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WithdrawnNCT03446222EMMCAFUpdated Feb 26, 2018

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

An interventional study of Catheter ablation and Mini-maze surgical procedure in Persistent Atrial Fibrillation, sponsored by The University of Texas Health Science Center, Houston. Withdrawn at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-02-26.

Sponsored by The University of Texas Health Science Center, Houston · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

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

Read the detailed description

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

02

Conditions studied

  • Persistent Atrial Fibrillation

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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

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
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    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.

    Procedure: Catheter ablation

  • Active comparator
    Mini-maze surgical procedure

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

    Procedure: Mini-maze surgical procedure

Interventions

  • ProcedureCatheter 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.

  • ProcedureMini-maze surgical procedure

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

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What researchers measure

Primary outcomes

  1. Number of participants who are free from atrial fibrillation (AF)

    Time frame: 12 months after the procedure

Secondary outcomes

  1. Number of participants who experienced a procedural complication

    Time frame: 2 weeks after the procedure

  2. Number of participants who are at risk of stroke

    Time frame: 12 months after the procedure

  3. Number of participants who were hospitalized for cardiovascular events

    Time frame: 12 months after the procedure

  4. AF burden as assessed by the CCA-SAF

    AF burden will be assessed using the Canadian Cardiovascular Society - Severity of Atrial Fibrillation Score (CCA-SAF), which provides objective symptoms severity scoring.

    Time frame: 12 months after the procedure

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Study locations

1 site
  • The University of Texas Health Science Center at Houston
    Houston, Texas 77030, United States
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03446222
Lead sponsor
The University of Texas Health Science Center, Houston
Responsible party
Sponsor
First posted
Feb 26, 2018
Start date
Jun 2016
Primary completion
Dec 2017 (estimated)
Completion
Dec 18, 2018 (estimated)
Last update
Feb 26, 2018

Study contacts

Rajesh Venkataraman, MD
principal investigator · The University of Texas Health Science Center, Houston

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Feb 2018. You cannot join it, but the record below documents what was studied.

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