Exclusion of Intra-atrial Thrombus Before Catheter Ablation

NCT ID: NCT03455673

Last Updated: 2023-12-22

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

3160 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-09-18

Study Completion Date

2020-11-07

Brief Summary

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Atrial fibrillation is the most frequent heart rhythm disorder. Its symptomatic forms, resistant to drug therapy, require invasive management (catheter ablation), which exposes to potentially serious complications including thromboembolic complications. Despite anticoagulant treatment, intra-atrial thrombus, which is a contraindication to catheter ablation, is detected in nearly 2 % of cases. Its diagnosis requires prior transoesophageal echocardiography, an unpleasant examination.

A previous study (NCT02199080) showed that a zero ATE score, defined by no heart failure, no hypertension, no history of stroke, d-dimer \< 270 ng/mL, has a negative predictive value of 100 % for the exclusion of intra-atrial thrombus.

The objective of the study is to confirm the negative predictive value, sensitivity and specificity of the ATE score for the exclusion of intra-atrial thrombus.

Detailed Description

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Conditions

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Atrial Fibrillation Thrombi

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Atrial fibrillation

ATE score will be determined for patients hospitalized for ablation of atrial fibrillation or symptomatic left atrial tachycardia

ATE score

Intervention Type DIAGNOSTIC_TEST

The Atrial Thrombus Exclusion (ATE) combine thromboembolic risk factors (hypertension, cardiac insufficiency, history of stoke) and d-dimer level for the prediction of intra-atrial thrombus :

Hypertension = 1 Heart failure = 1 History of stroke = 1 High plasma d-dimer level (\> 270 ng/ml) = 1

Interventions

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ATE score

The Atrial Thrombus Exclusion (ATE) combine thromboembolic risk factors (hypertension, cardiac insufficiency, history of stoke) and d-dimer level for the prediction of intra-atrial thrombus :

Hypertension = 1 Heart failure = 1 History of stroke = 1 High plasma d-dimer level (\> 270 ng/ml) = 1

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Adult patients,
* Patients hospitalized for ablation of atrial fibrillation or symptomatic left atrial tachycardia,
* have signed or orally given an informed consent

Exclusion Criteria

* Contraindication to transoesophageal echocardiography,
* Transoesophageal echocardiography made in another centre than the centre of ablation,
* Pregnant women, parturient mothers and nursing mothers,
* Lives in an institution on court or authority order,
* Severely altered psychological health,
* Persons leaving in health or social establishment,
* Minors,
* Under guardianship,
* Persons unable to give their consent,
* Refusal to participate in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Diagnostica Stago

INDUSTRY

Sponsor Role collaborator

Groupe Hospitalier de la Rochelle Ré Aunis

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Antoine MILHEM, MD

Role: STUDY_DIRECTOR

Groupe Hospitalier de la Rochelle Ré Aunis

Locations

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Service de cardiologie, Centre Hospitalier du pays d'Aix

Aix-en-Provence, , France

Site Status

Service de cardiologie, CH Annecy Genevois

Annecy, , France

Site Status

Service de cardiologie, CHU Brest

Brest, , France

Site Status

Groupe Hospitalier de la Rochelle Ré Aunis

La Rochelle, , France

Site Status

Service de cardiologie, CH Le Mans

Le Mans, , France

Site Status

Service de cardiologie, CHR Metz Thionville

Metz, , France

Site Status

Service de cardiologie, Hôpital privé du Confluent

Nantes, , France

Site Status

Service de cardiologie, CHU Nîmes

Nîmes, , France

Site Status

Hôpital Pitié Salpêtrière

Paris, , France

Site Status

Centre Hospitalier de Pau

Pau, , France

Site Status

Service de cardiologie, CHU Rouen

Rouen, , France

Site Status

Service de cardiologie, CHU Saint Etienne

Saint-Etienne, , France

Site Status

Service de cardiologie, CHU Toulouse

Toulouse, , France

Site Status

Service de cardiologie, Clinique Saint Joseph

Trélaze, , France

Site Status

University Hospital Geneva

Geneva, , Switzerland

Site Status

Countries

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Italy France Switzerland

References

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Milhem A, Ingrand P, Treguer F, Cesari O, Da Costa A, Pavin D, Rivat P, Badenco N, Abbey S, Zannad N, Winum PF, Mansourati J, Maury P, Bader H, Savoure A, Sacher F, Andronache M, Allix-Beguec C, De Chillou C, Anselme F; ATE Study Group. Exclusion of Intra-Atrial Thrombus Diagnosis Using D-Dimer Assay Before Catheter Ablation of Atrial Fibrillation. JACC Clin Electrophysiol. 2019 Feb;5(2):223-230. doi: 10.1016/j.jacep.2018.09.009. Epub 2018 Nov 1.

Reference Type BACKGROUND
PMID: 30784695 (View on PubMed)

Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001 Jun 13;285(22):2864-70. doi: 10.1001/jama.285.22.2864.

Reference Type BACKGROUND
PMID: 11401607 (View on PubMed)

Natale A, Mohanty S, Goldstein L, Gomez T, Hunter TD. Real-world safety of catheter ablation for atrial fibrillation with contact force or cryoballoon ablation. J Interv Card Electrophysiol. 2021 Apr;60(3):445-452. doi: 10.1007/s10840-020-00734-w. Epub 2020 May 11.

Reference Type BACKGROUND
PMID: 32390061 (View on PubMed)

Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Davies DW, Day JD, d'Avila A, de Groot NMSN, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017 Oct;14(10):e275-e444. doi: 10.1016/j.hrthm.2017.05.012. Epub 2017 May 12. No abstract available.

Reference Type BACKGROUND
PMID: 28506916 (View on PubMed)

Scherr D, Dalal D, Chilukuri K, Dong J, Spragg D, Henrikson CA, Nazarian S, Cheng A, Berger RD, Abraham TP, Calkins H, Marine JE. Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2009 Apr;20(4):379-84. doi: 10.1111/j.1540-8167.2008.01336.x. Epub 2008 Oct 27.

Reference Type BACKGROUND
PMID: 19017348 (View on PubMed)

Puwanant S, Varr BC, Shrestha K, Hussain SK, Tang WH, Gabriel RS, Wazni OM, Bhargava M, Saliba WI, Thomas JD, Lindsay BD, Klein AL. Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation. J Am Coll Cardiol. 2009 Nov 24;54(22):2032-9. doi: 10.1016/j.jacc.2009.07.037.

Reference Type BACKGROUND
PMID: 19926009 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2017/P02/211

Identifier Type: -

Identifier Source: org_study_id