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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01570361
Registration number
NCT01570361
Ethics application status
Date submitted
28/03/2012
Date registered
4/04/2012
Date last updated
14/05/2020
Titles & IDs
Public title
Atrial Fibrillation Progression Trial
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Scientific title
Atrial Fibrillation Progression Trial
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Secondary ID [1]
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ATTEST
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Universal Trial Number (UTN)
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Trial acronym
ATTEST
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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
Treatment: Devices - Catheter Ablation
Treatment: Drugs - Drug Treatment
Experimental: Catheter Ablation - Radiofrequency catheter ablation treatment in subjects with Paroxysmal Atrial Fibrillation (PAF)
Active comparator: Drug Treatment - Drug therapy (either rate or rhythm control) using current AF management guidelines
Treatment: Devices: Catheter Ablation
Treat subjects with Paroxysmal Atrial Fibrillation (PAF)
Treatment: Drugs: Drug Treatment
Drug therapy (either rate or rhythm control): Class I or class III, or AV nodal blocking agents such as beta blockers and calcium channel blockers in accordance with current atrial fibrillation management guidelines.
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Intervention code [1]
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Treatment: Devices
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Intervention code [2]
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Treatment: Drugs
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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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Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Years
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Assessment method [1]
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Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [1]
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3 years
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Secondary outcome [1]
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Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 1 Year
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Assessment method [1]
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Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [1]
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1 year
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Secondary outcome [2]
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Time to Persistent Atrial Fibrillation/Atrial Tachycardia at 2 Years
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Assessment method [2]
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Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [2]
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2 years
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Secondary outcome [3]
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Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 1 Year
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Assessment method [3]
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Percentage of Participants with Persistent Atrial Fibrillation/Atrial Tachycardia at 1 year were reported. The percentage of participants was calculated using Kaplan Meier (KM) rate estimate. Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [3]
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1 year
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Secondary outcome [4]
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Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 2 Years
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Assessment method [4]
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Percentage of Participants with Persistent Atrial Fibrillation/Atrial Tachycardia at 2 year were reported. The percentage of participants was calculated using Kaplan Meier (KM) rate estimate. Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [4]
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2 Years
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Secondary outcome [5]
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Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Year
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Assessment method [5]
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Percentage of Participants with Persistent Atrial Fibrillation/Atrial Tachycardia at 3 year were reported. The percentage of participants was calculated using Kaplan Meier (KM) rate estimate. Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [5]
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3 year
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Secondary outcome [6]
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Percentage of Participants With Persistent Atrial Fibrillation/Atrial Tachycardia at 3 Years by Number of Repeat Ablations
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Assessment method [6]
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Percentage of Participants with Persistent Atrial Fibrillation/Atrial Tachycardia at 3 year by number of repeat ablations were reported. The percentage of participants was calculated using Kaplan Meier (KM) rate estimate. Persistent atrial fibrillation/atrial tachycardia (AF/AT) (excluding isthmus-dependent atrial flutter) was defined as AF/AT lasting longer than 7 consecutive days or requiring termination by cardioversion after 48 hours.
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Timepoint [6]
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3 years
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Secondary outcome [7]
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Number of Repeat Ablations
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Assessment method [7]
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Number of repeat ablations refers to the total number of ablation procedures (including initial ablation procedure). If the number of repeat ablations =1 then subject only had one ablation procedure (initial ablation procedure in test group as randomized or cross-over procedure in cross-over subjects). If the number of repeat ablations is \>= 2, then subject had at least one repeat procedure.
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Timepoint [7]
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3 years
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Secondary outcome [8]
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Number of New Antiarrhythmic Drugs
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Assessment method [8]
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Number of new antiarrhythmic drugs were administered as per investigator's discretion and 2006 AF management guidelines.
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Timepoint [8]
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3 years
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Secondary outcome [9]
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Number of Participants in Sinus Rhythm at Each Visit Throughout the Follow-up
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Assessment method [9]
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Subject in sinus rhythm: no other rhythms documented at specific visit, based on ECG, Holter and event recorder. Percentages are calculated with respect to number of subjects with data available at corresponding visit
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Timepoint [9]
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3 months, 6 months, 1 year, 2 years, 3 years
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Secondary outcome [10]
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Number of Participants With Recurrent AF/AT at Each Visit Throughout the Follow-up
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Assessment method [10]
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Subjects with recurrent AF/AT: any AF/AT documented between previous visit up to visit analyzed at any TTM, Holter or ECG. Percentages are calculated with respect to number of subjects with data available at corresponding visit
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Timepoint [10]
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3 months, 6 months, 1 year, 2 year and 3 years
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Eligibility
Key inclusion criteria
1. Patients with recurrent paroxysmal atrial fibrillation (AF) for at least 2 years, with = 2 episodes over the last 6 months; (per Amendment v3, 09APR2013, previous "6 episodes" )
2. HATCH Score of at least =1 and =4.
3. Eligible for catheter ablation and for anti-arrhythmic or rate control medications, after having failed at least 1 but no more than 2 prescribed drugs (either anti-arrhythmic or rate control drug).
4. Age 60 years or older.
5. Left atrium (LA) diameter = 55mm by TTE.
6. Left ventricle (LV) ejection fraction =50% when in sinus rhythm or LV ejection fraction =35% when in atrial fibrillation.
NOTE: For patients entering the study in AF with an ejection fraction =35% and <50%; the ejection fraction should be re-checked when in sinus rhythm. In case the ejection fraction is >50% the subject can continue in the study.
7. Patient signed the Informed Consent Form and is able and willing to comply with protocol requirements, including all baseline and follow-up testing.
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Minimum age
60
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
1. Patients awaiting cardiac transplantation or other cardiac surgery.
2. Acute illness (ongoing) or active systemic infection or sepsis which in the opinion of the investigator, may adversely affect the safety and/or effectiveness of the participant of the study.
3. Reversible causes of atrial fibrillation, e.g. but not limited to thyroid disorders, acute alcohol intoxication, recent major surgical procedures or trauma, etc.
4. Recent cardiac events including myocardial infarction (MI), percutaneous coronary intervention (PCI), or valve or bypass surgery in the preceding 3 months.
5. Heart failure decompensation.
6. Previously diagnosed with persistent/permanent atrial fibrillation/ atrial flutter.
7. Previously required cardioversion >48 hours after onset of atrial fibrillation/ atrial flutter.
8. Subject having previous transischemic attack (TIA) or stroke (cerebrovascular accident) one year prior to patient enrolment and/or no sufficient recovery.
9. Pulmonary embolism or recent atrial embolism/thrombosis.
10. Hypertrophic obstructive cardiomyopathy.
11. Class IV angina or Class IV congestive heart failure (CHF) (including past or planned heart transplantation).
12. Mandated anti-arrhythmic drug therapy for disease conditions other than atrial fibrillation.
13. Heritable arrhythmias or increased risk for torsade de pointes with class I or III Drugs.
14. Prior left atrial catheter ablation with the intention of treating atrial fibrillation; prior surgical interventions for AF such as the MAZE procedure.
15. Prior AV nodal ablation.
16. Patients presenting contra-indications for the study catheter(s), as indicated in the respective Instructions For Use.
17. Contraindication to warfarin, other anticoagulation therapy, or all anti-platelet medications.
18. Medical conditions limiting expected survival to <3 years.
19. Concurrent participation in any other clinical study.
20. Prior history of non-adherence to prescribed drug regimens.
21. Women of child bearing potential whom are pregnant, lactating, or planning to become pregnant during the course of the trial
NOTE: Prior ablation of the cavo-tricuspid isthmus is not a reason to exclude, if the patient develops subsequent recurrent atrial fibrillation.
NOTE: For patients randomized to the PVI group (Test Group), a Transesophageal Echocardiography (TEE) should be performed (as per standard of care), within 48 hours pre-procedure, to exclude atrial thrombus or other structural contraindications for an ablation procedure.
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Study design
Purpose of the study
Treatment
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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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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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
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Actual
13/02/2012
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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
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Actual
19/12/2018
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Sample size
Target
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Accrual to date
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Final
255
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
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5000 - Adelaide
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Recruitment outside Australia
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Austria
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State/province [1]
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Graz
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Austria
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Linz
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Belgium
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Aalst
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Belgium
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Brugge
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Germany
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Bad Nauheim
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Germany
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Berlin
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Germany
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Göttingen
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Germany
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Hamburg
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Hungary
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Budapest
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Ireland
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Dublin
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Italy
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Bari
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Italy
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Pisa
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Italy
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Roma
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Korea, Republic of
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Seoul
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Latvia
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Riga
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Norway
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Bergen
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Poland
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Warszaw
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Russian Federation
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Krasnoyarsk
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Russian Federation
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Moscow
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Russian Federation
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Novosibirsk
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Russian Federation
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Saint-Petersburg
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Russian Federation
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Tomsk
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Spain
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Madrid
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Spain
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Malaga
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Spain
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Salamanca
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Sweden
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Örebro
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United Kingdom
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Bournemouth
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United Kingdom
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Cambridge
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United Kingdom
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State/province [29]
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Manchester
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Biosense Webster, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The objective of this study is to determine whether early radiofrequency (RF) ablation treatment, using the CARTO® 3 or CARTO® XP System, and THERMOCOOL® Catheter Family (including THERMOCOOL® SF or THERMOCOOL® SMARTTOUCHâ„¢) in subjects with paroxysmal atrial fibrillation (PAF), delays progression of atrial fibrillation (AF) compared with drug therapy (either rate or rhythm control) using current AF management guidelines.
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Trial website
https://clinicaltrials.gov/study/NCT01570361
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Karl-Heinz Kuck, MD
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Address
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Asklepios Klinik St. Georg
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Contact person for public queries
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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
Type
Other Details
Attachment
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/61/NCT01570361/SAP_000.pdf
Study protocol
https://cdn.clinicaltrials.gov/large-docs/61/NCT01570361/Prot_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT01570361
Download to PDF