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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01803438
Registration number
NCT01803438
Ethics application status
Date submitted
1/03/2013
Date registered
4/03/2013
Date last updated
25/02/2020
Titles & IDs
Public title
Catheter Cryoablation Versus Antiarrhythmic Drug as First-Line Therapy of Paroxysmal Atrial Fibrillation
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Scientific title
Catheter Cryoablation Versus Antiarrhythmic Drug as First-Line Therapy of Paroxysmal Atrial Fibrillation.
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Secondary ID [1]
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Cryo-FIRST
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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:
Symptomatic Paroxysmal Atrial Fibrillation Without Clinically Significant Heart Diseases
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Condition category
Condition code
Cardiovascular
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Other cardiovascular diseases
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Cardiovascular
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Antiarrhythmic Drugs
Active comparator: AADs - AAD therapy based on hospital clinical practice according to ESC Guidelines 2012
Experimental: Cryoablation procedure - electrical pulmonary veins isolation performed with cryoballoon ablation system
Treatment: Drugs: Antiarrhythmic Drugs
AAD therapy based on hospital clinical practice according to ESC Guidelines 2012
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Freedom from any atrial arrhythmia recurrence
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Assessment method [1]
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The primary endpoint is freedom from any atrial arrhythmia recurrence at 12 months (at least one episode of AF, atrial flutter or atrial tachycardia with a duration \> 30 seconds documented by 7 day Holter ECG or any other printed ECG recording following a blanking period or a dosing optimizing period of 3 months).
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Timepoint [1]
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12 months
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Secondary outcome [1]
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quality of life
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Assessment method [1]
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The quality of life of the two arms measured by means of SF-36 Health Survey and Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) questionnaires will be compared at 12 months follow-up.
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Timepoint [1]
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12 months
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Secondary outcome [2]
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Hospital or emergency services accesses
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Assessment method [2]
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Hospital or emergency services accesses due to symptoms caused by documented atrial arrhythmias will be compared in the two arms at 12 months follow-up.
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Timepoint [2]
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12 Months
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Secondary outcome [3]
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Freedom from occurrence of AF
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Assessment method [3]
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Freedom from occurrence of AF (after 3 months blanking period) will be compared between the two arms at 12 months follow-up.
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Timepoint [3]
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12 months
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Secondary outcome [4]
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Freedom from occurrence of documented left atrial tachycardia and left atrial flutter
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Assessment method [4]
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Freedom from occurrence of documented left atrial tachycardia and typical - or atypical left atrial flutter (after 3 months blanking period or AAD optimization period) will be compared between the two arms at 12 months follow-up.
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Timepoint [4]
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12 months
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Secondary outcome [5]
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Symptomatic palpitations burden
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Assessment method [5]
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Symptomatic palpitations burden will be evaluated by mean of Patient's diary information and compared between the two arms at 12 months follow-up.
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Timepoint [5]
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12 months
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Secondary outcome [6]
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Severe adverse events incidence
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Assessment method [6]
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Severe adverse events incidence will be compared between the two arms during the whole course of the study.
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Timepoint [6]
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12 months
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Secondary outcome [7]
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Freedom from persistent AF
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Assessment method [7]
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Freedom from persistent AF (AF episode lasting longer than 7 days or interrupted by pharmacological or electrical cardioversion after 48h from the onset of the episode) will be compared between the two arms at 12 months follow-up.
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Timepoint [7]
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12 months
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Secondary outcome [8]
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Echocardiographic left atrial re-modelling
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Assessment method [8]
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Echocardiographic left atrial parameters will be compared between the two arms at 6 and 12 months follow ups.
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Timepoint [8]
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12 months
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Secondary outcome [9]
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health care utilization
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Assessment method [9]
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Frequency, type and associated cost of health care utilization and utility will be compared between the two arms at 12 months follow-up.
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Timepoint [9]
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12 months
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Eligibility
Key inclusion criteria
* Subject has been diagnosed with symptomatic paroxysmal atrial fibrillation as defined above and at least two symptomatic episodes in the last six months prior to inclusion.
* At least one episode of AF must be documented during the prior year by any kind of ECG recording.
* Subject has structural normal heart with an LVEF = 50%, thickness of the inter-ventricular septum =12 mm and left atrium diameters (short axis) < 46 mm obtained by transthoracic echocardiography.
* Subject has normal ECG parameters (QRS width in the 12 channel surface ECG =120 ms, QTc - interval < 440 ms, PQ - interval = 210 ms; all parameters should be measured at sinus rhythm).
* Subject is at least 18 and not older than 75years old.
* Subject is able and willing to give informed consent.
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Minimum age
18
Years
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Maximum age
75
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
* Subject developed persistent AF at least once in history (electrical or pharmacological cardioversion after 48h or episode duration >7 days).
* Subject has documented typical atrial flutter.
* Subject has any history of successful or unsuccessful treatment of AF with class I or III antiarrhythmic or sotalol with the intention to prevent an AF recurrence. Patients pretreated with above AAD at maximum 48 hours with the intention to convert an AF episode are allowed.
* Subject had any previous left atrial ablation.
* Subject had any previous cardiac surgery, e.g. prosthetic valves.
* Subject has permanent pacemaker or defibrillator implant.
* Subject has 2° type II, 3° degree AV-block or left/right bundle branch block pattern.
* Subject has unstable angina pectoris.
* Subject has history of previous myocardial infarction or percutaneous intervention during the last three months.
* Subject has symptomatic carotid stenosis.
* Subject has chronic obstructive pulmonary disease with detected pulmonary hypertension or any other evidence of significant lung disease.
* Subject has any contraindication for oral anticoagulation.
* Subject has any history of previous transient ischemic attack or stroke.
* Subject has known intra-cardiac thrombus formation.
* Subject has any significant congenital heart defect corrected or not (except for patent foramen ovale that is allowed).
* Subject has evidence of congestive heart failure (NYHA class II, III or IV) in sinus rhythm.
* Subject has hypertrophic cardiomyopathy.
* Subject has abnormal long or short QT interval, signs of Brugada syndrome, known inheriting ion channel disease on the family, arrhythmogenic right ventricular dysplasia.
* Subject has sarcoidosis.
* Subject has pulmonary vein stent.
* Subject has myxoma. Exclusion criteria based on laboratory abnormalities
* Subject has thrombocytosis (platelet count > 600,000 / µl) or thrombocytopenia (platelet count <100,000 / µl).
* Subject has any untreated or uncontrolled hyperthyroidism or hypothyroidism.
* Subject has renal dysfunction with glomerular filtration rate < 60 ml / min.
* Subject has known cryoglobulinaemia. General exclusion criteria
* Subject has a reversible causes for AF like hyperthyroidism and alcoholism.
* Subject is a pregnant woman or woman of childbearing potential not on adequate birth control: only woman with a highly effective method of contraception [oral contraception or intra-uterine device] (who must have a negative pregnancy test within 1 week of the start of the therapy) or sterile woman can be enrolled.
* Subject is a breastfeeding woman.
* Subject has an active systemic infection.
* Subject is employed by Medtronic or by the department of any of the investigators or is a close relative of any of the investigators.
* Subject is unwilling or unable to comply fully with study procedures and follow-up due to any disease condition, which can raise doubt about compliance and influencing the study outcome especially any kind of cancer, severe bleeding in history or a suspected pro-coagulant state.
* Legal incapacity or evidence that a subject cannot understand the purpose and risks of the study or inability to comply fully with study procedures and follow up.
* Subject has a life expectancy of = 1 year.
* Subject is currently enrolled or planning to participate in a potentially confounding drug or device trial during the course of this study. Co-enrollment in concurrent trials is only allowed when documented pre-approval is obtained from the Medtronic study manager.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/06/2014
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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
20/01/2020
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Sample size
Target
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Accrual to date
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Final
220
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Monash Medical Centre - Melbourne
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Recruitment postcode(s) [1]
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- Melbourne
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Recruitment outside Australia
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Argentina
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State/province [1]
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Buenos Aires
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Belgium
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Brussel
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Croatia
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Zagreb
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France
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Amiens
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France
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Grenoble
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France
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Paris
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France
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Rouen
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Germany
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Bad Nauheim
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Germany
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Frankfurt
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Germany
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Hamburg
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Germany
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Kaiserslautern
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Germany
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Munich
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Italy
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Cotignola
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Italy
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State/province [14]
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Massa
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Netherlands
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Eindhoven
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Netherlands
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Rotterdam
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Norway
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State/province [17]
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Bergen
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Medtronic Cardiac Rhythm and Heart Failure
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Medtronic Atrial Fibrillation Solutions
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to evaluate the effectiveness of Pulmonary Vein Isolation (PVI) performed with the Arctic Frontâ„¢ Advance Cardiac CryoAblation Catheter System as first-line therapy in comparison with antiarrhythmic drugs (AAD) in patients with paroxysmal atrial fibrillation (AF).
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Trial website
https://clinicaltrials.gov/study/NCT01803438
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Trial related presentations / publications
Pavlovic N, Chierchia GB, Velagic V, Hermida JS, Healey S, Arena G, Badenco N, Meyer C, Chen J, Iacopino S, Anselme F, Dekker L, Scazzuso F, Packer DL, de Asmundis C, Pitschner HF, Piazza FD, Kaplon RE, Kuniss M; Cryo-FIRST Investigators. Initial rhythm control with cryoballoon ablation vs drug therapy: Impact on quality of life and symptoms. Am Heart J. 2021 Dec;242:103-114. doi: 10.1016/j.ahj.2021.08.007. Epub 2021 Sep 8.
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Public notes
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Contacts
Principal investigator
Name
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Malte Kuniss, MD
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Address
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Kerckhoff - Klinik, Bad Nauheim, Germany
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Fax
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Contact person for scientific queries
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
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01803438
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