Curing Atrial Fibrillation in Heart Failure

NHS Trust

Status

Completed

Conditions

Atrial Fibrillation

Chronic Heart Failure

Treatments

Drug: Beta Blocker (BB) - metoprolol, bisoprolol, carvedilol

Drug: ACE inhibitor - ramipril, enalapril, captopril, perindopril, lisinopril

Procedure: radiofrequency ablation

Drug: Aldosterone Antagonists - spironolactone

Study type

Interventional

Funder types

Other

Identifiers

NCT00292162

05/S0704/47

Details and patient eligibility

About

Heart failure is a condition that occurs when the heart muscle weakens and no longer contracts normally. Half of these patients have an irregularity of heart rhythm called atrial fibrillation (AF). Patients with both heart failure and AF spend more time in hospital, and die earlier than those with heart failure alone. AF is difficult to treat with conventional methods in patients with heart failure. Radiofrequency ablation is a new technique used to cure AF. The investigators aim to establish if radiofrequency ablation for atrial fibrillation in patients with advanced heart failure can result in marked improvement in the function of the heart.

Enrollment

41 patients

Sex

All

Ages

16+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Informed consent
Persistent atrial fibrillation (AF)
New York Heart Association (NYHA) II, III and IV chronic heart failure (CHF) despite optimal medical therapy for at least 3 months
left ventricular ejection fraction (LVEF) <35% - as measured by radionuclide ventriculography (RNVG)
Patients with CHF secondary to ischaemic and non-ischaemic aetiology

Exclusion criteria

QRS duration >150ms (or QRS 120-150 with evidence of mechanical cardiac dysynchrony)
Magnetic resonance imaging (MRI) - incompatible metallic (ferrous) prosthesis
Primary valvular disease as a cause of CHF
Reversible causes of CHF
Acute myocarditis
Patients aged 18 or less
Patients having undergone revascularisation procedures within 6 months
Paroxysmal AF
Pregnancy
Expected cardiac transplantation within 6 months

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

41 participants in 2 patient groups

medical therapy

Active Comparator group

Description:

Standard therapy for heart failure with angiotensin converting enzyme inhibitors(ACE) - (Ramipril, enalapril, lisinopril, captopril, perindopril), beta-blocker (BB) - (carvedilol, bisoprolol, metoprolol), Aldosterone antagonists (spironolactone) +/- diuretics and digoxin

Treatment: