Routine Versus Aggressive Upstream Rhythm Control for Prevention of Early Atrial Fibrillation in Heart Failure

NCT ID: NCT00877643

Last Updated: 2021-08-19

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

COMPLETED

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-05-04

Study Completion Date

2021-01-31

Brief Summary

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The purpose of this study is to investigate whether in patients with early persistent atrial fibrillation and mild to moderate early heart failure an aggressive upstream rhythm control approach, including aldosterone receptor antagonists and statins, dietary restrictions, counseling and cardiac rehabilitation programs, increases persistence of sinus rhythm compared with conventional rhythm control after one year of follow-up.

A randomized long term extension of the RACE 3 will be performed with a total follow-up of 5 years to investigate the long term effects on persistence of sinus rhythm and cardiovascular morbidity and mortality of the two treatment strategies.

Detailed Description

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Conditions

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Atrial Fibrillation

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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Upstream rhythm control

Group Type EXPERIMENTAL

Upstream therapy

Intervention Type OTHER

Aldosterone receptor antagonists and statins, dietary restrictions, counseling, and cardiac rehabilitation.

Conventional rhythm control

Group Type ACTIVE_COMPARATOR

Conventional rhythm control

Intervention Type OTHER

Usual care for atrial fibrillation and heart failure according to the present guidelines

Interventions

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Upstream therapy

Aldosterone receptor antagonists and statins, dietary restrictions, counseling, and cardiac rehabilitation.

Intervention Type OTHER

Conventional rhythm control

Usual care for atrial fibrillation and heart failure according to the present guidelines

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Early symptomatic persistent atrial fibrillation
* Mild to moderate early heart failure
* Optimal documentation and treatment of underlying heart disease
* No contra-indication for oral anticoagulation
* Eligible for cardiovascular rehabilitation
* Age \>= 40 years

Exclusion Criteria

* On waiting list for pulmonary vein isolation or expected to be placed on waiting list within one year
* Heart failure NYHA class IV
* LVEF \< 25%
* Left atrial size \> 50 mm (parasternal axis)
* Present aldosterone receptor antagonist use
* Previous use of class I or III antiarrhythmic drugs (except for sotalol, which should be discontinued at inclusion and replaced with betablocker)
* Cardiac resynchronization therapy
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Interuniversity Cardiology Institute of the Netherlands

OTHER_GOV

Sponsor Role collaborator

Netherlands Heart Foundation

OTHER

Sponsor Role collaborator

Dutch Network for Cardiovascular Research

UNKNOWN

Sponsor Role collaborator

Trial Coordination Center UMC Groningen

UNKNOWN

Sponsor Role collaborator

Bayer

INDUSTRY

Sponsor Role collaborator

Boehringer Ingelheim

INDUSTRY

Sponsor Role collaborator

Medtronic

INDUSTRY

Sponsor Role collaborator

Biotronik SE & Co. KG

INDUSTRY

Sponsor Role collaborator

Abbott Medical Devices

INDUSTRY

Sponsor Role collaborator

Boston Scientific Corporation

INDUSTRY

Sponsor Role collaborator

AstraZeneca

INDUSTRY

Sponsor Role collaborator

I.C. Van Gelder

OTHER

Sponsor Role lead

Responsible Party

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I.C. Van Gelder

Prof.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Marco Alings, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Amphia Hospital Breda

Isabelle C Van Gelder, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Medical Center Groningen

Harry J Crijns, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Maastricht University Medical Center

Locations

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Ziekenhuisgroep Twente

Almelo, , Netherlands

Site Status

Onze Lieve Vrouwe Gasthuis

Amsterdam, , Netherlands

Site Status

Hospital Rijnstate

Arnhem, , Netherlands

Site Status

Ter Gooi Hospital

Blaricum, , Netherlands

Site Status

Amhia Hospital

Breda, , Netherlands

Site Status

Ommelander Hospital Group

Delfzijl, , Netherlands

Site Status

Deventer Hospital

Deventer, , Netherlands

Site Status

Oosterscheldeziekenhuis

Goes, , Netherlands

Site Status

Martini Hospital

Groningen, , Netherlands

Site Status

University Medical Center Groningen

Groningen, , Netherlands

Site Status

Kennemer Gasthuis

Haarlem, , Netherlands

Site Status

Medical University Center Maastricht

Maastricht, , Netherlands

Site Status

University Medical Center Nijmegen

Nijmegen, , Netherlands

Site Status

Viecuri Hospital

Venlo, , Netherlands

Site Status

Ommelander Hospital Group

Winschoten, , Netherlands

Site Status

City Hospital (Sandwell and West Birmingham Hospitals NHS Trust)

Birmingham, , United Kingdom

Site Status

University Hospitals Birmingham NHS Foundation Trust

Birmingham, , United Kingdom

Site Status

Leeds Teaching Hospitals NHS Trust

Leeds, , United Kingdom

Site Status

Poole Hospital NHS Foundation Trust

Poole, , United Kingdom

Site Status

Good Hope Hospital (Heart of England NHS Foundation Trust)

Sutton Coldfield, , United Kingdom

Site Status

Countries

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Netherlands United Kingdom

References

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Nguyen BO, Crijns HJGM, Tijssen JGP, Geelhoed B, Hobbelt AH, Hemels MEW, Mol WJM, Weijs B, Alings M, Smit MD, Tieleman RG, Tukkie R, Van Veldhuisen DJ, Van Gelder IC, Rienstra M; RACE 3 Investigators. Long-term outcome of targeted therapy of underlying conditions in patients with early persistent atrial fibrillation and heart failure: data of the RACE 3 trial. Europace. 2022 Jul 15;24(6):910-920. doi: 10.1093/europace/euab270.

Reference Type DERIVED
PMID: 34791160 (View on PubMed)

Nguyen BO, Rienstra M, Hobbelt AH, Tijssen JGP, Smit MD, Tieleman RG, Geelhoed B, Van Veldhuisen DJ, Crijns HJGM, Van Gelder IC; RACE 3 Investigators. Optimal treatment of underlying conditions improves rhythm control outcome in atrial fibrillation - Data from RACE 3. Am Heart J. 2020 Aug;226:235-239. doi: 10.1016/j.ahj.2019.12.005. Epub 2020 Feb 14. No abstract available.

Reference Type DERIVED
PMID: 32067695 (View on PubMed)

De With RR, Rienstra M, Smit MD, Weijs B, Zwartkruis VW, Hobbelt AH, Alings M, Tijssen JGP, Brugemann J, Geelhoed B, Hillege HL, Tukkie R, Hemels ME, Tieleman RG, Ranchor AV, Van Veldhuisen DJ, Crijns HJGM, Van Gelder IC. Targeted therapy of underlying conditions improves quality of life in patients with persistent atrial fibrillation: results of the RACE 3 study. Europace. 2019 Apr 1;21(4):563-571. doi: 10.1093/europace/euy311.

Reference Type DERIVED
PMID: 30629160 (View on PubMed)

Rienstra M, Hobbelt AH, Alings M, Tijssen JGP, Smit MD, Brugemann J, Geelhoed B, Tieleman RG, Hillege HL, Tukkie R, Van Veldhuisen DJ, Crijns HJGM, Van Gelder IC; RACE 3 Investigators. Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. Eur Heart J. 2018 Aug 21;39(32):2987-2996. doi: 10.1093/eurheartj/ehx739.

Reference Type DERIVED
PMID: 29401239 (View on PubMed)

Other Identifiers

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NHS B 2008 035

Identifier Type: -

Identifier Source: secondary_id

NHS B 2008 035

Identifier Type: -

Identifier Source: org_study_id

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