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| Name | Class |
|---|---|
| British Heart Foundation | OTHER |
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Heart failure and atrial fibrillation (AF) often coexist, and each increases the morbidity and mortality associated with the other. The investigators hypothesized that restoration of normal sinus rhythm by catheter ablation is superior to medical treatment of AF in heart failure. This study randomizes patients with heart failure and persistent AF to medical treatment of AF or catheter ablation to restore sinus rhythm.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Catheter Ablation | Experimental | Catheter ablation of persistent atrial fibrillation to restore normal sinus rhythm. |
|
| Medical treatment alone | Active Comparator | Patients are randomised to medical treatment alone for atrial fibrillation. Treatment will be as per current guidelines for persistent atrial fibrillation, with rate control as first line (using beta-blockers, calcium channel blockers and digoxin as indicated) and rhythm control as second line (using sotalol, dronedarone, or amiodarone as indicated). (Both groups will receive standard heart failure medication including angiotensin converting enzyme inhibitors, beta blockers, aldosterone antagonists, and diuretics as indicated). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Catheter ablation of persistent atrial fibrillation | Procedure | Catheter ablation of AF as described previously by our group (e.g. Hunter et al, Heart 2010). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Difference in ejection fraction between groups | Difference in left ventricular ejection fraction between groups on echocardiography at 6 months | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in peak VO2 between groups | 6 months | |
| Difference in NYHA class between groups | 6 months | |
| Difference in BNP between groups |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ross J Hunter, MRCP | Contact | 442076018639 | ross.hunter@bartsandthelondon.nhs.uk |
| Name | Affiliation | Role |
|---|---|---|
| Richard J Schilling, MD FRCP | Professor of Cardiology, Barts & The London NHS Trust | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Barts & The London NHS Trust | Recruiting | London | UK | EC1A 7BE | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24382410 | Derived | Hunter RJ, Berriman TJ, Diab I, Kamdar R, Richmond L, Baker V, Goromonzi F, Sawhney V, Duncan E, Page SP, Ullah W, Unsworth B, Mayet J, Dhinoja M, Earley MJ, Sporton S, Schilling RJ. A randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure (the CAMTAF trial). Circ Arrhythm Electrophysiol. 2014 Feb;7(1):31-8. doi: 10.1161/CIRCEP.113.000806. Epub 2014 Jan 1. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Sep 7, 2015 | |
| Reset | Oct 8, 2015 | |
| Release | Apr 29, 2025 | |
| Reset | May 15, 2025 | |
| Release | May 20, 2025 | |
| Reset | Jun 5, 2025 | |
| Release | Jun 6, 2025 | |
| Reset | Jun 18, 2025 | |
| Release | Jul 7, 2025 | |
| Reset | Jul 24, 2025 | |
| Release | Sep 3, 2025 | |
| Reset | Sep 23, 2025 | |
| Release | Dec 30, 2025 | |
| Reset | Jan 16, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 7, 2015 | Oct 8, 2015 | |||
| Apr 29, 2025 |
| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
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| Medical treatment alone | Drug | Medical treatment of persistent AF as 'normal care'. Patients are randomised to medical treatment alone for atrial fibrillation. Treatment will be as per current guidelines for persistent atrial fibrillation, with rate control as first line (using beta-blockers, calcium channel blockers and digoxin as indicated) and rhythm control as second line (using sotalol, dronedarone, or amiodarone as indicated). (Both groups will receive standard heart failure medication including angiotensin converting enzyme inhibitors, beta blockers, aldosterone antagonists, and diuretics as indicated). |
|
| 6 months |
| Difference in Quality of Life between groups | Using SF36 and Minnessota questionaire | 6 months |
| Reduction in end systolic volume | Comparisson between groups of the percentage reduction in left ventricular end systolic volume at 6 months compared to baseline. | 6 months compared to baseline |
| Difference in heart failure symptoms | Comparisson between groups in heart failure symptoms using the Minessota living with heart failure questionaire. | 6 months |
| May 15, 2025 |
| May 20, 2025 | Jun 5, 2025 |
| Jun 6, 2025 | Jun 18, 2025 |
| Jul 7, 2025 | Jul 24, 2025 |
| Sep 3, 2025 | Sep 23, 2025 |
| Dec 30, 2025 | Jan 16, 2026 |
| D013568 |
| Pathological Conditions, Signs and Symptoms |