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The Modified Ablation Guided by Ibutilide Use in Chronic Atrial Fibrillation (MAGIC-AF) Study:: Clinical Background and Study Design.
MedLine Citation:
PMID:  22034996     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The MAGIC-AF Study. Background: Beyond pulmonary vein isolation (PVI), adjuvant ablation at the sites of complex fractionated atrial electrograms (CFAE) has been shown to improve the long-term success of catheter ablation of persistent atrial fibrillation (AF). However, this approach often requires extensive ablation due to the widespread distribution of CFAE within the left atrium. An optimal strategy would identify areas of CFAE which, when selectively targeted with ablation, result in AF termination with an acceptable long-term freedom from AF. It is possible that the intraprocedural administration of an antiarrhythmic drug may help accomplish this. Objective: The Modified Ablation Guided by Ibutilide Use in Chronic AF (MAGIC-AF) Study is an international multicenter prospective randomized double-blinded clinical trial assessing the utility of the intraprocedural administration of 0.25 mg of intravenous ibutilide before performing CFAE ablation. The primary efficacy endpoint of this study will be the freedom from AF at 1 year after a single procedure off antiarrhythmic agents. Safety endpoints will include procedural and radiofrequency ablation time as well as overall procedural complication rate. Methods: Patients undergoing a first ever catheter ablation procedure for persistent AF will be included. Individuals with hypertrophic cardiomyopathy, complex congenital heart disease including atrial septal defects, and ejection fraction <35% will be excluded from the study. All patients will first undergo PVI. Those patients who remain in AF will then be randomized in a 1:1 fashion to receive either 0.25 mg intravenous ibutilide or saline placebo followed by a CFAE based ablation strategy. Two hundred randomized patients will be enrolled in this study-100 in each study arm. Conclusion: The MAGIC-AF study will assess the utility of a combined pharmaco-ablative strategy in patients with persistent AF undergoing a CFAE based ablation strategy. (J Cardiovasc Electrophysiol, Vol. pp. 1-7).
Authors:
Sheldon M Singh; Andre D'Avila; Young-Hoon Kim; Arash Aryana; J Michael Mangrum; Gregory F Michaud; Srinivas R Dukkipati; David J Callans; Conor D Barrett; Maximo R Beras-Jovine; Vivek Y Reddy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-28
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Schulich Heart Program, Division of Cardiology, Sunnybrook Health Science Center, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Helmsley Cardiac Arrhythmia Service, Mount Sinai Medical Center, Mount Sinai School of Medicine, New York, New York, USA Cardiovascular Division, Korea University Medical Center, Seoul, Korea Regional Cardiology Associates, Sacramento, California, USA Cardiovascular Medicine, Department of Internal Medicine, University of Virginia, Charlottesville, Virginia, USA Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA Cardiovascular Division, Electrophysiology Section, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
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