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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02168829
Registration number
NCT02168829
Ethics application status
Date submitted
18/06/2014
Date registered
20/06/2014
Titles & IDs
Public title
Optimal Anticoagulation for Higher Risk Patients Post-Catheter Ablation for Atrial Fibrillation Trial
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Scientific title
The Optimal Anticoagulation for Enhanced Risk Patients Post-Catheter Ablation for Atrial Fibrillation Trial
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Secondary ID [1]
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327494
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Universal Trial Number (UTN)
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Trial acronym
OCEAN
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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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Stroke
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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
Active comparator: Rivaroxaban - Rivaroxaban 15 mg daily
Active comparator: Acetylsalicylic acid (ASA) - ASA 75-160 mg daily (if intolerant to ASA, no antiplatelet therapy will be prescribed)
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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 stroke, systemic embolism and covert embolic stroke as detected by cerebral MRI
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Assessment method [1]
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Composite of stroke, systemic embolism and covert embolic stroke as detected by cerebral MRI. A patient will be considered to have a covert stroke if one or more lesions \> 15 mm has been detected between the baseline, and final (3 year) MRI on T2 weighted and/or FLAIR imaging protocols.
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Timepoint [1]
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3 years
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Secondary outcome [1]
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Clinical, overt stroke
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Assessment method [1]
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Clinical, Overt stroke
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Timepoint [1]
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Up to 3 years
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Secondary outcome [2]
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Incidence of one or more covert MRI stroke(s) >15 mm
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Assessment method [2]
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Incidence of one or more covert MRI stroke(s) \>15 mm
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Timepoint [2]
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Up to 3 years
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Secondary outcome [3]
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Composite of all major and minor bleeding
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Assessment method [3]
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Composite of all major and minor bleeding
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Timepoint [3]
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Up to 3 years
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Secondary outcome [4]
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Major bleeding only
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Assessment method [4]
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Major bleeding only
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Timepoint [4]
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Up to 3 years
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Secondary outcome [5]
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Minor bleeding only
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Assessment method [5]
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Minor bleeding only
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Timepoint [5]
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Up to 3 years
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Secondary outcome [6]
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Intracranial hemorrhage
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Assessment method [6]
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Intracranial hemorrhage (clinical and covert on MRI alone)
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Timepoint [6]
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Up to 3 years
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Secondary outcome [7]
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Transient ischemic attack
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Assessment method [7]
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Transient ischemic attack defined as presence of a new focal neurologic deficit thought to be vascular in origin, with signs or symptoms lasting \<24 hours
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Timepoint [7]
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Up to 3 years
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Secondary outcome [8]
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All-cause mortality
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Assessment method [8]
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All-cause mortality
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Timepoint [8]
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Up to 3 years
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Secondary outcome [9]
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Net clinical benefit based on reduction in stroke/TIA rate compared to major bleeding events.
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Assessment method [9]
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Net clinical benefit based on reduction in stroke/TIA rate compared to major bleeding events.
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Timepoint [9]
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Up to 3 years
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Secondary outcome [10]
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Occurrence of non-primary endpoint MRI changes from baseline to final scan
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Assessment method [10]
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Occurrence of non-primary endpoint MRI changes from baseline to final scan including: quantification of cerebral atrophy, quantification of cerebral white matter changes, number of all new MRI lesions \> 3mm, \>5 mm, \> 15 mm, and \> 20 mm, and number of lesions detected exclusively on DW-MRI
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Timepoint [10]
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3 years
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Secondary outcome [11]
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Neuropsychological testing
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Assessment method [11]
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Neuropsychological testing - performed at baseline and repeated at 3 years.
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Timepoint [11]
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3 years
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Secondary outcome [12]
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Health economics
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Assessment method [12]
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Cost utilization and cost effectiveness analysis
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Timepoint [12]
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3 years
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Eligibility
Key inclusion criteria
Inclusion Criteria
1. Patient must be at least one year post-successful catheter ablation(s) for atrial fibrillation without evidence of any clinically apparent arrhythmia recurrence defined as all of the following: No AF/AT/AFL on at least 24 hour Holter and an ECG (or equivalent) from 2-6 months after the last ablation, AND no AF/AT/AFL on at least 24 hour Holter and an ECG any time after 6 months after the last ablation AND no AF/AT/AFL on at least 24 hour Holter and ECG 2 months before enrolment in the study. The Holter/ECG within 2 months of enrolment may also serve as the Holter performed 6 months or later after the last ablation - see section 2.3.1 for details.
2. Patient must have a CHA2DS2-VASc risk score of 1 or more. Patients in whom female sex or vascular disease are their sole risk factor may not be enrolled.
3. Patient must be >18 years of age.
4. Patient must have non-valvular AF.
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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
Exclusion Criteria
1. Patient does not meet all of the above listed inclusion criteria.
2. Patient is unable or unwilling to provide informed consent.
3. Patient is included in another randomized clinical trial or a clinical trial requiring an insurance.
4. Patient has been on an investigational drug within 30 days of enrolment.
5. Patient has been on strong CYP3A inducers (such as rifampicin, phenytoin, phenobarbital, or carbamazepine) or strong CYP3A inhibitors (such as ketoconazole or protease inhibitors) within 4 days of enrolment.
6. Patient has creatinine clearance < 30 mL/min.
7. Patient has bleeding contra-indication to oral anticoagulation (such as bleeding diathesis, hemorrhagic disorder, significant gastrointestinal bleeding within 6 months, intracranial/intraocular/ atraumatic bleeding history, fibrinolysis within 48 hours of enrollment).
8. Patient has other contraindication to oral anticoagulation or treatment with antiplatelet agent (such as allergy).
9. Patient has a contraindication to magnetic resonance imaging (MRI) or is unlikely to tolerate due to severe claustrophobia.
10. Patients with a contraindication to implantation of an implantable loop recorder if the patient opts for a loop recorder as part of the study (such as limited immunocompetence or a wound healing disorder).
11. Patient has valvular atrial fibrillation [reference AHA guidelines].
12. Patient has a non-arrhythmic condition necessitating long-term oral anticoagulation.
13. Patient had a severe, disabling stroke within one year prior to enrollment or any stroke within 14 days of enrollment.
14. Patient with special risk factors for stroke unrelated to AF, specifically known thrombophilia/ hypercoagulability, uncontrolled hypertension (systolic blood pressure >180 mmHg and/or diastolic blood pressure >100 mmHg within 4 days of enrollment), untreated familial hyperlipidemia, known vascular anomaly (intracranial aneurysm/ arteriovenous malformation or chronic vascular dissection), or known severe carotid disease.
15. Pregnancy or breastfeeding.
16. Women of childbearing age who refuse to use a highly effective and medically acceptable form of contraception throughout the study.
17. Patients who are > 85 years of age.
18. Patients who are critically ill or who have a life expectancy <3 years.
19. Patients for whom the investigator believes that the trial is not in the interest of the patient.
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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
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
Active, not 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
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Actual
1/01/2016
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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
1/08/2025
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Actual
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Sample size
Target
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Accrual to date
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Final
1284
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Recruitment in Australia
Recruitment state(s)
ACT,SA,VIC,WA
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Recruitment hospital [1]
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Canberra Hospital - Canberra
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Recruitment hospital [2]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [3]
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The Alfred Melbourne - Melbourne
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Recruitment hospital [4]
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Melbourne Health - Melbourne
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Recruitment hospital [5]
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Heart Rhythm Clinic - Nedlands
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Recruitment postcode(s) [1]
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2605 - Canberra
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Recruitment postcode(s) [2]
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5000 - Adelaide
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Recruitment postcode(s) [3]
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3004 - Melbourne
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Recruitment postcode(s) [4]
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3050 - Melbourne
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Recruitment postcode(s) [5]
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6009 - Nedlands
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Recruitment outside Australia
Country [1]
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Belgium
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State/province [1]
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Aalst
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Country [2]
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Belgium
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State/province [2]
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Antwerp
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Country [3]
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Belgium
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State/province [3]
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Arlon
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Country [4]
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Belgium
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State/province [4]
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Bonheiden
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Country [5]
0
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Belgium
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State/province [5]
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Brugge
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Country [6]
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Belgium
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State/province [6]
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Brussels
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Country [7]
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Belgium
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State/province [7]
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Brussel
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Country [8]
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Belgium
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State/province [8]
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Edegem
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Country [9]
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Belgium
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State/province [9]
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Ghent
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Country [10]
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Belgium
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State/province [10]
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Hasselt
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Country [11]
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Belgium
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State/province [11]
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Lanaken
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Country [12]
0
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Belgium
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State/province [12]
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Leuven
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Country [13]
0
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Belgium
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State/province [13]
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Liège
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Country [14]
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Belgium
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State/province [14]
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Roeselare
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Country [15]
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Canada
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State/province [15]
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Alberta
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Country [16]
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Canada
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State/province [16]
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British Columbia
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Country [17]
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Canada
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State/province [17]
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Nova Scotia
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Country [18]
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Canada
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State/province [18]
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Ontario
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Country [19]
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Canada
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State/province [19]
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Quebec
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Country [20]
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Canada
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State/province [20]
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Kelowna
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Country [21]
0
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China
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State/province [21]
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Zhejiang
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Country [22]
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Germany
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State/province [22]
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Bayern
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Country [23]
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Germany
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State/province [23]
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Hessen
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Country [24]
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Germany
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State/province [24]
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Nordrhein-westfalen
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Country [25]
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Germany
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State/province [25]
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Schleswig-Holstein
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Country [26]
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Germany
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State/province [26]
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Hamburg
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Country [27]
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Germany
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State/province [27]
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Leipzig
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Country [28]
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Israel
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State/province [28]
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Nahariya
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Funding & Sponsors
Primary sponsor type
Other
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Name
Ottawa Heart Institute Research Corporation
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Address
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Country
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Other collaborator category [1]
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Government body
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Name [1]
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Canadian Institutes of Health Research (CIHR)
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Address [1]
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Country [1]
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Other collaborator category [2]
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Commercial sector/industry
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Name [2]
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Bayer
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Address [2]
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Country [2]
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Other collaborator category [3]
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Commercial sector/industry
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Name [3]
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Biotronik Canada Inc
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Address [3]
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Country [3]
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Ethics approval
Ethics application status
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Summary
Brief summary
This trial is comparing medical approaches for stroke prevention in people who have atrial fibrillation (AF) and have undergone a successful procedure called ablation to eliminate or substantially reduce the arrhythmia. AF is normally associated with an increased risk of stroke which in many patients can be prevented with appropriate blood thinner therapy. This trial will compare a strategy of oral anticoagulant therapy after successful ablation to therapy with an aspirin per day.
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Trial website
https://clinicaltrials.gov/study/NCT02168829
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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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Atul Verma, MD
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Address
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Southlake Regional Health Centre
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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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Address
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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 scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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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/NCT02168829