of right PV (PVI+6L group). Patients received monthly 12-lead electrocardiogram, 24-hour Holter at 3, 6 and 9 months and 14-days continuous monitoring at 12 months to detect atrial tachyarrhythmia. The follow-up period was 12 months. The primary end point was freedom from AF recurrence between 91 and 365 days after catheter ablation. The secondary end points included the AF burden, procedural parameters, and complications.

Read the detailed description

We randomly assigned 390 patients with symptomatic, paroxysmal AF to undergo catheter ablation with PVI (PVI group) alone or combined with 6 additional ablation lines extended outside the PVI circumferences at 1, 3 and 6 o'clock of left PV and 6, 9 and 11 o'clock of right PV (PVI+6L group). Patients received monthly 12-lead electrocardiogram, 24-hour Holter at 3, 6 and 9 months and 14-days continuous monitoring at 12 months to detect atrial tachyarrhythmia. The follow-up period was 12 months. The primary end point was freedom from AF recurrence between 91 and 365 days after catheter ablation. The secondary end points included the AF burden, procedural parameters, and complications.

Being tested
PVI, CPVI+6L
Keywords
Paroxysmal Atrial Fibrillation; Ablation
Medical subject headings
Atrial Fibrillation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PVIProcedure or surgery

    Pulmonary vein isolation

  • CPVI+6LProcedure or surgery

    After PVI, 6 ablation lines were added with an extension from pulmonary vein ostium at 1, 3 and 6 o'clock (from internal view) of left PV and 6, 9 and 11 o'clock of right PV

Study groups in NCT02637453
Study groupRoleWhat they receive
PVIActive comparatorPulmonary vein isolation (PVI)
Receives: Procedure: PVI
PVI+6LExperimentalPVI plus 6 additional lines at 1, 3 and 6 o'clock (from internal view) of left PV and 6, 9 and 11 o'clock of right PV
Receives: Procedure: CPVI+6L

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Freedom from AF recurrence between 91 and 365 days

    AF recurrence was defined by AF (including atrial flutter or atrial tachycardia) of 30 seconds or more captured by ECG monitoring or any clinical presentation with AF outside the 90-day blanking period (between 91 and 365 days). Cardioversion, or use of class I or III antiarrhythmic drugs outside blanking period was also considered as AF recurrence.

    Measured: 91 to 365 days

Secondary outcomes (6)
  1. AF burden

    Percentage of time in AF, atrial flutter or atrial tachycardia on 14-days continuous monitoring at 12 months.

    Measured: 12 months

  2. Procedural time

    Total procedural time from femoral vein puncture to decannulation (skin-to-skin time)

    Measured: Within procedure

  3. Fluoroscopy time

    Time of patients' exposure to the real-time X-ray imaging during the procedure.

    Measured: Within procedure

  4. Ablation time

    Radiofrequency delivery time during the procedure.

    Measured: Within procedure

  5. Early onset complications

    Complications within 30 days post-ablation, including death, myocardial infarction, diaphragmatic paralysis, stroke or transient ischemic attack, systemic embolism, pericardial effusion or tamponade requiring drainage, heart block, pericarditis, and vascular access complications requiring intervention.

    Measured: Within 30 days

  6. Late onset complications

    Complications detected any time during the follow-up, including severe pulmonary vein stenosis (>70%), and atrioesophageal fistula.

    Measured: within 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Dec 2015 (estimated)
  2. Study start4 Jan 2017
  3. Primary completion10 Jan 2021
  4. Study completion10 Jan 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
390 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02637453
Sponsor's protocol ID
ShanghaiXinhua-Af
Status last verified
Apr 2021
First submitted
16 Dec 2015
Last updated
15 Jun 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Steinberg BA, Beckley PD, Deering TF, Clark CL, Amin AN, Bauer KA, Cryer B, Mansour M, Scheiman JM, Zenati MA, Newby LK, Peacock WF, Bhatt DL; Society of Cardiovascular Patient Care. Evaluation and management of the atrial fibrillation patient: a report from the Society of Cardiovascular Patient Care. Crit Pathw Cardiol. 2013 Sep;12(3):107-15. doi: 10.1097/HPC.0b013e31829834ed.

    PubMed 23892939
  • Haissaguerre M, Jais P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Metayer P, Clementy J. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998 Sep 3;339(10):659-66. doi: 10.1056/NEJM199809033391003.

    PubMed 9725923
  • Zhang S. Atrial fibrillation in mainland China: epidemiology and current management. Heart. 2009 Jul;95(13):1052-5. doi: 10.1136/hrt.2008.146589. Epub 2009 Mar 23.

    PubMed 19318342
  • Weerasooriya R, Khairy P, Litalien J, Macle L, Hocini M, Sacher F, Lellouche N, Knecht S, Wright M, Nault I, Miyazaki S, Scavee C, Clementy J, Haissaguerre M, Jais P. Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? J Am Coll Cardiol. 2011 Jan 11;57(2):160-6. doi: 10.1016/j.jacc.2010.05.061.

    PubMed 21211687
  • Cheema A, Vasamreddy CR, Dalal D, Marine JE, Dong J, Henrikson CA, Spragg D, Cheng A, Nazarian S, Sinha S, Halperin H, Berger R, Calkins H. Long-term single procedure efficacy of catheter ablation of atrial fibrillation. J Interv Card Electrophysiol. 2006 Apr;15(3):145-55. doi: 10.1007/s10840-006-9005-9. Epub 2006 Aug 5.

    PubMed 17019636
  • Ouyang F, Tilz R, Chun J, Schmidt B, Wissner E, Zerm T, Neven K, Kokturk B, Konstantinidou M, Metzner A, Fuernkranz A, Kuck KH. Long-term results of catheter ablation in paroxysmal atrial fibrillation: lessons from a 5-year follow-up. Circulation. 2010 Dec 7;122(23):2368-77. doi: 10.1161/CIRCULATIONAHA.110.946806. Epub 2010 Nov 22.

    PubMed 21098450
  • Calo L, Rebecchi M, Sciarra L, De Luca L, Fagagnini A, Zuccaro LM, Pitrone P, Dottori S, Porfirio M, de Ruvo E, Lioy E. Catheter ablation of right atrial ganglionated plexi in patients with vagal paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol. 2012 Feb;5(1):22-31. doi: 10.1161/CIRCEP.111.964262. Epub 2011 Dec 6.

    PubMed 22147839
  • Katritsis DG, Pokushalov E, Romanov A, Giazitzoglou E, Siontis GC, Po SS, Camm AJ, Ioannidis JP. Autonomic denervation added to pulmonary vein isolation for paroxysmal atrial fibrillation: a randomized clinical trial. J Am Coll Cardiol. 2013 Dec 17;62(24):2318-25. doi: 10.1016/j.jacc.2013.06.053. Epub 2013 Aug 21.

    PubMed 23973694
  • Noheria A, Kumar A, Wylie JV Jr, Josephson ME. Catheter ablation vs antiarrhythmic drug therapy for atrial fibrillation: a systematic review. Arch Intern Med. 2008 Mar 24;168(6):581-6. doi: 10.1001/archinte.168.6.581.

    PubMed 18362249
  • Stabile G, Bertaglia E, Senatore G, De Simone A, Zoppo F, Donnici G, Turco P, Pascotto P, Fazzari M, Vitale DF. Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multi-centre, randomized, controlled study (Catheter Ablation For The Cure Of Atrial Fibrillation Study). Eur Heart J. 2006 Jan;27(2):216-21. doi: 10.1093/eurheartj/ehi583. Epub 2005 Oct 7.

    PubMed 16214831
  • Wilber DJ, Pappone C, Neuzil P, De Paola A, Marchlinski F, Natale A, Macle L, Daoud EG, Calkins H, Hall B, Reddy V, Augello G, Reynolds MR, Vinekar C, Liu CY, Berry SM, Berry DA; ThermoCool AF Trial Investigators. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010 Jan 27;303(4):333-40. doi: 10.1001/jama.2009.2029.

    PubMed 20103757
  • Reddy VY, Dukkipati SR, Neuzil P, Natale A, Albenque JP, Kautzner J, Shah D, Michaud G, Wharton M, Harari D, Mahapatra S, Lambert H, Mansour M. Randomized, Controlled Trial of the Safety and Effectiveness of a Contact Force-Sensing Irrigated Catheter for Ablation of Paroxysmal Atrial Fibrillation: Results of the TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) Study. Circulation. 2015 Sep 8;132(10):907-15. doi: 10.1161/CIRCULATIONAHA.114.014092. Epub 2015 Aug 10.

    PubMed 26260733

Questions about this trial

What is this clinical trial studying?

A study testing PVI and CPVI+6L in people with Paroxysmal Atrial Fibrillation, run by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Freedom from AF recurrence between 91 and 365 days (time frame: 91 to 365 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02637453, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2021.

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