Prophylactic Pulmonary Vein Isolation During Atrial Flutter Ablation

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age55+
SponsorUniversity of Rochester

About this trial

Pulmonary vein isolation (PVI) via catheter ablation has been successfully employed for years to treat symptomatic atrial fibrillation (AF). Moreover, PVI has not been used as a prophylactic intervention even in groups known to be high-risk for the future development of AF. Preliminary studies, including our pilot PREVENT AF I randomized trial, suggested that prophylactic PVI may be effective at reducing new onset AF and overall AF burden in atrial flutter (AFL) patients.

This is a multicenter single-blind randomized controlled trial, "Prophylactic Pulmonary Vein Isolation During Atrial Flutter Ablation" (PREVENT AF II) to determine if PVI in conjunction with AFL ablation for patients with typical AFL results in a significant reduction in cardiac events and healthcare utilization.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age ≥ 55 years on date of consent

History of typical AFL and plans for a guideline-supported catheter ablation for AFL - including paroxysmal AFL defined as AFL with duration of up to 7 days and persistent AFL as longer than 7 days or if interrupted by cardioversion for clinical reasons and up to 1 year

No identifiable AF on any prior ECG within past 1 year

CHA2DS2 -VASc ≥ 2

Disqualifiers

Inability to undergo or AFL or AF catheter ablation (e.g., presence of a left atrial thrombus)

AFL or AF due to reversible cause e.g. hyperthyroid state

Contraindication to systemic anticoagulation

Prior surgical or percutaneous cardiac ablation procedure any time in the past

Trial design

Design model

Parallel

Treatments tested in this trial

  • Catheter ablation

    Device

    CTI ablation; pulmonary vein isolation (PVI)

Treatment groups

620 Participants
are divided into 2 treatment groups
Group A: Atrial flutter ablationActive comparator 1 intervention
Group B: Atrial flutter ablation + prophylactic pulmonary vein isolationExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Composite endpoint

Time to cardiovascular hospitalization/emergency room visits, stroke, or death, whichever comes first

Time frame
Up to 4 years

Secondary outcomes

1

Quality of life before and after ablation

Atrial Fibrillation Effect Severity Scale (AFSS) consisting of 19 items including a visual analogue scale related to global well-being; 4 items on AF frequency, duration and severity (AF Burden); 4 items on health care utilization; and most importantly, 7 items regarding the severity of specific symptoms (AF Symptom Score). Scores range between 0 to 35, and higher scores mean worse quality of life.

Time frame
12 months and baseline
2

Procedural complications

Adverse events

Time frame
1 month
3

Number of subjects with Incident atrial fibrillation

Obtained by standard of care ECGs or ECG recordings

Time frame
During follow-up of 24 months

Other outcomes

Locations

This trial has no locations.

Sponsors and contacts

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