Curing Atrial Fibrillation in Heart Failure

NHS Greater Glasgow and Clyde41 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Chronic Heart Failure Atrial Fibrillation

Interventions

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Change in Left Ventricular Ejection Fraction by Magnetic Resonance Imaging (MRI)%

left ventricular ejection fraction (LVEF) is a measure of the % of blood ejected from the ventricle in one heart beat. It is a measure of cardiac function. We measured LVEF at baseline and at 6 months, to assess whether there had been a change in the patients cardiac function over time.

Time frame: baseline and 6 months

Baseline Left Ventricular Ejection Fraction by Magnetic Resonance Imaging (MRI)

Baseline Left Ventricular Ejection Fraction by Magnetic Resonance Imaging (MRI)in %

Time frame: Baseline

Left Ventricular Ejection Fraction by Magnetic Resonance Imaging (MRI)at 6 Months

Left Ventricular Ejection Fraction as measured by Magnetic Resonance Imaging (MRI)at 6 months

Time frame: 6 months

Secondary Outcomes

Plasma B-type Natriuretic Peptide (BNP)

venous blood taken to assess levels of the above peptide. High evels of the peptide are associated with adverse prognosis. Blood levels are taken at baseline and 6 months. The change over 6 months is assessed, thereore it is possible to have a negative number if the level falls.