Hybrid Ablation Plus Medical Therapy for Persistent Atrial Fibrillation

NCT ID: NCT04190186

Last Updated: 2025-07-29

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

55 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-25

Study Completion Date

2024-02-15

Brief Summary

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This clinical trial is designed to compare two management strategies for the treatment of asymptomatic/subclinical atrial fibrillation after ablation based on data from the Biotronik ICM (BioMonitor3® or future generation of Biotronik ICM).

Detailed Description

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In this study, subjects will be randomized (1:1) to conventional AF management vs. Biotronik ICM-guided AF management following ablation for persistent AF. Subjects will be followed for 15 months including a 3 month blanking period following AF ablation. The study subject population will include subjects with persistent atrial fibrillation (sustained AF episode lasting more than 7 days, but less than 1 year), according to current guideline indications for persistent AF ablation and ICM (Biotronik ICM) implantation.

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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Biotronik ICM-guided AF management

ICM obtained data will be actively used to guide and monitor treatment .

Group Type ACTIVE_COMPARATOR

Insertable Cardiac Monitor

Intervention Type DEVICE

Implantable device that provides accurate daily transmission of cardiac electrical data for arrhythmia detection.

Conventional AF Management

Treating physicians/nurses will be blinded to the AF episodes data from the monitor, but will be provided information on asystole, or ventricular arrhythmia events (for safety).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Insertable Cardiac Monitor

Implantable device that provides accurate daily transmission of cardiac electrical data for arrhythmia detection.

Intervention Type DEVICE

Other Intervention Names

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BioMonitor3® or future generation of Biotronik ICM

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older
* History of persistent atrial fibrillation (sustained AF episode lasting more than 7 days, but less than a year)
* Planned to undergo first AF ablation with successful Biotronik ICM implant before or at time of ablation

Exclusion Criteria

* Paroxysmal atrial fibrillation
* Long persistent atrial fibrillation (continuous atrial fibrillation that lasts more than 1 year)
* Permanent atrial fibrillation
* Left atrial diameter of 60 mm or greater
* Patients with CHF status prohibiting EP study and ablation, but may be re-considered for enrollment later after effective treatment
* Patients with metabolic derangements (e.g. renal/hepatic failure, electrolyte disturbance, etc.), prohibiting EP study and ablation or antiarrhythmic medical therapy (e.g. dofetilide, sotalol or amiodarone, etc.)
* Patients with an intra-cardiac thrombus, but may be re-considered for enrollment later after effective treatment
* Serious known concomitant disease with a life expectancy of \< 1 year
* Pregnancy or nursing
* Unwilling or unable to give informed consent
* Existing CIED such as pacemaker or ICD
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biotronik, Inc.

INDUSTRY

Sponsor Role collaborator

University of Rochester

OTHER

Sponsor Role lead

Responsible Party

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David Huang

Professor Medicine M&D-Cardiology Div

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David Huang, MD

Role: PRINCIPAL_INVESTIGATOR

University of Rochester

Locations

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Michigan Heart, PC

Ypsilanti, Michigan, United States

Site Status

Cardiology Associates Research, LLC

Tupelo, Mississippi, United States

Site Status

Rochester Regional Health

Rochester, New York, United States

Site Status

University of Rochester

Rochester, New York, United States

Site Status

Countries

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United States

References

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Verma A, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P; STAR AF II Investigators. Approaches to catheter ablation for persistent atrial fibrillation. N Engl J Med. 2015 May 7;372(19):1812-22. doi: 10.1056/NEJMoa1408288.

Reference Type BACKGROUND
PMID: 25946280 (View on PubMed)

Huang DT, Monahan KM, Zimetbaum P, Papageorgiou P, Epstein LM, Josephson ME. Hybrid pharmacologic and ablative therapy: a novel and effective approach for the management of atrial fibrillation. J Cardiovasc Electrophysiol. 1998 May;9(5):462-9. doi: 10.1111/j.1540-8167.1998.tb01837.x.

Reference Type BACKGROUND
PMID: 9607453 (View on PubMed)

Kirchhof P, Calkins H. Catheter ablation in patients with persistent atrial fibrillation. Eur Heart J. 2017 Jan 1;38(1):20-26. doi: 10.1093/eurheartj/ehw260. Epub 2016 Jul 7.

Reference Type BACKGROUND
PMID: 27389907 (View on PubMed)

Willems S, Khairy P, Andrade JG, Hoffmann BA, Levesque S, Verma A, Weerasooriya R, Novak P, Arentz T, Deisenhofer I, Rostock T, Steven D, Rivard L, Guerra PG, Dyrda K, Mondesert B, Dubuc M, Thibault B, Talajic M, Roy D, Nattel S, Macle L; ADVICE Trial Investigators*. Redefining the Blanking Period After Catheter Ablation for Paroxysmal Atrial Fibrillation: Insights From the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial. Circ Arrhythm Electrophysiol. 2016 Aug;9(8):e003909. doi: 10.1161/CIRCEP.115.003909.

Reference Type BACKGROUND
PMID: 27516462 (View on PubMed)

Schreiber D, Rostock T, Frohlich M, Sultan A, Servatius H, Hoffmann BA, Luker J, Berner I, Schaffer B, Wegscheider K, Lezius S, Willems S, Steven D. Five-year follow-up after catheter ablation of persistent atrial fibrillation using the stepwise approach and prognostic factors for success. Circ Arrhythm Electrophysiol. 2015 Apr;8(2):308-17. doi: 10.1161/CIRCEP.114.001672. Epub 2015 Mar 5.

Reference Type BACKGROUND
PMID: 25744570 (View on PubMed)

Reiffel JA, Camm AJ, Belardinelli L, Zeng D, Karwatowska-Prokopczuk E, Olmsted A, Zareba W, Rosero S, Kowey P; HARMONY Investigators. The HARMONY Trial: Combined Ranolazine and Dronedarone in the Management of Paroxysmal Atrial Fibrillation: Mechanistic and Therapeutic Synergism. Circ Arrhythm Electrophysiol. 2015 Oct;8(5):1048-56. doi: 10.1161/CIRCEP.115.002856. Epub 2015 Jul 30.

Reference Type BACKGROUND
PMID: 26226999 (View on PubMed)

Tondo C, Iacopino S, Pieragnoli P, Molon G, Verlato R, Curnis A, Landolina M, Allocca G, Arena G, Fassini G, Sciarra L, Luzi M, Manfrin M, Padeletti L; ClinicalService 1STOP Project Investigators. Pulmonary vein isolation cryoablation for patients with persistent and long-standing persistent atrial fibrillation: Clinical outcomes from the real-world multicenter observational project. Heart Rhythm. 2018 Mar;15(3):363-368. doi: 10.1016/j.hrthm.2017.10.038. Epub 2017 Oct 26.

Reference Type BACKGROUND
PMID: 29107190 (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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00004318

Identifier Type: -

Identifier Source: org_study_id

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