Ablation for Atrial Fibrillation and Heart Failure

(AMPERE Trial)

Not currently recruiting at 1 trial location
EY
CT
EY
TP
Overseen ByTracy Plummer
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Johns Hopkins University
Must be taking: Diuretics
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether a heart procedure called pulmonary vein isolation (PVI) is more effective than standard medications for treating atrial fibrillation in individuals with heart failure with preserved ejection fraction (HFpEF). Participants will be divided into two groups: one will undergo the PVI procedure, while the other will continue with standard medical management. Ideal candidates for this trial are those experiencing heart failure symptoms and dealing with recurrent or ongoing atrial fibrillation. As an unphased trial, this study provides participants the chance to contribute to important research that could enhance treatment options for heart conditions.

Do I need to stop my current medications for the trial?

The trial information does not specify if you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that pulmonary vein isolation is safe for atrial fibrillation in patients with heart failure?

Research has shown that pulmonary vein isolation (PVI), a treatment for atrial fibrillation (AF), is generally safe. In a large study involving over 18,000 patients, PVI achieved a long-term success rate of about 43% for treating non-paroxysmal AF, indicating effectiveness for less than half of the patients over time. Regarding safety, another study found that 2.3% of patients experienced major safety issues, including serious but rare events like inflammation of the heart lining (pericarditis) and heart attacks.

Over the past 30 years, PVI has been recognized as a safe and effective treatment for AF. While risks exist, they are generally low, and many patients handle the procedure well. However, understanding the potential risks and discussing them with a doctor is important.12345

Why are researchers excited about this trial?

Researchers are excited about Pulmonary Vein Isolation (PVI) for atrial fibrillation and heart failure because it offers a unique approach compared to traditional medical management. While standard treatments often rely on medication to control heart rhythm, PVI directly targets the areas in the heart that trigger irregular beats by isolating the pulmonary veins. This technique aims to provide a more permanent solution by addressing the root cause of atrial fibrillation, potentially reducing symptoms and improving heart function. By focusing on the precise source of the arrhythmia, PVI has the potential to offer a more effective and long-lasting outcome for patients.

What evidence suggests that pulmonary vein isolation might be an effective treatment for atrial fibrillation in patients with heart failure?

Research shows that pulmonary vein isolation (PVI), a procedure participants in this trial may receive, can reduce episodes of atrial fibrillation (AF), a type of irregular heartbeat. Studies have found that PVI significantly lowers the chances of AF recurrence and reduces hospital visits due to irregular heartbeats. One study found that PVI was 63.5% effective one year after the procedure. Additionally, patients with heart failure and normal heart pumping function (HFpEF) experienced fewer hospital visits for heart failure soon after undergoing PVI. These findings suggest that PVI might help manage AF symptoms in patients with HFpEF.24678

Who Is on the Research Team?

BA

Brett Atwater, MD

Principal Investigator

Inova Heart and Vascular Institute

EY

Eunice Yang, MD PhD

Principal Investigator

Inova Heart and Vascular Institute

Are You a Good Fit for This Trial?

This trial is for adults aged 18-90 with heart failure symptoms treated by diuretics, documented atrial fibrillation in the last 3 months, specific echocardiographic findings of structural heart disease, and elevated BNP or NT-proBNP levels. Exclusions include life expectancy under a year, recent cardiac events or procedures, severe other conditions like pulmonary hypertension not due to HFpEF, uncontrolled thyroid issues or blood pressure, extreme obesity (BMI >65), and certain previous treatments.

Inclusion Criteria

I currently have symptoms of heart failure.
I was hospitalized for heart failure and treated with IV fluids within the last year.
I have been on diuretics for heart failure symptoms for at least 30 days.
See 6 more

Exclusion Criteria

I cannot take long-term blood thinners or heparin.
Your blood pressure is very high, even when you are resting.
You are on the waiting list for a heart transplant.
See 18 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo either pulmonary vein isolation (PVI) or medical management for atrial fibrillation

6 months
Routine post-procedural follow-up visits

Follow-up

Participants are monitored for changes in quality of life, NT pro-BNP levels, exercise capacity, and AF burden

12 months
Multiple follow-up assessments at 3, 6, 9, and 12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Pulmonary Vein Isolation
Trial Overview The study compares two approaches for managing atrial fibrillation in patients with Heart Failure with preserved Ejection Fraction: Pulmonary Vein Isolation (a type of surgical procedure) versus standard medical management. Participants are randomly assigned to one of these treatment paths to evaluate their effectiveness.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Pulmonary Vein Isolation (PVI) GroupExperimental Treatment1 Intervention
Group II: Medical ManagementActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials
2,366
Recruited
15,160,000+

Biosense Webster, Inc.

Industry Sponsor

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128
Recruited
37,100+
Dr. Nick West profile image

Dr. Nick West

Biosense Webster, Inc.

Chief Medical Officer

MD from Harvard Medical School

Jasmina Brooks profile image

Jasmina Brooks

Biosense Webster, Inc.

Chief Executive Officer since 2023

Bachelor of Science in Biomedical Engineering from Louisiana Tech University

Medtronic

Industry Sponsor

Trials
627
Recruited
767,000+
Geoff Martha profile image

Geoff Martha

Medtronic

Chief Executive Officer since 2020

Finance degree from Penn State University

Dr. Richard Kuntz profile image

Dr. Richard Kuntz

Medtronic

Chief Medical Officer since 2023

MD, MSc

Citations

Comparing outcomes after pulmonary vein isolation in ...Reductions in HF and arrhythmia hospitalizations are observed early after PVI across all patients with HF, but patients with HFpEF demonstrate higher HF ...
Pulsed Field Ablation for Persistent Atrial FibrillationPrimary effectiveness was 63.5% (57.3% lower confidence limit) at 1 year, with 8.5% patients having a single, isolated atrial fibrillation ...
Five-Year Outcomes after Segmental Pulmonary Vein ...Overall five-year outcomes after PVI for PAF are consistent with previously reported shorter term follow-up (≤2 years); however, late recurrences (>2 years) ...
Abstract 4139264: Outcomes Of Pulmonary Vein Isolation ...Our analysis revealed a significant improvement in AF recurrence for the cryoablation technique with PVI+PWI (RR=0.56, 95% CI: 0.41, 0.76, I2=0% ...
Outcomes of Atrial Fibrillation Ablation Among Older Adults ...The purpose of this study was to evaluate patient characteristics, population rates, and 30-day outcomes of PVI in a nationwide sample of US adults aged >65 ...
Acute and long-term outcomes of pulmonary vein isolation ...A meta-analysis involving 18,657 patients with non-paroxysmal AF showed that the long-term success rate of a single PVI was only 43% (3). Various combined ...
2024 European Heart Rhythm Association ... - Oxford AcademicIn the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the ...
Effect of Catheter Ablation Using Pulmonary Vein Isolation ...Meta-analyses had reported a single procedure success for catheter ablation for persistent AF ranging from 43% to 67%. In an attempt to improve ...
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