Document Detail


Comparison of the rhythm control treatment strategy versus the rate control strategy in patients with permanent or long-standing persistent atrial fibrillation and heart failure treated with cardiac resynchronization therapy - a pilot study of Cardiac Resynchronization in Atrial Fibrillation Trial (Pilot-CRAfT): study protocol for a randomized controlled trial.
MedLine Citation:
PMID:  25281275     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The only subgroups of patients with heart failure and atrial fibrillation in which the efficacy of cardiac resynchronization therapy has been scientifically proven are patients with indications for right ventricular pacing and patients after atrioventricular junction ablation. However it is unlikely that atrioventricular junction ablation would be a standard procedure in the majority of the heart failure patients with cardiac resynchronization therapy and concomitant atrial fibrillation due to the irreversible character of the procedure and a spontaneous sinus rhythm resumption that occurs in about 10% of these patients.
METHODS: Pilot-CRAfT is the first randomized controlled trial evaluating the efficacy of a rhythm control strategy in atrial fibrillation patients with cardiac resynchronization therapy devices. The aim of this prospective, single center randomized controlled pilot study is to answer the question whether the patients with cardiac resynchronization therapy and permanent atrial fibrillation would benefit from a strategy to restore and maintain sinus rhythm (that is 'rhythm control' strategy) in comparison to rate control strategy. The study population consists of 60 patients with heart failure and concomitant long-standing persistent or permanent atrial fibrillation who underwent a cardiac resynchronization therapy device implantation at least 3 months before qualification. Study participants are randomly assigned to the rhythm control strategy (including electrical cardioversion and pharmacotherapy) or to the rate control group whose goal is to control ventricular rate. The follow-up time is 12 months. The primary endpoint is the ratio of effectively captured biventricular beats. The secondary endpoints include peak oxygen consumption, six-minute walk test distance, heart failure symptom escalation, reverse remodelling of the heart on echo and quality of life.Trial registration: NCT01850277 registered on 22 April 2013 (ClinicalTrails.gov).
Authors:
Jan Ciszewski; Aleksander Maci G; Ilona Kowalik; Pawe Syska; Micha Lewandowski; Micha Farkowski; Anna Borowiec; Tomasz Chwyczko; Mariusz Pytkowski; Hanna Szwed; Maciej Sterli Ki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-4
Journal Detail:
Title:  Trials     Volume:  15     ISSN:  1745-6215     ISO Abbreviation:  Trials     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-4     Completed Date:  -     Revised Date:  2014-10-5    
Medline Journal Info:
Nlm Unique ID:  101263253     Medline TA:  Trials     Country:  -    
Other Details:
Languages:  ENG     Pagination:  386     Citation Subset:  -    
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