Trial Outcomes & Findings for New Formulations of Propafenone to Treat Atrial Fibrillation (NCT NCT02710669)

NCT ID: NCT02710669

Last Updated: 2022-06-03

Results Overview

A rapid atrial pacing protocol was used to attempt to induce atrial fibrillation/atrial flutter. Twenty minutes after start of the study drug, participants underwent placement of a decapolar coronary sinus catheter. Pacing was performed from the proximal electrode at 20 milliamps and a pulse width of 2 ms. Bursts from the CS proximal electrode were induced to attempt atrial fibrillation.

Recruitment status

TERMINATED

Study phase

PHASE1/PHASE2

Target enrollment

193 participants

Primary outcome timeframe

Twenty minutes post-dosage to end of induction protocol (approximately 10 minutes)

Results posted on

2022-06-03

Participant Flow

193 participants were enrolled. 1 participant withdrew consent prior to randomization.

Participant milestones

Participant milestones
Measure
(R)-Propafenone
Single intravenous dose of (R)-propafenone (1mg/kg) infused over 10 minutes (R)-propafenone
(S)-Propafenone
Single intravenous dose of (S)-propafenone (1mg/kg) infused over 10 minutes (S)-Propafenone
Placebo
Placebo (normal saline) is infused over 10 minutes Placebo
Overall Study
STARTED
85
86
21
Overall Study
COMPLETED
71
75
19
Overall Study
NOT COMPLETED
14
11
2

Reasons for withdrawal

Reasons for withdrawal
Measure
(R)-Propafenone
Single intravenous dose of (R)-propafenone (1mg/kg) infused over 10 minutes (R)-propafenone
(S)-Propafenone
Single intravenous dose of (S)-propafenone (1mg/kg) infused over 10 minutes (S)-Propafenone
Placebo
Placebo (normal saline) is infused over 10 minutes Placebo
Overall Study
Physician Decision
2
1
0
Overall Study
Institutional delays (including COVID)
2
2
0
Overall Study
arrived in afib/aflutter
10
8
2

Baseline Characteristics

New Formulations of Propafenone to Treat Atrial Fibrillation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
(R)-Propafenone
n=85 Participants
Single intravenous dose of (R)-propafenone (1mg/kg) infused over 10 minutes (R)-propafenone
(S)-Propafenone
n=86 Participants
Single intravenous dose of (S)-propafenone (1mg/kg) infused over 10 minutes (S)-Propafenone
Placebo
n=21 Participants
Placebo (normal saline) is infused over 10 minutes Placebo
Total
n=192 Participants
Total of all reporting groups
Age, Continuous
62 years
n=99 Participants
64 years
n=107 Participants
59 years
n=206 Participants
63 years
n=7 Participants
Sex: Female, Male
Female
38 Participants
n=99 Participants
35 Participants
n=107 Participants
8 Participants
n=206 Participants
81 Participants
n=7 Participants
Sex: Female, Male
Male
47 Participants
n=99 Participants
51 Participants
n=107 Participants
13 Participants
n=206 Participants
111 Participants
n=7 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
85 Participants
n=99 Participants
86 Participants
n=107 Participants
21 Participants
n=206 Participants
192 Participants
n=7 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
2 Participants
n=7 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
2 Participants
n=107 Participants
0 Participants
n=206 Participants
3 Participants
n=7 Participants
Race (NIH/OMB)
White
84 Participants
n=99 Participants
83 Participants
n=107 Participants
20 Participants
n=206 Participants
187 Participants
n=7 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Region of Enrollment
United States
85 participants
n=99 Participants
86 participants
n=107 Participants
21 participants
n=206 Participants
192 participants
n=7 Participants

PRIMARY outcome

Timeframe: Twenty minutes post-dosage to end of induction protocol (approximately 10 minutes)

Population: 27 Participants not analyzed as follows: R GROUP: (1) prolonged pharmacy time compounding the study med; (8) arrived in atrial fib/flutter; (1) physician withdrew due to PAC's; (1) took antiarrhythmic prior to ablation; (1) difficult anatomy (1) ischemia on MRI; (1) Due to COVID the lab halted elective research. S GROUP: (7) arrived in afib; (1) clot on TEE; (1) elevated anxiety in patient; (1) procedure scheduled late in day; (1) cardiac cath work-up needed. PLACEBO GROUP: (2) arrived in afib

A rapid atrial pacing protocol was used to attempt to induce atrial fibrillation/atrial flutter. Twenty minutes after start of the study drug, participants underwent placement of a decapolar coronary sinus catheter. Pacing was performed from the proximal electrode at 20 milliamps and a pulse width of 2 ms. Bursts from the CS proximal electrode were induced to attempt atrial fibrillation.

Outcome measures

Outcome measures
Measure
(R)-Propafenone
n=71 Participants
Single intravenous dose of (R)-propafenone (1mg/kg) infused over 10 minutes (R)-propafenone
(S)-Propafenone
n=75 Participants
Single intravenous dose of (S)-propafenone (1mg/kg) infused over 10 minutes (S)-Propafenone
Placebo
n=19 Participants
Placebo (normal saline) is infused over 10 minutes Placebo
Number of Participants With Successful Induction of 30 Seconds of Atrial Fibrillation/Atrial Flutter
Sustained AF and/or AFL induced
60 Participants
60 Participants
12 Participants
Number of Participants With Successful Induction of 30 Seconds of Atrial Fibrillation/Atrial Flutter
Non-sustained AF and/or AFL induced
11 Participants
15 Participants
7 Participants

SECONDARY outcome

Timeframe: Twenty minutes post-dosage to end of induction protocol (approximately 10 minutes)

Population: 27 Participants not analyzed as follows: R GROUP: (1) prolonged pharmacy time compounding the study med; (8) arrived in atrial fib/flutter; (1) physician withdrew due to PAC's; (1) took antiarrhythmic prior to ablation; (1) difficult anatomy (1) ischemia on MRI; (1) Due to COVID the lab halted elective research. S GROUP: (7) arrived in afib; (1) clot on TEE; (1) elevated anxiety in patient; (1) procedure scheduled late in day; (1) cardiac cath work-up needed. PLACEBO GROUP: (2) arrived in afib

Inducibility of atrial fibrillation (AF) or atrial flutter (AFL) expressed as an ordinal variable based on stage of the induction protocol. * Stage 1 measured the AV block (Wenckebach) cycle length (AVBCL), AV node effective refractory period (AVN ERP) and atrial ERP (AERP). AVN ERP and AERP were measured at drive trains (S1) of 600 ms and 450 ms. Extrastimuli (S2) were introduced starting at a coupling interval of 500ms and decremented by 10ms with each pacing train. * Stage 2 consisted of 15-beat bursts from the CS proximal electrode. The starting cycle length was 250ms, which was decremented by 10ms with each burst. A 10-second rest period was used between bursts. Step 2 was complete when 1:1 atrial capture was lost or a minimum cycle length of 180ms was reached. Stage 3 consisted of 15-second bursts. The cycle length used for the bursts was the fastest cycle length achieved during Step 2 that maintained 1:1 atrial conduction.

Outcome measures

Outcome measures
Measure
(R)-Propafenone
n=71 Participants
Single intravenous dose of (R)-propafenone (1mg/kg) infused over 10 minutes (R)-propafenone
(S)-Propafenone
n=75 Participants
Single intravenous dose of (S)-propafenone (1mg/kg) infused over 10 minutes (S)-Propafenone
Placebo
n=19 Participants
Placebo (normal saline) is infused over 10 minutes Placebo
Number of Participants With Successful Inducibility of Atrial Fibrillation/Atrial Flutter Expressed as an Ordinal Variable Based on Stage of the Induction Protocol
Stage 1
5 Participants
5 Participants
1 Participants
Number of Participants With Successful Inducibility of Atrial Fibrillation/Atrial Flutter Expressed as an Ordinal Variable Based on Stage of the Induction Protocol
Stage 2
28 Participants
31 Participants
3 Participants
Number of Participants With Successful Inducibility of Atrial Fibrillation/Atrial Flutter Expressed as an Ordinal Variable Based on Stage of the Induction Protocol
Stage 3
27 Participants
24 Participants
8 Participants
Number of Participants With Successful Inducibility of Atrial Fibrillation/Atrial Flutter Expressed as an Ordinal Variable Based on Stage of the Induction Protocol
Non-inducible AF/AFL
11 Participants
15 Participants
7 Participants

SECONDARY outcome

Timeframe: Twenty minutes post-dosage to end of induction protocol (approximately 10 minutes)

Population: 27 Participants not analyzed as follows: R GROUP: (1) prolonged pharmacy time compounding the study med; (8) arrived in atrial fib/flutter; (1) physician withdrew due to PAC's; (1) took antiarrhythmic prior to ablation; (1) difficult anatomy (1) ischemia on MRI; (1) Due to COVID the lab halted elective research. S GROUP: (7) arrived in afib; (1) clot on TEE; (1) elevated anxiety in patient; (1) procedure scheduled late in day; (1) cardiac cath work-up needed. PLACEBO GROUP: (2) arrived in afib

A rapid atrial pacing protocol was used to attempt to induce atrial flutter. Twenty minutes after start of the study drug, participants underwent placement of a decapolar coronary sinus catheter. Pacing was performed from the proximal electrode at 20 milliamps and a pulse width of 2 ms. Bursts from the CS proximal electrode were induced to attempt atrial flutter.

Outcome measures

Outcome measures
Measure
(R)-Propafenone
n=71 Participants
Single intravenous dose of (R)-propafenone (1mg/kg) infused over 10 minutes (R)-propafenone
(S)-Propafenone
n=75 Participants
Single intravenous dose of (S)-propafenone (1mg/kg) infused over 10 minutes (S)-Propafenone
Placebo
n=19 Participants
Placebo (normal saline) is infused over 10 minutes Placebo
Number of Participants With Successful Induction of 30 Seconds of Atrial Flutter
Sustained AFL
23 Participants
26 Participants
1 Participants
Number of Participants With Successful Induction of 30 Seconds of Atrial Flutter
Non-Sustained AFL
48 Participants
49 Participants
18 Participants

Adverse Events

(R)-Propafenone

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

(S)-Propafenone

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Benjamin Shoemaker, MD

Vanderbilt University Medical Center

Phone: 615-322-2318

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place