Prospective trial comparing the efficacy and safety of CryoBalloonAblation (CBA) to standardized medication for treatment of early onset persistent atrial fibrillation (AF) without structural heart disease. The value of CBA in these patients has never been studied; the endpoints for persistent patients are much easier than for paroxysmal patients. Reduction in left atrial (LA) size will be compared versus patients on drug therapy and versus failing patients.
The total AF history should be shorter than 24 months. Symptomatic patients can be included if they have had within the last year at least 2 episodes of documented AF, lasting minimal 30 sec. One episode in the entire history should have lasted more than 48 h, requiring electrical or pharmacological cardioversion or stopped spontaneously after more than 7 days. All patients eligible for the study will sign informed consent, have an echocardiogram prior to inclusion to exclude severe left ventricular dysfunction, to rule out significant valve abnormalities, left ventricular hypertrophy and to assess the LA volume and diameter. Prior to randomization, and after inclusion it is suggested to the local investigators to perform an MRI-scan or CT scan of the LA and pulmonary veins (in both branches of the study ) in eligible patients to assess the anatomy and the left atrial volume. The results should not influence the strategy of treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
13
Cryoablation at entry, after randomization to this group
Correct drug dosage at entry, sequential adjustment / titration, in stage 2 amiodarone
Brussels Heart Centre
Brussels, Belgium
Saint Luc
Brussels, Belgium
Dept Cardiologie
Ghent, Belgium
Sinus rhythm
Sinus rhythm at one year
Time frame: one year
Reduction LA volume
Reduction left atrial volume in successfully treated patients
Time frame: one year
Number of cardioversions
Number of cardioversions
Time frame: one year
Percentage on anti arrhythmic drugs (AAD)
Percentage on AAD in each group
Time frame: 6 months
Percentage on AAD
Percentage on AAD in each group
Time frame: 12 months
Vascular complications
Vascular complications, including tamponade
Time frame: one year
Stroke, transient ischemic attack (TIA)
Stroke, TIA (symptomatic)
Time frame: one year
Serious adverse events (SAE)
Adverse events leading to admission or death
Time frame: one year
Freedom of AF
Freedom of atrial fibrillation with all means
Time frame: one year
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