AV Node Ablation and Pacemaker Therapy Compared to Drug Therapy for Atrial Fibrillation - Pilot Study

Last updated: February 25, 2013
Sponsor: Mayo Clinic
Overall Status: Terminated

Phase

3

Condition

Atrial Fibrillation

Hyponatremia

Dysrhythmia

Treatment

N/A

Clinical Study ID

NCT00589303
06-004554
  • Ages > 65
  • All Genders

Study Summary

The purpose of this study is to determine whether early atrioventricular node (AVN) ablation with pacing device therapy will reduce death and hospitalization when compared to the conventional drug therapy in elderly patients with recurrent and symptomatic atrial fibrillation (AF).

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age greater than or equal to 65 years

  • Paroxysmal, persistent, or permanent atrial fibrillation

  • Index event of atrial fibrillation is documented on electrocardiogram or rhythm strip.Atrial fibrillation must be the qualifying event. Atrial flutter can have been presentin the past, but it must not be considered the index arrhythmia.

  • Paroxysmal atrial fibrillation episodes must be recurrent (two or more episodes in thepast 6 months). At least one of the paroxysmal episodes must be "sustained", definedas lasting greater than 1 hour documented by a Holter monitor or by history inconjunction with an ECG or a rhythm strip.

  • At least one attempt of unsuccessful drug therapy, either for rate, for rhythm, or forrate-and-rhythm control.

  • Symptoms related to atrial fibrillation within the last 6 months

  • Eligible for long-term treatment with both treatment strategies

  • Must provide informed consent, Health Insurance Portability and Accountability Act (HIPAA) authorization, and be willing to comply with follow-up requirements.

Exclusion

Exclusion Criteria:

  • Reversible causes of atrial fibrillation

  • On heart transplant list

  • Familial cardiac conditions with increased risk of sudden death

  • Asymptomatic

  • Medical condition limiting expected survival to be less than one year

  • Contraindications to anticoagulation

  • Pre-existing implanted pacemaker, implantable automatic cardioverter-defibrillator orcardiac resynchronization device.

  • Pre-existing indication for permanent pacemaker, implantable automaticcardioverter-defibrillator or cardiac resynchronization device

  • More than one attempt of drug therapy for rate, for rhythm, or for rate-and-rhythmcontrol

  • Planned major surgery within the next six months, including thoracic surgery

  • Disability that would preclude collection of study data or have co-morbidity thatwould contraindicate device implantation

  • Participated in another clinical trial within the previous 30 days using a therapeuticmodality which could have potential residual effects that might confound the resultsof this pilot study

  • Unable to provide informed consent

Study Design

Total Participants: 27
Study Start date:
December 01, 2007
Estimated Completion Date:
July 31, 2011

Study Description

Epidemiologic studies have shown that 70-80% of patients with atrial fibrillation are older than 65 years of age. Drug therapy for atrial fibrillation is not effective or not tolerated in many elderly patients, for both rate or rhythm strategies. Preliminary data from AVN ablation and pacemaker therapy demonstrated this strategy is highly effective in controlling symptoms among patients who have failed numerous drug therapy. Quality of life is improved while hospital admission and office visits are reduced.

Pilot Study Design

  • All patients will be 1:1 randomized to standard-care drug therapy (American College of Cardiology/American Heart Association Guideline, 2006) or AV node ablation and pacemaker therapy

  • For patients randomized to AVN ablation, there will be a 1:1 sub-randomization to conventional right ventricular apex pacing or cardiac resynchronization therapy (biventricular pacing)

  • All patients will be followed at 2 and 6 months from the time of randomization in the pilot study.

  • A total of 60 patients from 5-15 clinical sites will be enrolled during an active recruiting period of 12 months for the pilot study.

Connect with a study center

  • University of Calgary and Calgary Health Region

    Calgary, Alberta T2N-4N1
    Canada

    Site Not Available

  • Mayo Clinic Arizona

    Scottsdale, Arizona 85259
    United States

    Site Not Available

  • The Heart Group

    Evansville, Indiana 47710
    United States

    Site Not Available

  • Mayo Clinic

    Rochester, Minnesota 55905
    United States

    Site Not Available

  • Oregon Health and Science University

    Portland, Oregon 97239
    United States

    Site Not Available

  • Chattanooga Heart Institute

    Chattanooga, Tennessee 37404
    United States

    Site Not Available

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.