Using Cryoballoon Ablation as Initial Treatment for Persistent Atrial Fibrillation

Launched by RUIJIN HOSPITAL · Jun 20, 2021

Keywords

ClinConnect Summary

This clinical trial is studying a treatment approach for a condition called persistent atrial fibrillation (AF), which is an irregular heartbeat that can last for a long time. The researchers want to see if using a procedure called cryoballoon ablation, which freezes heart tissue to help restore a normal rhythm, is more effective and safer compared to taking anti-arrhythmic medications for patients who haven't received any treatment before.

To participate in the trial, you need to be between 18 and 75 years old and have been diagnosed with symptomatic persistent AF. This means you’ve had symptoms like palpitations or shortness of breath for more than a week but less than a year. Your heart also needs to be structurally normal, and certain heart health measurements must be within specific ranges. Participants can expect to receive either the cryoballoon ablation or drug therapy, and they'll be closely monitored throughout the study to assess how well the treatments work. It’s important to know that certain medical conditions and previous treatments may prevent someone from joining the study, so discussing your health history with the research team is essential.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Documentation of symptomatic persistent AF: Defined as having a continuous episode lasting longer than 7 days but less than 1 year documented by consecutive ECG recordings OR Defined as having a continuous episode lasting longer than 7 days but less than 1 year documented by an ECG recording and one doctor note indicating patient had symptoms consistent with AF
• • Age 18 -75 years old
• • Structurally normal heart with LVEF ≥50%, interventricular septum thickness ≤ 12 mm, and left atrial diameter \<46 mm (short axis) as obtained by transthoracic echocardiography. •
• • Normal ECG parameters when measured in sinus rhythm (QRS width ≤120 ms in a 12-channel surface ECG, QTc interval \<440 ms, and PQ interval ≤210 ms).
• Exclusion Criteria:
• • History of AF treatment with class I or III antiarrhythmic drug, including sotalol, with the intention to prevent an AF recurrence. However, patients pretreated with above AAD for less than 7 days with the intention to convert an AF episode are allowed.
• • left atrial ablation or surgical procedure (including left atrial appendage closures)
• • Presence or likely implant of a permanent pacemaker, biventricular pacemaker, loop recorder, or any type of implantable cardiac defibrillator (with or without biventricular pacing function) within 12 months
• • Presence of any pulmonary vein stents
• • Presence of any pre-existing pulmonary vein stenosis
• • Pre-existing hemidiaphragmatic paralysis
• • Presence of any cardiac valve prosthesis
• • +3 and +4 mitral valve regurgitation or stenosis
• • Any cardiac surgery, myocardial infarction, percutaneous coronary intervention (PCI) / percutaneous transluminal coronary angioplasty (PTCA) or coronary artery stenting which occurred during the 3 month interval preceding e consent date
• • Unstable angina
• • New York Heart Association (NYHA) Class II, III or IV congestive heart failure
• • Primary pulmonary hypertension
• • Rheumatic heart disease
• • Thrombocytosis, thrombocytopenia
• • Any condition contraindicating chronic anticoagulation
• • Active systemic infection
• • Hypertrophic cardiomyopathy
• • Cryoglobulinemia
• • Uncontrolled hyperthyroidism
• • Any cerebral ischemic event (strokes or transient ischemic attacks (TIAs)) which occurred during the 6 month interval preceding the consent date
• • Any woman known to be pregnant or breastfeeding.
• • Life expectancy less than one year
• • Current or anticipated participation in any other clinical trial of a drug, device or biologic during the duration of the study not pre-approved by Medtronic
• • Active intracardiac thrombus
• • Known drug or alcohol dependency
• • Unwilling or unable to comply fully with study procedures and follow-up
• • Significant Chronic Kidney Disease-estimated Glomerular Filtration Rate(CKD-eGFR) \<30umol/L