NCT03554330

Brief Summary

Though graded balloon-atrial-septostomy (BAS) has been accepted as an effective palliative therapy for severe pulmonary arterial hypertension, spontaneous closure of septostomy is not uncommon. Radiofrequency-catheter-ablation (RFA), which has the potential to cause irreversible damage around the rim of created inter-atrial communication, might contribute to prevent the spontaneous closure. In patients with severe pulmonary arterial hypertension, the combined use of RFA and BAS (CURB) is investigated to create a stable inter-atrial communication.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
90

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jul 2018

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 31, 2018

Completed
13 days until next milestone

First Posted

Study publicly available on registry

June 13, 2018

Completed
29 days until next milestone

Study Start

First participant enrolled

July 12, 2018

Completed
4.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 30, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 30, 2022

Completed
Last Updated

November 16, 2022

Status Verified

November 1, 2022

Enrollment Period

4.5 years

First QC Date

May 31, 2018

Last Update Submit

November 11, 2022

Conditions

Keywords

pulmonary arterial hypertensionballoon atrial septostomyradiofrequency catheter ablationspontaneous closure

Outcome Measures

Primary Outcomes (1)

  • The size change of the fenestration created with atrial septostomy

    The changes of the fenestration-size will be followed up in three different groups

    12 months

Secondary Outcomes (3)

  • The exercise tolerance

    12 months

  • The systemic arterial oxygen saturation

    12 months

  • World Health Organization functional class

    12 months

Study Arms (3)

control group

ACTIVE COMPARATOR

Only graded balloon atrial septostomy is carried out, and no radiofrequency catheter ablation is performed.

Other: Balloon atrial septostomy

single-RFA group

EXPERIMENTAL

After graded balloon atrial septostomy procedure identical to control group, radiofrequency catheter ablation will be performed immediately around the rim of created inter-atrial fenestration.

Other: Radiofrequency catheter ablationOther: Balloon atrial septostomy

double-RFA group

EXPERIMENTAL

The first step is radiofrequency catheter ablation on fossae ovalis; and then the other two steps are identical to the single-RFA group (graded balloon atrial septostomy and radiofrequency catheter ablation around the rim of fenestration).

Other: Radiofrequency catheter ablationOther: Balloon atrial septostomy

Interventions

(1) In control group: only graded balloon atrial septostomy will be carried out and there is no radiofrequency catheter ablation. (2) In single-RFA group: after graded balloon atrial septostomy identical to control group, radiofrequency catheter ablation will be performed immediately around the rim of created inter-atrial fenestration. (3) In double-RFA group: the first step is radiofrequency catheter ablation on fossae ovalis; and then the other two steps are identical to the single-RFA group (BAS and RFA around the rim of fenestration).

double-RFA groupsingle-RFA group

Graded balloon atrial septostomy is performed in all patients.

control groupdouble-RFA groupsingle-RFA group

Eligibility Criteria

Age18 Years - 60 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Idiopathic severe pulmonary arterial hypertension;
  • Severe pulmonary arterial hypertension associated with repaired congenital heart disease;
  • World Health Organization functional class III or IV with right heart failure refractory to medical therapy;
  • Severe syncopal symptoms;

You may not qualify if:

  • Mean right atrial pressure \>20 mm Hg;
  • Room-air resting arterial oxygen saturation \<85%;
  • Left ventricular end diastolic pressure (LVEDP) \>18mm Hg;
  • Pulmonary vascular resistance \>55 wood units/m2.
  • Severe right ventricular failure on cardio-respiratory support
  • The predicted one-year survival \<40%;

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences,Fuwai Hospital

Beijing, Beijing Municipality, 100037, China

RECRUITING

Related Publications (2)

  • Yan C, Wan L, Li H, Wang C, Guo T, Niu H, Li S, Yundan P, Wang L, Fang W. First in-human modified atrial septostomy combining radiofrequency ablation and balloon dilation. Heart. 2022 Oct 13;108(21):1690-1698. doi: 10.1136/heartjnl-2022-321212.

  • Yan C. Is combined use of radiofrequency ablation and balloon dilation the future of interatrial communications? Expert Rev Cardiovasc Ther. 2022 Nov;20(11):895-903. doi: 10.1080/14779072.2022.2144233. Epub 2022 Nov 10.

MeSH Terms

Conditions

Pulmonary Arterial Hypertension

Interventions

Catheter Ablation

Condition Hierarchy (Ancestors)

Hypertension, PulmonaryLung DiseasesRespiratory Tract Diseases

Intervention Hierarchy (Ancestors)

Radiofrequency AblationRadiofrequency TherapyTherapeuticsAblation TechniquesSurgical Procedures, Operative

Study Officials

  • Chaowu Yan, PhD and MD

    National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences,Fuwai Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Chaowu Yan, PhD and MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
CARE PROVIDER, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 31, 2018

First Posted

June 13, 2018

Study Start

July 12, 2018

Primary Completion

December 30, 2022

Study Completion

December 30, 2022

Last Updated

November 16, 2022

Record last verified: 2022-11

Locations