Status:

COMPLETED

Cardiac Surgical Treatment by Radiofrequency Ablation on Valvular Patients: Efficacy at 3 Months

Lead Sponsor:

University Hospital, Toulouse

Conditions:

Atrial Fibrillation

Eligibility:

All Genders

18-80 years

Phase:

NA

Brief Summary

The objective of the study is to evaluate the efficacy of the epicardial or endocardial radiofrequency ablation in the treatment of atrial fibrillation. It is a multicentric, prospective, randomized,...

Detailed Description

Principal objective: To evaluate the efficacy at 3 months of combined ablation technique in the treatment of chronic atrial fibrillation during cardiac surgery in order to obtain a sinusal heart rate...

Eligibility Criteria

Inclusion

  • Adult patients with no age limit, presenting a chronic atrial fibrillation and planned to undergo a surgical intervention on mitral valve (valve replacement or plasty) associated or not with myocardial revascularization or replacement/plasty of another valve (aortic, tricuspid)
  • The chronic atrial fibrillation is defined as a continuous atrial fibrillation more than 1 month before the surgery despite all anti-arrhythmia treatments including cardioversion ; the atrial fibrillation can be associated to another rhythm trouble except the severe ventricular rhythm troubles.
  • The indication for surgery is performed using the clinical evaluation : NYHA \>2 and the usual echocardiography criteria (mitral regurgitation \> grade 3, mitral gradient \>10 mm Hg or valve surface \< 1,5 cm2)
  • Patients with a vital prognosis not compromised by comorbidity in the next 2 years and with a mental state enabling to give informed consent
  • Patients agreeing to take part in the study and having signed the informed consent form.
  • For the part of the study pursued in open independent to the actual protocol, patients having signed the modified informed consent with approval of the new study procedure not yet published.

Exclusion

  • Paroxystic atrial fibrillation or atrial fibrillation for less than 1 month
  • Atrial fibrillation never treated by cardioversion or pharmacology before surgery.
  • Contra-indication to surgery, i.e. severe respiratory failures, multivisceral deficiencies (renal, cardiac or hepatic), rapidly evolutive or metastatic cancers, malignant hemopathies not stabilized by chemotherapy
  • Contra-indication to the following arrhythmia treatments: class III (amiodarone) associated to contra-indication to class II (beta blockers) or to class Ic (flecainide, propafenone, cibenzoline).
  • Severe decompensated heart failure.
  • Uncontrolled, repetitive, severe documented ventricular arrhythmia (ventricular tachycardia, ventricular fibrillation episodes)
  • Contra indication to epicardic ablation procedure (pericardic adhesions, intra-atrial thrombus) In these cases the ablation could be only an endocardic ablation but it does not necessarily exclude the patient.
  • Ventricular "ejection fraction " \< 40%
  • Impossibility to follow the pre-inclusion phases i.e. emergency surgery for mitral break or evolutive endocarditis.
  • Patients with disabled mental status
  • Patient participating in another clinical study

Key Trial Info

Start Date :

December 1 2005

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

October 1 2007

Estimated Enrollment :

13 Patients enrolled

Trial Details

Trial ID

NCT00259623

Start Date

December 1 2005

End Date

October 1 2007

Last Update

July 17 2009

Active Locations (5)

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Page 1 of 2 (5 locations)

1

Service de Chirurgie Cardio-Vasculaire - Hôpital Côte de Nacre

Caen, CAEN, France, 14033

2

Service de Chirurgie Cardio-Vasculaire - Hôpital Gabriel Montpied

Clermont-Ferrand, Clermont-ferrand, France, 63003

3

Service de Chirurgie Cardio-vasculaire - CHU Dupuytren

Limoges, Limoges, France, 87042

4

Service de Chirurgie Cardio Vasculaire - CHU RANGUEIL

Toulouse, Toulouse, France, 31059