Atrial Fibrillation Clinical Trial
Official title:
A Randomized, Open-label, Active-controlled Multi-center Study to Assess Safety of Uninterrupted Rivaroxaban vs. Usual Care in Subjects Undergoing Catheter Ablation Therapy for Atrial Fibrillation
The purpose of this exploratory study is to evaluate the safety of rivaroxaban and uninterrupted vitamin K antagonist (VKA) in adult participants with non-valvular atrial fibrillation (NVAF) who undergo catheter ablation as measured by post-procedure major bleeding events.
This is a randomized (participants are assigned to intervention groups by chance),
open-label (both physicians and participants know the identity of the assigned treatment),
active-controlled, multi-center safety study of rivaroxaban or VKA before and after a
catheter ablation procedure. This study requires collaboration with medical institutions
that provide access to electrophysiologists who normally perform the catheter ablation
procedure. In this study, NVAF is to be defined as the presence of AF in a person who does
not have a prosthetic heart valve (annuloplasty with or without prosthetic ring,
commissurotomy and/or valvuloplasty are permitted) and who does not have hemodynamically
significant mitral valve stenosis. Approximately 250 eligible participants, age 18 years or
older, with a history of paroxysmal, persistent, or long standing persistent NVAF who are
scheduled to undergo an elective catheter ablation procedure will be randomized in a 1:1
ratio to receive either rivaroxaban 20 mg orally, once-daily, administered preferably with
the evening meal or VKA (adjusted to achieve a recommended International Normalized Ratio of
2.0 to 3.0).
The study will consist of a screening period, a pre-procedure period, procedure period and
post-procedure period. The screening period will begin up to 2 weeks prior to randomization.
Participants will be randomized at the beginning of the pre-procedure period. During this
period, participants will be recommended to receive their assigned treatment for at least 4
weeks (maximum of 5 weeks) before the catheter ablation procedure. For participants with the
sufficient anticoagulation, documented for the 3 weeks prior to randomization, and for
participants with a transesophageal echocardiogram (TEE) or intracardiac echocardiography
(ICE), the length of the pre-procedure period may be reduced down to 1-7 days and must
include any transition from the previous anticoagulation therapy to randomized study drug.
After the catheter ablation procedure, participants will receive their post-procedure dose
of study drug through a minimum of 30 + - 5 days. In addition to scheduled visits and
telephone calls the study may also include additional phone calls and visits by the
participant to the site when dose adjustment is required for usual care.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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