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Trial registered on ANZCTR
Registration number
ACTRN12618000166279
Ethics application status
Approved
Date submitted
22/01/2018
Date registered
2/02/2018
Date last updated
2/02/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Electroanatomical Remodeling of the Atria in Obesity:
Impact of the Adjacent Epicardial Fat
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Scientific title
Electroanatomical Remodeling of the Atria in Obesity patients undergoing AF ablation:
Impact of the Adjacent Epicardial Fat
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Secondary ID [1]
293839
0
N/A
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Universal Trial Number (UTN)
N/A
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Trial acronym
N/A
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Linked study record
N/A
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Health condition
Health condition(s) or problem(s) studied:
Obesity
306285
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Atrial fibrillation
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Epicardial fat
306287
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Condition category
Condition code
Cardiovascular
305372
305372
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0
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Other cardiovascular diseases
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Diet and Nutrition
305374
305374
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0
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Obesity
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is an observational study where data is collected from investigations and electrophysiology study prior to ablation for atrial fibrillation. There is no follow up for the patients. The data collected will with 1) electrical atrial remodelling: a) voltage, b) fractionation, c) conduction velocity. The cardiac MRI will be analysed for 1) cardiac structure and function and 2) epicardial fat.
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Intervention code [1]
300099
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Not applicable
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Comparator / control treatment
The patients were allocated into the following two groups on the basis on body mass index (BMI): (1) Obese group with a BMI greater than and equal to 27 kg/m2; and (2) Reference group with a BMI<27 kg/m2
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Control group
Active
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Outcomes
Primary outcome [1]
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Characterise electrophysiological and electroanatomical remodeling of the atria due to obesity in humans assessed by bipolar voltage, fractionation and conduction velocity.
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Assessment method [1]
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Timepoint [1]
304519
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single assessment prior to ablation
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Primary outcome [2]
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Epicardial fat assessment- total, total atrial, left atrial as assessed by cardiac MRI
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Assessment method [2]
304568
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Timepoint [2]
304568
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single assessment prior to electrophysiology study and ablation
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Primary outcome [3]
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Correlation between epicardial fat (MRI) and electrical properties (voltage, fractionation, conduction velocity assessed on electrophysiology study)
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Assessment method [3]
304569
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Timepoint [3]
304569
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based on measure obtained in single timepoint
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Secondary outcome [1]
342220
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N/A
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Assessment method [1]
342220
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Timepoint [1]
342220
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N/A
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Eligibility
Key inclusion criteria
The inclusion criterion was (1) Symptomatic AF refractory to at least one anti-arrhythmic medication.
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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
The exclusion criteria were (1) long standing persistent AF; (2) previous left atrial ablation; (3) contraindication for cardiac magnetic resonance imaging (CMR); (4) restrictive or hypertrophic cardiomyopathy; (5) valvular heart disease; (6) left ventricular dysfunction with LVEF<45%; (7) uncontrolled hypertension with left ventricular hypertrophy (LV wall thickness 12mm or more); (8) uncontrolled diabetes mellitus with HBA1C >7%; (9) amiodarone use in previous 6 months; (10) left atrial thrombus; (11) atrial arrhythmia > 30 seconds in the 7 days prior to the procedure by continuous ambulatory monitoring; (11) pregnancy and (12) inability to provide informed consent.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Case control
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Timing
Retrospective
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Statistical methods / analysis
Normally distributed data will be expressed as mean ± standard deviation. A mixed effects model will be used for all analyses that contained multiple regional measures within each patient (e.g. CV, Voltage). Generalized estimating equations will be utilised for nested categorical variables (e.g. % fractionation, % low voltage). To investigate left atrial regional patterns in both approaches, region (posterior LA, anterior LA, septal LA, inferior LA, lateral LA, and LA roof) and group (obese and control) will be modeled as fixed effects with an interaction term (region*group). If a significant interaction is seen present, mixed effects post-hoc test p-values will be reported.
For data without multiple measures or levels of data within an individual (e.g. fat mass, LA size, LVEF) a conventional unpaired t test will be used. Linear regressions between predictor variables of 1) total pericardial fat, 2) atrial epicardial fat 3) left atrial epicardial fat and 4) BMI will be correlated with mean posterior LA conduction velocity, mean posterior LA voltage and percent fractionation of posterior LA. Statistical significance will be set as p<0.05 and a trend at p<0.10.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/12/2011
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Date of last participant enrolment
Anticipated
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Actual
1/12/2012
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Date of last data collection
Anticipated
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Actual
1/06/2013
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Sample size
Target
33
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Accrual to date
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Final
33
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
18618
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Adelaide
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Address [1]
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Centre of Heart Rhythm Disorders,
Cardiology - 4G751
Royal Adelaide Hospital
Port Road,
Adelaide, SA 5000,
Australia
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Country [1]
298458
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Australia
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Primary sponsor type
University
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Name
The University of Adelaide
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Address
Cardiology - 4G751
Royal Adelaide Hospital
Port Road,
Adelaide, SA 5000,
Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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N/A
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Address [1]
297599
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N/A
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Country [1]
297599
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299449
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Royal Adelaide Hospital Ethic Committee
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Ethics committee address [1]
299449
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Royal Adelaide Hospital, Port Road, Adelaide, SA 5000
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Ethics committee country [1]
299449
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Australia
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Date submitted for ethics approval [1]
299449
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11/11/2011
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Approval date [1]
299449
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22/11/2011
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Ethics approval number [1]
299449
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111116
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Summary
Brief summary
The study aims to delineate the electroanatomical remodelling in obese patients with atrial fibrillation. Importantly, it will analyse the impact of contiguous epicardial fat deposits on the electrophysiological properties of adjacent atrial tissue. It is a retrospective study based on the analysis of prospectively collected database. The patients underwent cardiac MRI prior to the ablation. Electrical remodelling and fat deposits and their association will be analysed
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Trial website
N/A
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Trial related presentations / publications
Mahajan R, Lau DH, Brooks AG et al. Electrophysiological, Electroanatomical, and Structural Remodeling of the Atria as Consequences of Sustained Obesity. J Am Coll Cardiol 2015;66:1-11. Mahajan R, Lau DH, Sanders P. Impact of obesity on cardiac metabolism, fibrosis, and function. Trends in cardiovascular medicine 2015;25:119-26.
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Public notes
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Contacts
Principal investigator
Name
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Dr Rajiv Mahajan
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Address
80438
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Centre of Heart Rhythm Disorders,
Cardiology - 4G751
Royal Adelaide Hospital
Port Road,
Adelaide, SA 5000
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Country
80438
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Australia
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Phone
80438
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+61870741785
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Fax
80438
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+61870746182
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Email
80438
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[email protected]
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Contact person for public queries
Name
80439
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Rajiv Mahajan
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Address
80439
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Centre of Heart Rhythm Disorders,
Cardiology - 4G751
Royal Adelaide Hospital
Port Road,
Adelaide SA 5000
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Country
80439
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Australia
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Phone
80439
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+61870741785
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Fax
80439
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+61870746182
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Email
80439
0
[email protected]
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Contact person for scientific queries
Name
80440
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Rajiv Mahajan
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Address
80440
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Centre of Heart Rhythm Disorders,
Cardiology - 4G751
Royal Adelaide Hospital
Port Road,
Adelaide SA 5000
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Country
80440
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Australia
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Phone
80440
0
+61870741785
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Fax
80440
0
+61870746182
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Email
80440
0
[email protected]
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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
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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