Epicardial Mini-Maze Versus Catheter Ablation for the Management of Persistent Atrial Fibrillation

NCT ID: NCT03446222

Last Updated: 2018-02-26

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2018-12-18

Brief Summary

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This study will assess the efficacy of catheter ablation versus the Wolf Mini-Maze surgical ablation for rhythm control in patients with persistent afib.

Detailed Description

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Higher success rates have been achieved after a single surgical ablation when compared to catheter ablation, however contiguous and transmural lesions are not always guaranteed.

Even though, catheter ablation is now being offered for symptomatic persistent AF, recurrence after the index procedure in such a persistent AF substrate is not unusual. Redo-catheter ablation is routinely offered for such patients; however long term success still remains low. Non-pulmonary vein triggers are often targeted in such redo-catheter ablation procedures; though this approach remains controversial. More recently, the Wolf Mini-Maze procedure has been utilized with promising results.

This study proposes to randomize a group of persistent AF patients to undergo either catheter ablation or the surgical mini-maze procedure with left atrial appendage (LAA) ligation

Conditions

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Persistent 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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Catheter Ablation

Catheter based radiofrequency ablation with wide antral circumferential PVI and isolation of posterior wall will be performed. Mitral and cavo-tricuspid isthmus ablation will be done only if such isthumus dependent flutters are documented prior to / during the procedure.

Group Type ACTIVE_COMPARATOR

Catheter ablation

Intervention Type PROCEDURE

Catheter based radiofrequency ablation with wide antral circumferential PVI and isolation of posterior wall will be performed. Mitral and cavo-tricuspid isthmus ablation will be done only if such isthumus dependent flutters are documented prior to / during the procedure.

Mini-maze surgical procedure

Wolf Mini-maze surgical ablation along with left atrial appendage ligation will be performed.

Group Type ACTIVE_COMPARATOR

Mini-maze surgical procedure

Intervention Type PROCEDURE

Wolf Mini-maze surgical ablation along with left atrial appendage ligation will be performed.

Interventions

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Catheter ablation

Catheter based radiofrequency ablation with wide antral circumferential PVI and isolation of posterior wall will be performed. Mitral and cavo-tricuspid isthmus ablation will be done only if such isthumus dependent flutters are documented prior to / during the procedure.

Intervention Type PROCEDURE

Mini-maze surgical procedure

Wolf Mini-maze surgical ablation along with left atrial appendage ligation will be performed.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Persistent symptomatic AF with failure of at least 1 anti-arrhythmic drug
* Prior pulmonary vein isolation (PVI)
* CHA2DS2VASC \> 0
* Able to tolerate and compliant with oral anticoagulation with either Warfarin, dabigatran, rivoraxaban or apixiban

Exclusion Criteria

* Inability to follow-up as per protocol
* Prior valvular surgery or valve replacement
* Reversible cause for atrial fibrillation
* Currently on dialysis or renal replacement therapy
* Need for concomitant cardiac surgery
* History of MI or stroke ≤2 months prior to ablation
* Intolerance to oral anticoagulants
* Thrombus in the Left atrial appendage
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The University of Texas Health Science Center, Houston

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rajesh Venkataraman, MD

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Health Science Center, Houston

Locations

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The University of Texas Health Science Center at Houston

Houston, Texas, United States

Site Status

Countries

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United States

Other Identifiers

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HSC-MS-15-0880

Identifier Type: -

Identifier Source: org_study_id

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