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Persistent Atrial FibrillationNO PERS-AFNCT03008811

Norwegian Study of Persistent Atrial Fibrillation Treatment: Cryoballoon Versus Radiofrequency Catheter Ablation

A study testing Pulmonary vein isolation with cryoballoon catheter. and Pulmonary vein isolation with radiofrequency ablation. in people with Persistent Atrial Fibrillation, run by Haukeland University Hospital at 3 sites in Norway.

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

This study will compare efficacy and safety of pulmonary vein isolation using a cryoballoon catheter versus a radiofrequency ablation with a contact force sensing catheter for treatment of patients with persistent or longstanding persistent atrial fibrillation. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Persistent Atrial Fibrillation
What is being tested?
Pulmonary vein isolation with cryoballoon catheter. and Pulmonary vein isolation with radiofrequency ablation.
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
101 participants
Where
3 sitesNorway
Study dates
Nov 2016to May 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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients plan to undergo pulmonary vein isolation as the first procedure for symptomatic persistent atrial fibrillation (>7 days) and longstanding persistent atrial fibrillation (> 12 months, but ≤ 3 years) who are refractory to at least one class I or class III antiarrhythmic drug and required at least one electrical or pharmacologic cardioversion.
  • Subject is at least 18 and ≤ 75 years old.
  • Subject is able and willing to give informed consent.

Who cannot join

  • Subject has paroxysmal atrial fibrillation (< 7days) or persistent atrial fibrillation with duration > 3 years.
  • Subject has any previous left atrial ablation procedure or surgery, including pulmonary vein isolation.
  • Subject has presence of an intracavitary thrombus.
  • Subject has uncontrolled heart failure.
  • Subject has severe valvular disease.
  • Subject has the left atrial diameter > 60 mm confirmed by echocardiography.
Show all 13Show fewer
  • Subject has contraindications to systemic anticoagulation with heparin or oral anticoagulants.
  • Subject has known cryoglobulinaemia.
  • Subject has severe renal dysfunction.
  • Subject who is or may potentially be pregnant.
  • Subject has unstable angina pectoris.
  • Subject has history of previous myocardial infarction or percutaneous intervention during the last three months.
  • Subject has chronic obstructive pulmonary disease with detected pulmonary hypertension.

Trial locations and contacts

3 sites in 1 country.

Norway3 sites
  • Haukeland University Hospital

    Bergen

  • University Hospital of North Norway

    Tromsø

  • St Olavs Hospital

    Trondheim

Other trials in Norway

About this study

Official title: Norwegian Randomized Study of Persistent Atrial Fibrillation Treatment: Cryoballoon Versus Radiofrequency Catheter Ablation (NO PERS-AF)

This study will compare efficacy and safety of pulmonary vein isolation using a cryoballoon catheter versus a radiofrequency ablation with a contact force sensing catheter for treatment of patients with persistent or longstanding persistent atrial fibrillation.

Read the detailed description

The purpose of this randomized clinical trial is to compare the efficacy and safety of pulmonary vein isolation with either the second generation cryoballoon (Arctic Front Advance™) or a radiofrequency ablation technique with an irrigated ablation catheter (TactiCath™ Quartz) . A total of 128 patients with persistent or longstanding persistent atrial fibrillation will be randomized for either radiofrequency or cryoballoon ablation treatment. With both techniques, pulmonary vein isolation will be performed and confirmed by a circular mapping catheter. The primary endpoint is freedom of any atrial arrhythmia recurrence at 12 months.Treatment success will be evaluated by using 12-lead electrocardiography and 7-day Holter recording.

Being tested
Pulmonary vein isolation with cryoballoon catheter., Pulmonary vein isolation with radiofrequency ablation.
Keywords
Atrial Fibrillation, Catheter 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.

  • Pulmonary vein isolation with cryoballoon catheter.Procedure or surgery

    Device: Arctic Front Advance™ cardiac cryoablation catheter system.

  • Pulmonary vein isolation with radiofrequency ablation.Procedure or surgery

    Device: TactiCath™ Quartz irrigated ablation catheter (St. Jude Medical) with aid of 3-D mapping system (EnSite Precision, St. Jude Medical).

Study groups in NCT03008811
Study groupRoleWhat they receive
CryoballoonActive comparatorPulmonary vein isolation with cryoballoon catheter.
Receives: Procedure: Pulmonary vein isolation with cryoballoon catheter.
RadiofrequencyActive comparatorPulmonary vein isolation with radiofrequency ablation catheter.
Receives: Procedure: Pulmonary vein isolation with radiofrequency ablation.

What is being measured

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

  1. The freedom of any atrial arrhythmias at 12 months.

    The primary endpoint is freedom of any atrial arrhythmias at 12 months (at least one episode of atrial fibrillation, or atrial flutter or atrial tachycardia with a duration > 30 seconds documented by 7-day Holter ECG, or any other printed ECG recording).

    Measured: 12 months

Secondary outcomes (10)
  1. Procedure duration

    Procedure duration documented

    Measured: 12 months

  2. Fluoroscopy time

    Fluoroscopy time documented

    Measured: 12 months

  3. Ablation time

    Ablation time documented

    Measured: 12 months

  4. Quality of life - Short Form (SF-36) Heath Survey

    Short Form (SF-36) Heath Survey filled in by patients.

    Measured: 12 months.

  5. Quality of life affected by atrial fibrillation.

    The Atrial Fibrillation Effect on Quality-of-life (AFEQT) questionnaire will be filled in by patients.

    Measured: 12 months.

  6. Admittance to hospital or emergency services due to symptoms caused by documented atrial arrhythmias.

    Hospitalization after the procedre

    Measured: 12 months.

  7. The burden of atrial fibrillation

    Total duration of atrial fibrillation recorded by 7-day Holter.

    Measured: 12 months.

  8. The occurrence of documented left atrial tachycardia and typical or atypical atrial flutter.

    Atrial tachycardia or atrial flutter recorded by all types of ECG

    Measured: 12 months.

  9. Symptoms related to atrial fibrillation.

    Symptoms related to atrial fibrillation documented

    Measured: 12 months.

  10. Serious adverse events.

    Serious adverse events documented

    Measured: 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 posted2 Jan 2017 (estimated)
  2. Study startNov 2016
  3. Primary completionApr 2021
  4. Study completionMay 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
None (open label)
Enrolment
101 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03008811
Sponsor's protocol ID
2016/27
Acronym
NO PERS-AF
Status last verified
Feb 2020
First submitted
23 Nov 2016
Last updated
12 Nov 2021
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Camm AJ, Obel OA. Epidemiology and mechanism of atrial fibrillation and atrial flutter. Am J Cardiol. 1996 Oct 17;78(8A):3-11. doi: 10.1016/s0002-9149(96)00559-0. No abstract available.

    PubMed 8903269
  • Biblo LA, Yuan Z, Quan KJ, Mackall JA, Rimm AA. Risk of stroke in patients with atrial flutter. Am J Cardiol. 2001 Feb 1;87(3):346-9, A9. doi: 10.1016/s0002-9149(00)01374-6.

    PubMed 11165976
  • Vidaillet H, Granada JF, Chyou Po, Maassen K, Ortiz M, Pulido JN, Sharma P, Smith PN, Hayes J. A population-based study of mortality among patients with atrial fibrillation or flutter. Am J Med. 2002 Oct 1;113(5):365-70. doi: 10.1016/s0002-9343(02)01253-6.

    PubMed 12401530
  • Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998 Sep 8;98(10):946-52. doi: 10.1161/01.cir.98.10.946.

    PubMed 9737513
  • Wolf PA, Mitchell JB, Baker CS, Kannel WB, D'Agostino RB. Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med. 1998 Feb 9;158(3):229-34. doi: 10.1001/archinte.158.3.229.

    PubMed 9472202
  • Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL, Josephson RA, Kellen JC, Klein RC, Krahn AD, Mickel M, Mitchell LB, Nelson JD, Rosenberg Y, Schron E, Shemanski L, Waldo AL, Wyse DG; AFFIRM Investigators. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation. 2004 Mar 30;109(12):1509-13. doi: 10.1161/01.CIR.0000121736.16643.11. Epub 2004 Mar 8.

    PubMed 15007003
  • 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
  • Verma A, Marrouche NF, Natale A. Pulmonary vein antrum isolation: intracardiac echocardiography-guided technique. J Cardiovasc Electrophysiol. 2004 Nov;15(11):1335-40. doi: 10.1046/j.1540-8167.2004.04428.x.

    PubMed 15574190
  • Oral H, Scharf C, Chugh A, Hall B, Cheung P, Good E, Veerareddy S, Pelosi F Jr, Morady F. Catheter ablation for paroxysmal atrial fibrillation: segmental pulmonary vein ostial ablation versus left atrial ablation. Circulation. 2003 Nov 11;108(19):2355-60. doi: 10.1161/01.CIR.0000095796.45180.88. Epub 2003 Oct 13.

    PubMed 14557355
  • Saad EB, Rossillo A, Saad CP, Martin DO, Bhargava M, Erciyes D, Bash D, Williams-Andrews M, Beheiry S, Marrouche NF, Adams J, Pisano E, Fanelli R, Potenza D, Raviele A, Bonso A, Themistoclakis S, Brachmann J, Saliba WI, Schweikert RA, Natale A. Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: functional characterization, evolution, and influence of the ablation strategy. Circulation. 2003 Dec 23;108(25):3102-7. doi: 10.1161/01.CIR.0000104569.96907.7F. Epub 2003 Nov 17.

    PubMed 14623799
  • Pappone C, Rosanio S, Augello G, Gallus G, Vicedomini G, Mazzone P, Gulletta S, Gugliotta F, Pappone A, Santinelli V, Tortoriello V, Sala S, Zangrillo A, Crescenzi G, Benussi S, Alfieri O. Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation: outcomes from a controlled nonrandomized long-term study. J Am Coll Cardiol. 2003 Jul 16;42(2):185-97. doi: 10.1016/s0735-1097(03)00577-1.

    PubMed 12875749
  • Marrouche NF, Martin DO, Wazni O, Gillinov AM, Klein A, Bhargava M, Saad E, Bash D, Yamada H, Jaber W, Schweikert R, Tchou P, Abdul-Karim A, Saliba W, Natale A. Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications. Circulation. 2003 Jun 3;107(21):2710-6. doi: 10.1161/01.CIR.0000070541.83326.15. Epub 2003 May 19.

    PubMed 12756153
  • Haissaguerre M, Jais P, Shah DC, Arentz T, Kalusche D, Takahashi A, Garrigue S, Hocini M, Peng JT, Clementy J. Catheter ablation of chronic atrial fibrillation targeting the reinitiating triggers. J Cardiovasc Electrophysiol. 2000 Jan;11(1):2-10. doi: 10.1111/j.1540-8167.2000.tb00727.x.

    PubMed 10695453
  • Ullah W, Hunter RJ, Haldar S, McLean A, Dhinoja M, Sporton S, Earley MJ, Lorgat F, Wong T, Schilling RJ. Comparison of robotic and manual persistent AF ablation using catheter contact force sensing: an international multicenter registry study. Pacing Clin Electrophysiol. 2014 Nov;37(11):1427-35. doi: 10.1111/pace.12501. Epub 2014 Sep 15.

    PubMed 25220575
  • Verma A, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P; STAR AF II Investigators. Approaches to catheter ablation for persistent atrial fibrillation. N Engl J Med. 2015 May 7;372(19):1812-22. doi: 10.1056/NEJMoa1408288.

    PubMed 25946280

Questions about this trial

What is this clinical trial studying?

A study testing Pulmonary vein isolation with cryoballoon catheter. and Pulmonary vein isolation with radiofrequency ablation. in people with Persistent Atrial Fibrillation, run by Haukeland University Hospital at 3 sites in Norway.

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 3 inclusion and 13 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 12 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Norway. 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?

The freedom of any atrial arrhythmias at 12 months. (time frame: 12 months). 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 NCT03008811, which also lists 18 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 12 Nov 2021.

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