Evaluation of Abbreviated Versus Conventional Course of Dabigatran Etexilate Before Electric Cardioversion in Patients With Atrial Fibrillation (RE-SOUND Study)

NCT ID: NCT03975062

Last Updated: 2019-06-05

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

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-28

Study Completion Date

2020-12-30

Brief Summary

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The purpose of the study is to evaluate the efficacy of abbreviated 3-day anticoagulation with dabigatran etexilate before cardioversion guided by trans-oesophageal echocardiography in comparison with conventional 3- week course of dabigatran etexilate before cardioversion

Detailed Description

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Current guidelines recommend for stroke prevention in patients with atrial fibrillation (AF) lasting more than 48 h designated for cardioversion standard approach with anticoagulation for a minimum 3 weeks before anticoagulation. The alternative is abbreviated anticoagulation in case of using trans-oesophageal echocardiography (TEE)-guided approach with quick cardioversion if no thrombus or high-grade spontaneous echo contrast is seen. There is currently no data on the direct comparison of efficacy and safety of conventional and abbreviated courses of non-vitamin K antagonist oral anticoagulants (NOAC) before cardioversion in AF.

The RE-SOUND study is prospective open label study with blinded outcome evaluation (PROBE design) multicenter active control trial comparing efficacy of 3-day abbreviated TEE-guided and conventional 3-week courses of NOAC dabigatran etexilate before cardioversion in adult patients with AF lasting more than 48 h

Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

PROBE design, multicenter, active control trial
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
Blinded evaluation of primary outcome by Imaging expert, who will made decision regarding achievement of primary outcome

Study Groups

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Abbreviated course group (ACG)

The patients receiving 3-days course of dabigatran etexilate during pre-cardioversion period. After cardioversion has been performed the patients continue with dabigatran etexilate until 30 days after cardioversion

Group Type EXPERIMENTAL

dabigatran etexilate

Intervention Type DRUG

150 mg twice daily (BID)

Conventional course group (CCG)

The patients receiving 3-weeks course of dabigatran etexilate before cardioversion of AF. After cardioversion has been performed the patients will continue with dabigatran etexilate until 30 days after cardioversion

Group Type ACTIVE_COMPARATOR

dabigatran etexilate

Intervention Type DRUG

150 mg twice daily (BID)

Interventions

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dabigatran etexilate

150 mg twice daily (BID)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* male and female subjects aged \>18 years old and \<75 years old
* the diagnosis of non-valvular atrial fibrillation/atrial flutter duration of 48 hours or more (or unknown) documented by ECG. Duration of AF will be defined on the base of patient source documents
* documented physician's decision to conduct electrical cardioversion
* written informed consent form (ICF) signed by patient

Exclusion Criteria

* effective treatment with oral anticoagulants within the last 30 days
* need in anticoagulant treatment for disorder other than AF
* rheumatic heart disease
* mitral stenosis of unknown origin
* mechanic heart valve
* acute coronary syndrome within 12 months
* percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery within the last 12 month or planned for the next 8 weeks
* known hypersensitivity for dabigatran, dabigatran etexilate or to any of capsul's components
* creatinine clearance \<30 ml/min
* active bleeding, haemorrhagic diathesis, coagulopathy
* major surgery within the previous month, surgery planned for the next 8 weeks,
* clinically relevant bleeding within the last 30 days
* symptomatic or endoscopically documented gastroduodenal ulcers within the last 30 days
* intracranial haemorrhages in medical history
* organ damages resulted from clinically relevant bleeding within 6 months before randomization.
* major trauma or any craniocerebral trauma within 30 days before randomization.
* any cancer within last 5 years
* uncontrolled hypertension (systolic blood pressure \>180mm Hg and/or diastolic blood pressure \>100 mmHg).
* chronic heart failure (CHF) III-IV functional classes (by NYHA)
* severe ischemic stroke within the last 12 month before randomization
* changes of liver functions with alanine aminotransferase (ALT)/aspartate aminotransferase (AST) \>3 upper limit of normal (ULN)
* liver disease having impact on survival
* pregnancy and breast feeding. Women of child bearing potential must agree to the requirements for pregnancy testing and contraceptive methods
* any contraindications for electric cardioversion (see attachment # 1 for details).
* any contraindications to cerebral MRI
* any contraindications to TEE ( perforated viscus; esophageal pathology (stricture, trauma, tumor, scleroderma, Mallory-Weiss tear, diverticulum); tracheoesophageal fistula; active upper GI bleeding; recent upper GI surgery; esophagectomy, esophagogastrectomy.)
* patients who on the discretion of physician will not benefit from 150 BID dose of dabigatran during study course
* active hepatitis
* anemia (hemoglobin level \<100g/L) or thrombocytopenia (platelet count \<100 × 109/L)
* alcohol abuse
* hyperthyroidism
Minimum Eligible Age

19 Years

Maximum Eligible Age

74 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boehringer Ingelheim

INDUSTRY

Sponsor Role collaborator

Ural State Medical University

OTHER

Sponsor Role lead

Responsible Party

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Vadim Grachev

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Olga G Smolenskaya, MD

Role: STUDY_CHAIR

Ural State Medical University

Vadim G Grachev, PhD

Role: PRINCIPAL_INVESTIGATOR

Ural State Medical University

Locations

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Limited Liability Company Medical Association "Novaya Bolnitsa"

Yekaterinburg, , Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Vadim G Grachev, PhD

Role: CONTACT

+79193920247 ext. +79193920247

Facility Contacts

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Elena G Fokina

Role: primary

+79122474898

Other Identifiers

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1160.242

Identifier Type: -

Identifier Source: org_study_id

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