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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06324188
Registration number
NCT06324188
Ethics application status
Date submitted
4/03/2024
Date registered
21/03/2024
Date last updated
21/03/2024
Titles & IDs
Public title
Early Atrial Fibrillation Ablation for Stroke Prevention in Patients With High Comorbidity Burden (EASThigh-AFNET 11)
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Scientific title
Early Atrial Fibrillation Ablation for Stroke Prevention in Patients With High Comorbidity Burden (EASThigh-AFNET 11)
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Secondary ID [1]
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EASThigh-AFNET 11
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Atrial Fibrillation
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Condition category
Condition code
Cardiovascular
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Early atrial fibrillation ablation
Other interventions - Usual Care
Other: Early atrial fibrillation ablation -
Other: Usual Care -
Other interventions: Early atrial fibrillation ablation
Patients randomised to early atrial fibrillation ablation will undergo pulmonary vein isolation within 2 months after randomisation.
Other interventions: Usual Care
Usual care will consist of optimal AF therapy based on guideline recommendations and local protocols and usage.The choice of therapies and medications follows routine care in line with medical guidelines and local policies at the discretion of the treating physician and should be based on the individual medical status of each study patient.
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Composite of cardiovascular complications related to AF
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Assessment method [1]
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It is defined as time from randomisation to the first occurrence of a composite of cardiovascular death, stroke (either ischemic or hemorrhagic), or hospitalisation for worsening of heart failure.
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Timepoint [1]
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Throughout study completion, estimated at a mean of 4 years
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Primary outcome [2]
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The primary safety outcome is a composite of all-cause death and serious complications of AF therapy.
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Assessment method [2]
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Serious Adverse Events (SAEs), including primary and secondary outcome parameters if based on clinical events, will be adjudicated by the independent Clinical Event Committee (CEC) according to standardised definitions given in the CEC charter.
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Timepoint [2]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [1]
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Number of nights spent in hospital
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Assessment method [1]
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Timepoint [1]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [2]
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Time from randomisation to first occurrence of each of the individual components of the primary outcome
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Assessment method [2]
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Timepoint [2]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [3]
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All-cause death
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Assessment method [3]
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Timepoint [3]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [4]
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Serious adverse events related to AF therapy
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Assessment method [4]
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Timepoint [4]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [5]
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Time from randomisation to first cardiovascular hospitalisation
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Assessment method [5]
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Timepoint [5]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [6]
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Number of cardiovascular hospitalisations (over-night stay)
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Assessment method [6]
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Timepoint [6]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [7]
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Changes in left ventricular ejection fraction
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Assessment method [7]
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Timepoint [7]
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comparing baseline with 24 months follow up (FU)
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Secondary outcome [8]
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Changes in quality of life
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Assessment method [8]
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assessed by EQ-5D-5L
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Timepoint [8]
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comparing baseline with 12 and 24 months FU
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Secondary outcome [9]
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Changes in quality of life
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Assessment method [9]
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assessed by AFEQT
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Timepoint [9]
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comparing baseline with 12 and 24 months FU
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Secondary outcome [10]
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Changes in cognitive function
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Assessment method [10]
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assessed by Montreal-Cognitive-Assessment-Test
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Timepoint [10]
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comparing baseline with 24 months FU
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Secondary outcome [11]
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Cardiac rhythm status
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Assessment method [11]
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sinus rhythm compared to AF
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Timepoint [11]
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at 12 and 24 months FU
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Secondary outcome [12]
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AF pattern
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Assessment method [12]
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Timepoint [12]
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at 12 and 24 months FU
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Secondary outcome [13]
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Time from randomisation to first clinical recurrence of AF
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Assessment method [13]
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Timepoint [13]
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Throughout study completion, estimated at a mean of 4 years
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Secondary outcome [14]
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Time from randomisation to first progression of AF
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Assessment method [14]
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i. e. from paroxysmal to persistent or longstanding persistent or permanent and each of these components
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Timepoint [14]
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Throughout study completion, estimated at a mean of 4 years
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Eligibility
Key inclusion criteria
I1. AF first diagnosed within 2 years prior to enrolment and documented in body surface ECG
I2. High comorbidity estimated by CHA2DS2-VASc score of 4 or more
I3. Patient suitable for ablation using cryoballoon ablation systems from Medtronic
I4. Age = 18 years
I5. Provision of signed informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
General exclusion criteria
E1. Any disease that limits life expectancy to less than 1 year.
E2. Participation in another clinical trial, either within the 3 months prior to enrolment or still on-going (participation in potential sub-studies connected to this trial is permitted).
E3. Previous participation in EASThigh-AFNET 11.
E4. Pregnant women.
E5. Breastfeeding women.
E6. Drug abuse or clinically manifest alcohol abuse.
Exclusion criteria related to a cardiac condition
E7. Prior AF ablation or surgical therapy of AF.
E8. Patients not suitable for AF ablation.
E9. Patients with a history of stroke which occurred within 3 months prior to enrolment.
E10. Valve disease requiring specific therapy.
Exclusion criteria based on laboratory abnormalities
E11. Clinically manifested thyroid dysfunction requiring therapy.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
1/06/2024
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/05/2030
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Actual
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Sample size
Target
2312
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Several sites - Multiple Locations
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Recruitment postcode(s) [1]
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- Multiple Locations
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Recruitment outside Australia
Country [1]
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Canada
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State/province [1]
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Multiple Locations
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Country [2]
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Germany
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State/province [2]
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Multiple Locations
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Country [3]
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Netherlands
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State/province [3]
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Multiple Locations
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Country [4]
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United Kingdom
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State/province [4]
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Multiple Locations
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Funding & Sponsors
Primary sponsor type
Other
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Name
Atrial Fibrillation Network
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
EASThigh-AFNET 11 is an international, prospective, randomized, open, blinded endpoint assessment, multicenter trial (Treatment Strategy trial). The objective of EASThigh-AFNET 11 is to investigate whether early atrial fibrillation ablation in patients with atrial fibrillation (AF) and a high comorbidity burden (CHA2DS2-VASc =4) reduces cardiovascular events (stroke, cardiovascular death, or heart failure events) compared to usual care.
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Trial website
https://clinicaltrials.gov/study/NCT06324188
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Trial related presentations / publications
Kirchhof P, Camm AJ, Goette A, Brandes A, Eckardt L, Elvan A, Fetsch T, van Gelder IC, Haase D, Haegeli LM, Hamann F, Heidbuchel H, Hindricks G, Kautzner J, Kuck KH, Mont L, Ng GA, Rekosz J, Schoen N, Schotten U, Suling A, Taggeselle J, Themistoclakis S, Vettorazzi E, Vardas P, Wegscheider K, Willems S, Crijns HJGM, Breithardt G; EAST-AFNET 4 Trial Investigators. Early Rhythm-Control Therapy in Patients with Atrial Fibrillation. N Engl J Med. 2020 Oct 1;383(14):1305-1316. doi: 10.1056/NEJMoa2019422. Epub 2020 Aug 29. Rillig A, Borof K, Breithardt G, Camm AJ, Crijns HJGM, Goette A, Kuck KH, Metzner A, Vardas P, Vettorazzi E, Wegscheider K, Zapf A, Kirchhof P. Early Rhythm Control in Patients With Atrial Fibrillation and High Comorbidity Burden. Circulation. 2022 Sep 13;146(11):836-847. doi: 10.1161/CIRCULATIONAHA.122.060274. Epub 2022 Aug 15. Eckardt L, Sehner S, Suling A, Borof K, Breithardt G, Crijns H, Goette A, Wegscheider K, Zapf A, Camm J, Metzner A, Kirchhof P. Attaining sinus rhythm mediates improved outcome with early rhythm control therapy of atrial fibrillation: the EAST-AFNET 4 trial. Eur Heart J. 2022 Oct 21;43(40):4127-4144. doi: 10.1093/eurheartj/ehac471. Andrade JG, Wells GA, Deyell MW, Bennett M, Essebag V, Champagne J, Roux JF, Yung D, Skanes A, Khaykin Y, Morillo C, Jolly U, Novak P, Lockwood E, Amit G, Angaran P, Sapp J, Wardell S, Lauck S, Macle L, Verma A; EARLY-AF Investigators. Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation. N Engl J Med. 2021 Jan 28;384(4):305-315. doi: 10.1056/NEJMoa2029980. Epub 2020 Nov 16. Andrade JG, Deyell MW, Macle L, Wells GA, Bennett M, Essebag V, Champagne J, Roux JF, Yung D, Skanes A, Khaykin Y, Morillo C, Jolly U, Novak P, Lockwood E, Amit G, Angaran P, Sapp J, Wardell S, Lauck S, Cadrin-Tourigny J, Kochhauser S, Verma A; EARLY-AF Investigators. Progression of Atrial Fibrillation after Cryoablation or Drug Therapy. N Engl J Med. 2023 Jan 12;388(2):105-116. doi: 10.1056/NEJMoa2212540. Epub 2022 Nov 7. Dickow J, Kirchhof P, Van Houten HK, Sangaralingham LR, Dinshaw LHW, Friedman PA, Packer DL, Noseworthy PA, Yao X. Generalizability of the EAST-AFNET 4 Trial: Assessing Outcomes of Early Rhythm-Control Therapy in Patients With Atrial Fibrillation. J Am Heart Assoc. 2022 Jun 7;11(11):e024214. doi: 10.1161/JAHA.121.024214. Epub 2022 May 27. Dickow J, Kany S, Roth Cardoso V, Ellinor PT, Gkoutos GV, Van Houten HK, Kirchhof P, Metzner A, Noseworthy PA, Yao X, Rillig A. Outcomes of Early Rhythm Control Therapy in Patients With Atrial Fibrillation and a High Comorbidity Burden in Large Real-World Cohorts. Circ Arrhythm Electrophysiol. 2023 May;16(5):e011585. doi: 10.1161/CIRCEP.122.011585. Epub 2023 Mar 21.
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Public notes
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Contacts
Principal investigator
Name
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Paulus Kirchhof, Prof. Dr.
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Address
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University Heart and Vascular Center Hamburg, University Hospital Hamburg Eppendorf
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Antje Albring, Dr.
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Address
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Country
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Phone
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+49 251 980 1330
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT06324188
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