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 volunteersQualifiers
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
Parallel
Treatments tested in this trial
Catheter ablation
DeviceCTI ablation; pulmonary vein isolation (PVI)
Treatment groups
Trial outcomes
Primary outcomes
Composite endpoint
Time to cardiovascular hospitalization/emergency room visits, stroke, or death, whichever comes first
Secondary outcomes
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.
Procedural complications
Adverse events
Number of subjects with Incident atrial fibrillation
Obtained by standard of care ECGs or ECG recordings
Locations
Sponsors and contacts
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This trial is not recruiting at the moment. You can still explore other options: