Atrial Fibrillation
Conditions
Brief summary
Prospective randomized (rhythm control or rate control) Objective of study 1. To analyze long term outcome of patients with acute stroke with atrial fibrillation according to the rhythm control 2. To analyze recurrence rate of atrial fibrillation or recurrence stroke in patients with acute stroke according to the rhythm control (by antiarrhythmic drug, cardioversion, catheter ablation)
Interventions
PROCEDURERhythm control
1. Start AAD right after evaluating for LA size, EF, LA thrombus, and presence of CAD during anticoagulation 2. Cardioversion after 1 month 3. Rhythm FU schedule (2012 ACC/AHA/ESC guidelines) 4. If AF recur, RFCA
PROCEDURERate control
1. No AAD, just anticoagulation 2. HR control between 60\ 110bpm (with beta blocker, calcium channel blocker, digoxin) 3. Without the treatment about antiarrhythmia and rhythm control, deification of rate control, the subject will be drop out for study.
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients with Atrial fibrillation (20\ 80 years old) 2. patients with Acute stroke within 7 days 3. LA diameter \< 55mm 4. patients possible to anticoagulation and anti arrhythmic drug 5. NIHSS score ≤12
Exclusion criteria
1. Hemorrhagic transformation 2. Large cerebral lesion or cerebellar lesion (more than 1/3 of MCA area and 1/2 of ACA area, 1/2 of PCA area, 1/2 of cerebellar area) 3. active internal bleeding 4. Impossible to anticoagulation or anti arrhythmic drug 5. Valvular AF (MA\> GII, Mechanical valve, Mitral valve replacement) 6. LV ejection fraction \< 30% 7. Structural cardiac disease 8. Catheter ablation history for AF, Cardiac surgery 9. Already prescribed anti arrhythmic drugs 10. With severe medical disease 11. Expected survival \< 1year 12. Severe alcoholics, drug addiction 14\. Contraindication to MRI 15. Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| acute stroke with AF | 1 year | Long term outcome of rhythm control in patients with acute stroke with AF related to all cause morality, hospital admission, recurrence rate of stroke, major adverse cardiac events |
| recurrence of silence stroke | 1 year | Adverse events after anticoagulation or anti arrhythmic drug, recurrence rate after RFCA on AF in patients with stroke, adverse events after RFCA, recurrence rate of silence stroke or clinical stroke |
| recurrence of AF after rhythm control | 1 year | Adverse events after anticoagulation or anti arrhythmic drug, recurrence rate after RFCA on AF in patients with stroke, adverse events after RFCA, recurrence rate of silence stroke or clinical stroke |
Countries
South Korea
Contacts
Primary ContactHui-Na Pak, MD
Outcome results
None listed