Rhythm Control of AF in Patients With Acute Stroke

Yonsei University300 enrolled

Overview

Prospective randomized (rhythm control or rate control) Objective of study 1. To analyze long term outcome of patients with acute stroke with atrial fibrillation according to the rhythm control 2. To analyze recurrence rate of atrial fibrillation or recurrence stroke in patients with acute stroke according to the rhythm control (by antiarrhythmic drug, cardioversion, catheter ablation)

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

300

Conditions

Atrial Fibrillation

Interventions

Rhythm controlPROCEDURE

1. Start AAD right after evaluating for LA size, EF, LA thrombus, and presence of CAD during anticoagulation 2. Cardioversion after 1 month 3. Rhythm FU schedule (2012 ACC/AHA/ESC guidelines) 4. If AF recur, RFCA

Rate controlPROCEDURE

1. No AAD, just anticoagulation 2. HR control between 60\~110bpm (with beta blocker, calcium channel blocker, digoxin) 3. Without the treatment about antiarrhythmia and rhythm control, deification of rate control, the subject will be drop out for study.

Eligibility

Sex: ALLMin age: 19 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients with Atrial fibrillation (20\~80 years old) 2. patients with Acute stroke within 7 days 3. LA diameter \< 55mm 4. patients possible to anticoagulation and anti arrhythmic drug 5. NIHSS score ≤12 Exclusion Criteria: 1. Hemorrhagic transformation 2. Large cerebral lesion or cerebellar lesion (more than 1/3 of MCA area and 1/2 of ACA area, 1/2 of PCA area, 1/2 of cerebellar area) 3. active internal bleeding 4. Impossible to anticoagulation or anti arrhythmic drug 5. Valvular AF (MA\> GII, Mechanical valve, Mitral valve replacement) 6. LV ejection fraction \< 30% 7. Structural cardiac disease 8. Catheter ablation history for AF, Cardiac surgery 9. Already prescribed anti arrhythmic drugs 10. With severe medical disease 11. Expected survival \< 1year 12. Severe alcoholics, drug addiction 14\. Contraindication to MRI 15. Pregnancy

Locations (1)

Severance Cardiovascular Hospital, Yonsei University Health System

Seoul, South Korea

RECRUITING

Outcomes

Primary Outcomes

acute stroke with AF

Long term outcome of rhythm control in patients with acute stroke with AF related to all cause morality, hospital admission, recurrence rate of stroke, major adverse cardiac events

Time frame: 1 year

recurrence of silence stroke

Adverse events after anticoagulation or anti arrhythmic drug, recurrence rate after RFCA on AF in patients with stroke, adverse events after RFCA, recurrence rate of silence stroke or clinical stroke

Time frame: 1 year

recurrence of AF after rhythm control

Adverse events after anticoagulation or anti arrhythmic drug, recurrence rate after RFCA on AF in patients with stroke, adverse events after RFCA, recurrence rate of silence stroke or clinical stroke

Time frame: 1 year

Central Contacts

Hui-Na Pak, MD

CONTACT

82-2-2228-8459

Data from ClinicalTrials.gov

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