Effect of Left Atrial Appendage Excision on Procedure Outcome in Patients With Persistent and Long-standing Persistent Atrial Fibrillation Undergoing Surgical Ablation

NCT ID: NCT02562391

Last Updated: 2015-09-29

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

PHASE2

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2017-05-31

Brief Summary

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The aim of this study is to assess the effect of left atrial appendage excision on atrial fibrillation recurrence and incidence of stroke in patients with persistent and long-standing persistent atrial fibrillation undergoing surgical ablation.

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

DOUBLE

Participants Outcome Assessors

Study Groups

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PVI+Box lesions

Patients were treated with video-assisted thoracoscopy under general anesthesia, according to a previously described protocol. In brief, PVI was performed from the epicardial side with a bipolar radiofrequency ablation clamp. At least 2 overlapping applications around each of the ipsilateral veins were made, and isolation was confirmed by the absence of PV potentials and exit block during pacing. In addition to PVI, the bilateral epicardial ganglia were found by high-frequency stimulation and ablated, as confirmed by the absence of a vagal response after ablation. Finally additional lines were made to create a posterior box lesion. Sensing and pacing maneuvers verified isolation of the posterior box.

Group Type ACTIVE_COMPARATOR

Surgical ablation of the left atrium (PVI+Box lesions)

Intervention Type DEVICE

PVI+Box lesions+LAA cutting

Patients were treated with video-assisted thoracoscopy under general anesthesia, according to a previously described protocol. In brief, PVI was performed from the epicardial side with a bipolar radiofrequency ablation clamp. At least 2 overlapping applications around each of the ipsilateral veins were made, and isolation was confirmed by the absence of PV potentials and exit block during pacing. In addition to PVI, the bilateral epicardial ganglia were found by high-frequency stimulation and ablated, as confirmed by the absence of a vagal response after ablation. Finally additional lines were made to create a posterior box lesion. Sensing and pacing maneuvers verified isolation of the posterior box.The left atrial appendage was removed by stapling and then cutting.

Group Type EXPERIMENTAL

Surgical ablation of the left atrium (PVI+Box lesions) and left atrial appendage cutting

Intervention Type DEVICE

Interventions

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Surgical ablation of the left atrium (PVI+Box lesions)

Intervention Type DEVICE

Surgical ablation of the left atrium (PVI+Box lesions) and left atrial appendage cutting

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with persistent and long-standing persistent atrial fibrillation eligible for thoracoscopy surgical ablation
* Signed inform consent

Exclusion Criteria

* Paroxysmal atrial fibrillation
* Contraindications for surgical ablation
* Unwilling to participate
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Meshalkin Research Institute of Pathology of Circulation

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Federal Center of Cardiovascular surgery

Krasnoyarsk, , Russia

Site Status

Federal State Institution Clinical Hospital of the Presidental Administration of the RF

Moscow, , Russia

Site Status

Scientific center of the cardiovascular surgery named by A.N. Bakulev

Moscow, , Russia

Site Status

State Research Institute of CIrculation Pathology

Novosibirsk, , Russia

Site Status

Countries

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Russia

References

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Romanov A, Pokushalov E, Elesin D, Bogachev-Prokophiev A, Ponomarev D, Losik D, Bayramova S, Strelnikov A, Shabanov V, Pidanov O, Kropotkin E, Ivanickii E, Karaskov A, Steinberg JS. Effect of left atrial appendage excision on procedure outcome in patients with persistent atrial fibrillation undergoing surgical ablation. Heart Rhythm. 2016 Sep;13(9):1803-9. doi: 10.1016/j.hrthm.2016.05.012. Epub 2016 May 12.

Reference Type DERIVED
PMID: 27180620 (View on PubMed)

Other Identifiers

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9872TLAA

Identifier Type: -

Identifier Source: org_study_id

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