A Prospective Randomized Study Comparing Radiofrequency Energy With Cryoenergy

NCT ID: NCT00773539

Last Updated: 2008-10-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-07-31

Study Completion Date

2009-08-31

Brief Summary

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Transvenous pulmonary vein (PV) isolation using radiofrequency energy is an effective treatment for atrial fibrillation (1-4). However, rare but potentially life threatening complications such as thromboembolism (5), PV stenosis (5-10), left atrium-oesophageal fistula (11) and inflammatory syndromes (12) have been described. In preliminary studies an alternate approach using cryoenergy induces less endothelial disruption/ thrombus formation (13), preserves the extra cellular matrix and creates lesions with well-delineated border zones (14). Therefore, cryoenergy seems to be the ideal form of energy to safely perform PV isolation.

We therefore hypothesise that in the setting of PV isolation for the treatment of atrial fibrillation (AF) cryoenergy is less traumatic and therefore reduces systemic inflammatory responses compared to radiofrequency energy.

78 patients presenting with symptomatic intermittent or persistent AF will be randomised to PV isolation with either radiofrequency (26 patients open irrigated tip, 26 patients closed irrigated tip) or cryoenergy (26 patients with cryoballoon). Systemic markers of cell damage and inflammatory response (t-troponin, CK, CK-MB, vWF, PAI-1, micro particles, platelet activation/overall function, CRP, IL-6, IL-8, IL-10, TNF alpha, procalcitonin) will be monitored before, during and 48h after the procedure. Further endpoints include time to PV-isolation and procedure related complications. Six month clinical follow-up will focus on freedom from AF and cardiovascular events.

Detailed Description

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Conditions

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Atrial Fibrillation Ablation

Keywords

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atrial fibrillation pulmonary veins ablation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Group Type ACTIVE_COMPARATOR

PVI using an open irrigated tip catheter

Intervention Type PROCEDURE

transseptal PVI using thermocooled ablation catheter (Biosense) with confirmation of conduction block

2

Group Type ACTIVE_COMPARATOR

PVI using a closed irrigated tip catheter

Intervention Type PROCEDURE

transseptal PVI using the CHILLI II catheter from BOSTON with confirmation of conduction block

3

Group Type ACTIVE_COMPARATOR

PVI using a cryoballoon

Intervention Type PROCEDURE

transseptal PVI using the cryoballoon from CRYOCATH

Interventions

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PVI using an open irrigated tip catheter

transseptal PVI using thermocooled ablation catheter (Biosense) with confirmation of conduction block

Intervention Type PROCEDURE

PVI using a closed irrigated tip catheter

transseptal PVI using the CHILLI II catheter from BOSTON with confirmation of conduction block

Intervention Type PROCEDURE

PVI using a cryoballoon

transseptal PVI using the cryoballoon from CRYOCATH

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 75 years
* Symptomatic drug refractory (more than 2 antiarrhythmic drugs) paroxysmal or persistent AF
* Documentation of AF on 12 lead ECG and/ or Holter
* Left atrium of less than 55 mm
* Informed consent signed by the patient

Exclusion Criteria

* Previous Ablation or operation for AF
* Contra-indication for heart catheterisation
* Cardioversion for AF during the 2 weeks before the procedure
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CryoCath Technologies Inc.

INDUSTRY

Sponsor Role collaborator

Boston Scientific Corporation

INDUSTRY

Sponsor Role collaborator

Herz-Zentrums Bad Krozingen

OTHER

Sponsor Role lead

Responsible Party

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Herz-Zentrum Bad Krozingen

Locations

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Herz-Zentrum

Bad Krozingen, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Thomas Arentz, MD

Role: CONTACT

Phone: 004976334020

Email: [email protected]

Dietmar Trenk

Role: CONTACT

Phone: 004976334020

Email: [email protected]

Facility Contacts

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Thomas Arentz, MD

Role: primary

Reinhold Weber, MD

Role: backup

References

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Jesel L, Arentz T, Herrera-Siklody C, Trenk D, Zobairi F, Abbas M, Weber R, Minners J, Toti F, Morel O. Do atrial differences in endothelial damage, leukocyte and platelet activation, or tissue factor activity contribute to chamber-specific thrombogenic status in patients with atrial fibrillation? J Cardiovasc Electrophysiol. 2014 Mar;25(3):266-70. doi: 10.1111/jce.12312. Epub 2013 Nov 22.

Reference Type DERIVED
PMID: 24172190 (View on PubMed)

Herrera Siklody C, Arentz T, Minners J, Jesel L, Stratz C, Valina CM, Weber R, Kalusche D, Toti F, Morel O, Trenk D. Cellular damage, platelet activation, and inflammatory response after pulmonary vein isolation: a randomized study comparing radiofrequency ablation with cryoablation. Heart Rhythm. 2012 Feb;9(2):189-96. doi: 10.1016/j.hrthm.2011.09.017. Epub 2011 Sep 13.

Reference Type DERIVED
PMID: 21920484 (View on PubMed)

Other Identifiers

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CRYO-BAD-KROZ

Identifier Type: -

Identifier Source: org_study_id