Atrial Fibrillation Ablation Clinical Trial
Official title:
Safety and Efficacy of Transvenous Pulmonary Isolation for the Treatment of Atrial Fibrillation: A Prospective Randomized Study Comparing Radiofrequency Energy With Cryoenergy
Transvenous pulmonary vein (PV) isolation using radiofrequency energy is an effective
treatment for atrial fibrillation (1-4). However, rare but potentially life threatening
complications such as thromboembolism (5), PV stenosis (5-10), left atrium-oesophageal
fistula (11) and inflammatory syndromes (12) have been described. In preliminary studies an
alternate approach using cryoenergy induces less endothelial disruption/ thrombus formation
(13), preserves the extra cellular matrix and creates lesions with well-delineated border
zones (14). Therefore, cryoenergy seems to be the ideal form of energy to safely perform PV
isolation.
We therefore hypothesise that in the setting of PV isolation for the treatment of atrial
fibrillation (AF) cryoenergy is less traumatic and therefore reduces systemic inflammatory
responses compared to radiofrequency energy.
78 patients presenting with symptomatic intermittent or persistent AF will be randomised to
PV isolation with either radiofrequency (26 patients open irrigated tip, 26 patients closed
irrigated tip) or cryoenergy (26 patients with cryoballoon). Systemic markers of cell damage
and inflammatory response (t-troponin, CK, CK-MB, vWF, PAI-1, micro particles, platelet
activation/overall function, CRP, IL-6, IL-8, IL-10, TNF alpha, procalcitonin) will be
monitored before, during and 48h after the procedure. Further endpoints include time to
PV-isolation and procedure related complications. Six month clinical follow-up will focus on
freedom from AF and cardiovascular events.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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