Heart failure and atrial fibrillation (AF) often coexist, and each increases the morbidity and mortality associated with the other. The investigators hypothesized that restoration of normal sinus rhythm by catheter ablation is superior to medical treatment of AF in heart failure. This study randomizes patients with heart failure and persistent AF to medical treatment of AF or catheter ablation to restore sinus rhythm.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Catheter ablation of AF as described previously by our group (e.g. Hunter et al, Heart 2010).
Medical treatment of persistent AF as 'normal care'. Patients are randomised to medical treatment alone for atrial fibrillation. Treatment will be as per current guidelines for persistent atrial fibrillation, with rate control as first line (using beta-blockers, calcium channel blockers and digoxin as indicated) and rhythm control as second line (using sotalol, dronedarone, or amiodarone as indicated). (Both groups will receive standard heart failure medication including angiotensin converting enzyme inhibitors, beta blockers, aldosterone antagonists, and diuretics as indicated).
Barts & The London NHS Trust
London, UK, United Kingdom
RECRUITINGDifference in ejection fraction between groups
Difference in left ventricular ejection fraction between groups on echocardiography at 6 months
Time frame: 6 months
Difference in peak VO2 between groups
Time frame: 6 months
Difference in NYHA class between groups
Time frame: 6 months
Difference in BNP between groups
Time frame: 6 months
Difference in Quality of Life between groups
Using SF36 and Minnessota questionaire
Time frame: 6 months
Reduction in end systolic volume
Comparisson between groups of the percentage reduction in left ventricular end systolic volume at 6 months compared to baseline.
Time frame: 6 months compared to baseline
Difference in heart failure symptoms
Comparisson between groups in heart failure symptoms using the Minessota living with heart failure questionaire.
Time frame: 6 months
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