ULTRA-HFIB-Redo: Ultrasound-based Renal Sympathetic Denervation vs Control in Redo Ablation Patients
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ClinicalTrials.gov Identifier: NCT05988411 |
Recruitment Status :
Recruiting
First Posted : August 14, 2023
Last Update Posted : February 15, 2024
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Paroxysmal Atrial Fibrillation Persistent Atrial Fibrillation | Device: Renal Denervation Device: Catheter Ablation | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 200 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | Prospective, controlled, single-blind, randomized (2:1, Intervention:Control) clinical trial. |
Masking: | Single (Participant) |
Masking Description: | single-blind |
Primary Purpose: | Treatment |
Official Title: | Ultrasound-Based Renal Sympathetic Denervation as Adjunctive Upstream Therapy During Atrial Fibrillation - Redo Ablation Procedures: A Pilot Study |
Actual Study Start Date : | December 7, 2023 |
Estimated Primary Completion Date : | December 2024 |
Estimated Study Completion Date : | December 2024 |
Arm | Intervention/treatment |
---|---|
Experimental: Catheter ablation + renal denervation
Catheter ablation + renal denervation
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Device: Renal Denervation
Renal denervation using the Paradise renal denervation system - a dedicated Renal Denervation (RDN) catheter that delivers a circumferential ring of ablative ultrasound energy Device: Catheter Ablation Catheter ablation - one of the most common procedures performed by Cardiac Electrophysiologists for atrial fibrillation. |
Active Comparator: Catheter ablation only
Catheter ablation
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Device: Catheter Ablation
Catheter ablation - one of the most common procedures performed by Cardiac Electrophysiologists for atrial fibrillation. |
- Freedom from atrial arrhythmias with no AADs [ Time Frame: after 90 days ]Freedom from atrial arrhythmias (AT/AF/AFL) recurrence ≥ 30 seconds off all antiarrhythmic drug uses (AADs) (after the 90-day blanking period).
- Freedom from atrial arrhythmias (AT/AF/AFL) with AADs [ Time Frame: at 12 months ]Freedom from AT/AF/AFL recurrence ≥ 30 seconds at 12 months (not including a 3-month blanking period) despite taking AADs
- Procedure-related adverse events [ Time Frame: at 12 months ]Number of procedure-related adverse events
- Atrial Fibrillation Effect on Qualify of Life Questionnaire (AFEQT) [ Time Frame: at 12 months ]Atrial Fibrillation Effect on Qualify of Life Questionnaire (AFEQT). Each item scored from 1-7, with total scale from 20-140, Lower score indicates better health outcomes.
- Blood pressure [ Time Frame: at 12 months ]Blood pressure - Systolic and Diastolic
- Number of AF episodes [ Time Frame: at 12 months ]AF burden assessed by the amount of AF episodes detected during Event Monitoring
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age ≥ 18;
- Planned for a redo AF ablation procedure (paroxysmal or persistent); (prior to randomization, a technically successful AF ablation procedure, defined as successful pulmonary vein isolation, if needed, as well as bidirectional block of any attempted anatomic lesion sets such as cavotricuspid isthmus line, roofline, mitral line and superior vena cava isolation, must have been completed). Note: the clinical recurrences must primarily be atrial fibrillation, and not atrial flutter/tachycardia (that is, a prospective patient may have a AFL/AT recurrences, but AF must be the dominant recurrent rhythm.)
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History of hypertension and either:
- Documented history of SBP≥160 or DBP≥100, or;
- Receiving ≥1 antihypertensive medication;
- Willingness to adhere to study restrictions and comply with all post-procedural follow-up requirements
Exclusion Criteria:
- Long-standing persistent AF (>12 months); >3 prior atrial fibrillation ablations (lifetime); AF ablation within 3 months of enrollment; extensive scar in left atrium.
- Individual with valvular AF or AF due to a reversible cause
- Prior treatment with other devices for hypertension including but not limited to ROX Coupler, Mobius stent, and/or the CVRx barostimulator device.
- NYHA class IV congestive heart failure;
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Individual has renal artery anatomy that is ineligible for treatment (as determined by renal angiography);
- Main renal artery diameter <3mm or >8.0 mm
- Main renal treatable artery length < 20 mm (length may include proximal branches)
- Presence of renal artery stenosis of any origin ≥30%
- Calcification in renal arteries
- Prior renal denervation procedure
- Presence of abnormal kidney tumors
- Renal artery aneurysm
- Pre-existing renal stent or history of renal artery angioplasty
- Pre-existing aortic stent or history of aortic aneurysm
- Fibromuscular disease of the renal arteries
- Iliac/femoral artery stenosis precluding insertion of the Paradise Catheter
- Individual has an estimated glomerular filtration rate (eGFR) of less than 40mL/min/1.73m2, using the MDRD calculation;
- Inability to undergo AF catheter ablation (e.g., presence of a left atrial thrombus, contraindication to all anticoagulation)
- Individual with known allergy to contrast medium not amendable to treatment.
- Life expectancy <1 year for any medical condition
- Individual has experienced a myocardial infarction, unstable angina, cerebrovascular accident, or heart failure admission within 3 months of the baseline visit.
- Documented history of chronic active inflammatory bowel disorders such as Crohn's disease or ulcerative colitis.
- Female participants who are pregnant or nursing.
- Individual has known secondary hypertension.
- Individual has a single functioning kidney (either congenitally or iatrogenically).
- Individual has a known, unresolved history of drug use or alcohol dependency, lacks the ability to comprehend or follow instructions, or would be unlikely or unable to comply with study follow-up requirements.
- Patients concurrently enrolled in any other investigational drug or device trial that would interfere with the conduction of this protocol.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05988411
Contact: Jeff Lam, MS | (212) 824-8929 | jeff.lam@mountsinai.org | |
Contact: Betsy Ellsworth, MSN ANP | (212) 824-8902 | betsy.ellsworth@mountsinai.org |
United States, New York | |
Mount Sinai Hospital | Recruiting |
New York, New York, United States, 10029 | |
Contact: Jeff Lam, MS 212-824-8929 jeff.lam@mountsinai.org | |
Contact: Betsy Ellsworth, MSN ANP (212) 824-8902 betsy.ellsworth@mountsinai.org | |
Principal Investigator: Abhishek Maan |
Principal Investigator: | Vivek Reddy, MD | MOUNT SINAI HOSPITAL |
Responsible Party: | Vivek Reddy, Professor of Medicine , Director, Cardiac Electrophysiology, Icahn School of Medicine at Mount Sinai |
ClinicalTrials.gov Identifier: | NCT05988411 |
Other Study ID Numbers: |
BRANY 23-02-344 |
First Posted: | August 14, 2023 Key Record Dates |
Last Update Posted: | February 15, 2024 |
Last Verified: | February 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | Yes |
Product Manufactured in and Exported from the U.S.: | No |
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes |