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Atrial FIbrillation Treatment With Cryoballoon in Heart failurE (AFICHE)

Effect of Cryoballoon Pulmonary Vein Isolation on Atrial Fibrillation Burden and Clinical Endpoints in Patients With Heart Failure With Impaired Left Ventricular Systolic Function

Status
UNKNOWN
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03573869
Acronym
AFICHE
Enrollment
404
Registered
2018-06-29
Start date
2018-06-01
Completion date
2022-06-01
Last updated
2018-07-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Atrial Fibrillation, Heart Failure, Systolic

Brief summary

In this study 404 patients with heart failure and an ejection fraction of 0.40 or less, with paroxysmal atrial fibrillation, will be randomly assigned to standard treatment or standard treatment plus a session of cryoballoon ablation (left atrial balloon cryoablation for pulmonary vein isolation). All patients with either have an ICD or CRT-D/P device implanted or an implantable electrocardiographic monitoring device. The primary study endpoint will be the time to AF burden exceeding 1% over any 30-day period (calculated as the ratio of time spent in AF over total time).16 This AF burden corresponds to 7.2 hours per month. A powered secondary endpoint will be the time to the composite of all-cause mortality and unplanned hospitalization for heart failure.

Interventions

PROCEDURECryoballoon ablation

Left atrial ablation using cryoballoon to achieve pulmonary vein isolation

Sponsors

G.Gennimatas General Hospital
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* A minimum of at least two separate AF episodes recorded within the last 12 months, either on 12-lead rest ECG or on ambulatory ECG recordings (at least 5 minutes of AF on Holter recordings will be required), * LVEF \<40% on sinus rhythm, * symptoms consistent with heart failure (New York Heart Association II or higher) despite rate control treatment, * age \>21 years old.

Exclusion criteria

* previous left atrial ablation, * left atrial diameter \>28 mm/m2 BSA on TTE (parasternal long axis view), * strong clinical suspicion that reduced LVEF is primarily due to tachycardiomyopathy, * pre-existing device (ICD or CRT) without AF detection algorithms and/or (for CRT devices) diagnostics of effective biventricular pacing, * known primary electrical heart disease (e.g. Brugada syndrome), * presence of thrombus in a heart chamber, * presence of prosthetic valve at any position, * moderate/severe valvular heart disease, * active infectious disease or malignancy, * moderate or severe hepatic impairment (Child-Pugh class B or C), * severe renal failure (estimated glomerular filtration rate \<20 ml/min/1.73 m2), * inability or unwillingness to adhere to standard treatment or to provide consent.

Design outcomes

Primary

MeasureTime frameDescription
Time to exceed AG burden cut-off of 1%Up to 2 yearsThe time to AF burden exceeding 1% over any 30-day period (calculated as the ratio of time spent in AF over total time)

Secondary

MeasureTime frameDescription
All-cause mortality or hospitalization for heart failureUp to 2 yearsTime to the composite of all-cause mortality and unplanned hospitalization for heart failure

Countries

Greece

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026