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Trial registered on ANZCTR
Registration number
ACTRN12614000857606
Ethics application status
Approved
Date submitted
10/07/2014
Date registered
8/08/2014
Date last updated
15/09/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparing exercise capacity, inflammation and endothelial function following cardioversion between asymptomatic and symptomatic patients with atrial fibrillation
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Scientific title
Changes in exercise capacity, inflammation and endothelial function following cardioversion in asymptomatic versus symptomatic persistent atrial fibrillation
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Secondary ID [1]
284961
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NONE
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Atrial Fibrillation
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Condition category
Condition code
Cardiovascular
292770
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Direct electrical cardioversion. The cardioversion will be performed under sedation. Remote patches will be attached in Anterior-posterior or anterior-lateral position and 200 Joule synchronized shock will be delivered. A maximum of three shocks will be delivered to restore sinus rhythm. Cardioversion will be performed on a single occasion, lasting approximately 30 minutes.
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Intervention code [1]
289790
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Treatment: Other
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
Symptomatic AF patients
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Exercise capacity, defined using peak oxygen consumption
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Assessment method [1]
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Timepoint [1]
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12 weeks post cardioversion
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Secondary outcome [1]
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Endothelial Function, assessed by reactive hyperemia and serum assay.
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Assessment method [1]
309348
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Timepoint [1]
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12 weeks
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Secondary outcome [2]
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Inflammation assessed by serum assay
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Assessment method [2]
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Timepoint [2]
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12 weeks
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Eligibility
Key inclusion criteria
Persistent AF, defined as an episode of AF lasting longer than 7 days or lasts <7 days and requires direct cardioversion.
Rate controlled during AF with resting ventricular rate less than 110bpm.
Able and willing to provide written informed consent to participate.
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients contraindicated for exercise testing according to American Heart Association guidelines.
Paroxysmal (AF duration <7 days) or Permanent AF (AF duration >1 year).
Decompensated heart failure
Unstable angina.
Hemodynamic instability defined as systolic blood pressure less than 90mmHg.
Previous AF ablation
Pregnancy or suspected pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
To examine the predictors of change in exercise capacity following cardioversion, we will use a multivariable mixed-effects model with the change in exercise capacity (VO2max) as the dependent variable. Analysis of variance (ANOVA) for repeated measures will be used to assess the change of haematological, morphological and QoL parameters following cardioversion. A P value <0.05 will be considered significant.
Using the mean VO2max value of 20.7+/- 6.3 ml/kg/min reported in persistent AF (Fiala et al., 2013) and a 50% attrition rate accounting for those not remaining in sinus rhythm, a recruitment target of 35 patients per group will give 80% power to detect a 3.5 ml/kg/min change in VO2max.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
25/08/2014
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
70
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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The Royal Adelaide Hospital - Adelaide
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Adelaide
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Address [1]
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North Terrace
Adelaide
SA 5005
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Centre for Heart Rhythm Disorders
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Address
Centre for Heart Rhythm Disorders
Level 5
Royal Adelaide Hospital
North Terrace
Adelaide
SA 5000
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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School of Medical Sciences
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Address [1]
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School of Medical Sciences
Level 4 Medical School South
Frome Road
Adelaide
SA 5005
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Royal Adelaide Hospital
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Ethics committee address [1]
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Level 3, IMVS Building Royal Adelaide Hospital Adelaide SA 5000
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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12/06/2014
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Approval date [1]
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07/07/2014
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Ethics approval number [1]
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HREC/14/RAH/250
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Summary
Brief summary
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1-2% of the population. Many patients remain asymptomatic, likely leading to an underestimation of the true prevalence of AF. Of particular importance is the similar risk of stroke and adverse health outcomes in the asymptomatic cohort. Catheter ablation has emerged as an effective treatment for symptomatic AF. However, the risk to benefit ratio of an ablation procedure in asymptomatic AF is less established. (i) Examine whether the restoration of sinus rhythm by cardioversion in asymptomatic patients improves exercise capacity to a similar degree as patients with symptomatic AF. (ii) Compare baseline and post-exercise parameters of the prothrombotic state between symptomatic and asymptomatic patients both before after cardioversion (1) We hypothesize that exercise capacity will be similarly impaired in symptomatic and asymptomatic patients and improve following restoration of sinus rhythm following cardioversion. (2) We further hypothesise that: a. acute exercise will elevate the prothrombotic state in both symptomatic and asymptomatic patients and; b. inflammation and endothelial dysfunction will be observed in both patient cohorts and similarly improved following the return of sinus rhythm.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Prashanthan Sanders
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Address
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Centre for Heart Rhythm Disorders
Royal Adelaide Hospital
Adelaide
SA 5000
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Country
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Australia
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Phone
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61882222272
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Adrian Elliott
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Address
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School of Medical Sciences, University of Adelaide
Med School South, Frome Road
Adelaide
SA 5005
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Country
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Australia
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Phone
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61883133194
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Rajiv Mahajan
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Address
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Centre for Heart Rhythm Disorders
Royal Adelaide Hospital
Adelaide
SA 5000
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Country
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Australia
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Phone
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61883133194
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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