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NCT04267159Recruiting

Acute Atrial Fibrillation and Flutter Treated Electively

Acute Atrial Fibrillation and Flutter Treated Electively - A Randomized Controlled Clinical Trial on the Safety of Elective Management of Acute Atrial Fibrillation and Flutter

Source: ClinicalTrials.gov · Last updated 22 May 2026

Brief summary (registry, in English)

The AFFELECT -study compares two types of treatment modalities for acute atrial fibrillation or flutter for patients in whom rhythm control is desirable. The main purpose is to observe if these arrhythmias can be safely treated electively (within 5-9 days). All patients are recruited in the emergency department. Patients must be in good clinical condition so that they can be discharged regardless to which treatment modality is randomly selected to them. Patients randomized to conventional care are treated conventionally which means acute rhythm control is applied by electrical or medical cardioversion in the emergency department (within 48 hours of onset of the arrhythmia). Patients randomized to elective care are discharged immediately after adequate temporary rhythm control is assured. All patients will visit a cardiologist out-patient clinic at approximately one week after the emergency room visit. Patients randomized to elective treatment and still in atrial fibrillation or in atrial flutter will be restored to sinus rhythm by electrical or medical cardioversion at the out-patient clinic. Cardiovascular status and treatment options are evaluated for all patients. Anticoagulation is managed according existing guidelines for all patients. Due to possibility of delayed cardioversion in the interventional group (elective care group), all patients receive anticoagulation before the out-patient clinic despite their thromboembolic risk. All patients who have not received adequate anticoagulation for three weeks prior to the delayed cardioversion will undergo a transesophageal cardiac ultrasound to ensure they are not in excess risk for thromboembolic events. Patients randomized to elective treatment have the possibility to opt-out and undergo acute cardioversion if their symptoms are unmanageable during the first week before the out-patient clinical. All patients are monitored for their symptoms by a standardized quality-of-life questionnaire and for possibly required acute medical interventions during the first week and one month after the out-patient clinic. After one month, all patients undergo an electrocardiography (ECG) to ensure the maintenance of normal rhythm in both treatment groups. After the months follow-up all patients are subsequently monitored for a maximum of five years for need of medical interventions due to atrial fibrillation of atrial flutter. New antiarrhythmics such as flecainide are not prescribed during the first month.

Status (registry)
Recruiting
Study type
Interventional
Enrollment
500 (estimated)
First submitted
10 Feb 2020
Start date
10 Feb 2020
Primary completion date
Jun 2027
Lead sponsor
Tampere University
NCT number
NCT04267159

What you commit to

  • Study type: Interventional
  • Planned participants: 500
  • From 10 Feb 2020 to the primary completion date, Jun 2027
  • 4 sites in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Other illness

  • No other major complicating acute illness (e.g. decompensated HF or acute MI)
  • Mechanical heart valve or mitral stenosis
  • Exceptionally high risk for thromboembolic events (e.g. history of thromboembolic stroke regardless of adequate anticoagulation)

Other

  • Haemodynamically stable (mean arterial pressure above 60mmHg)
  • Need for acute restoration of sinus rhythm due to some other somatic cause
  • Anticoagulation not safe
  • The need for prolonged (\>24h) hospitalization due to any cause
  • Transesophageal echocardiography contraindicated

Who the study is looking for

  • Patients presenting with acute (\<48hours) atrial fibrillation or atrial flutter to ER
  • Planned acute rhythm control for the arrhythmia by the attending physician in ER
  • Good perceived health as assessed by attending physician in ER
  • Resting heart rate 110bpm or lower before or after adequate rate control therapy

Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (4)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Kanta-Häme Central Hospital
Coordinator of this site? Confirm its status
HämeenlinnaFinlandRecruiting
Central Finland Central Hospital
Coordinator of this site? Confirm its status
JyväskyläFinlandRecruiting
Päijät-Häme Central Hospital
Coordinator of this site? Confirm its status
LahtiFinlandNot yet recruiting
Tampere University Hospital
Coordinator of this site? Confirm its status
TampereFinlandRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.