RecruitingPHASE3INTERVENTIONAL

Early Treatment of Atrial Fibrillation for Stroke Prevention Trial in Acute STROKE

This study, called EAST-STROKE, is investigating the best way to treat an irregular heartbeat called atrial fibrillation (AF) in people who have recently had a stroke. AF can increase your risk of having another stroke or other serious heart issues. Usually, doctors focus on regular care for AF, but this study wants to see if treating it more actively and earlier, possibly with medications to control heart rhythm or special procedures, can prevent further strokes, heart problems, or even death. It compares this early, active treatment to standard care to understand which approach is safer and more effective for people in this situation.

At a glance

Status

Recruiting

Phase

PHASE3

Sponsor

Universitätsklinikum Hamburg-Eppendorf

Enrolment target

1,746

Start

06 Nov 2025

Estimated completion

01 Sep 2031

Acute Ischemic Stroke Atrial Fibrillation

What is this study about?

When you have an irregular heartbeat called atrial fibrillation (AF) and then have a stroke, it's a serious situation. AF is actually a very common reason why people have strokes, and it can also increase your risk of having another stroke or other heart-related problems. Currently, after a stroke, doctors often give medicines to prevent blood clots (anticoagulants) and other medicines to control how fast your heart beats. This is called 'usual care'.

However, some doctors wonder if treating the AF itself more aggressively and earlier could be better. This might involve using special medications to bring your heart back into a regular rhythm, or sometimes procedures like electrical cardioversion (a controlled electric shock to reset the heart) or even a procedure called ablation, which carefully targets parts of the heart causing the irregular rhythm. The main goal of this study is to find out if these earlier and more active treatments of AF can help prevent another stroke, stop other serious heart problems, or even save lives, compared to the usual care.

The EAST-STROKE study is designed to answer this important question. It will compare people who receive these earlier, more active treatments for their AF with those who receive the standard care. By carefully looking at their health over time, researchers hope to understand which approach leads to better long-term health outcomes for stroke patients with AF.

Key takeaways

This study compares early, active treatment of AF with usual care after a stroke.
It aims to see if early AF treatment can prevent more strokes and heart problems.
Participants will be randomly assigned to one of two treatment groups.
The study includes adults who had an ischemic stroke in the last four weeks and newly detected AF.
It seeks to find the best long-term care strategy for these patients.

Who may be eligible?

To be part of this study, you would generally need to have experienced a type of stroke called an ischemic stroke within the last four weeks. An ischemic stroke happens when a blood clot blocks blood flow to your brain. This stroke needs to have been confirmed by brain scans or by your doctor's assessment.

Also, your irregular heartbeat (atrial fibrillation, or AF) must have been first found within the last year before you might join the study. You also need to be able to start the study treatment within four weeks of your stroke and give your permission (informed consent) to take part.

However, there are reasons you might not be able to join. For example, if you have advanced cancer or another serious illness meaning you're not expected to live longer than 12 months, or if you've already had a procedure to treat your AF like ablation surgery. If your heart condition makes it unsuitable for you to have treatments that control your heart rhythm, you also wouldn't be able to participate. This study includes adults aged 18 and older, both men and women.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Did I have an ischemic stroke in the last four weeks?
Was my atrial fibrillation (AF) first found less than a year ago?
Am I able to start treatment within four weeks of my stroke?
Have I not had previous AF ablation or surgery for AF?
Do I not have a serious illness that limits my life expectancy to less than 12 months?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you would be randomly assigned to one of two groups: either to receive enhanced, early treatment for your atrial fibrillation (AF) or to receive the usual care. This means that a computer would decide which group you are in, like flipping a coin.

Depending on your group, the enhanced treatment for AF might involve receiving certain medications to help your heart keep a regular rhythm, or undergoing procedures such as electrical cardioversion (a gentle electrical shock to reset your heart) or ablation (a procedure to correct parts of your heart causing the irregular rhythm). The usual care group would receive standard treatments for AF, which usually focus on controlling your heart rate and preventing blood clots.

You would have regular check-ups and assessments to monitor your health and see how you are responding to the treatment. The study will look at various health measures, including if you have another stroke, if you need to go to hospital for heart-related issues, or other important health events. We don't have information on the exact number of visits or the total length of follow-up for the entire study, but your study team will give you all the details.

Potential risks and benefits

Taking part in a study like this means you might benefit from closer monitoring of your health and potentially receive an early, active treatment for your AF. However, there are no guarantees of personal benefit. As with any medical treatment or procedure, there are potential risks, side effects, or complications associated with both the enhanced AF treatments and usual care. These will be fully explained by the study team so you can understand them. You always have the right to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

University Medical Center Hamburg-Eppendorf
Verified postcode
Hamburg, Germany· Recruiting

Common questions

What is 'atrial fibrillation' (AF)?

AF is a type of irregular and often very fast heartbeat. It can sometimes lead to blood clots forming, which can then travel to the brain and cause a stroke.

What is an 'ischemic stroke'?

An ischemic stroke is the most common type of stroke. It happens when a blood clot blocks an artery that supplies blood to the brain.

What do they mean by 'rhythm control' for AF?

Rhythm control means trying to get your heart back into a regular, steady beat. This can be done with medications, an electrical shock, or a procedure called ablation.

What is 'usual care' for AF and stroke?

Usual care typically involves medicines to prevent blood clots and medications to control how fast your heart beats, rather than trying to restore a normal rhythm.

Will I know which treatment I am getting?

Yes, you and your doctors will know which treatment you are receiving (either early rhythm control or usual care). The people assessing your health outcomes won't know, to keep things fair.

How to find out more

Märit Jensen, MD

m.jensen@uke.de +4940741053770 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.