Status:

RECRUITING

Pulsed Field Ablation Versus Conventional Radiofrequency Catheter Ablation for Repeat PVI in Patients With Paroxysmal AF

Lead Sponsor:

University Medical Center Groningen

Collaborating Sponsors:

Boston Scientific Corporation

Conditions:

Atrial Fibrillation Recurrent

Eligibility:

All Genders

18-80 years

Phase:

NA

Brief Summary

Various methods exist for performing pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF), including thermal ablation and pulse-field ablation (PFA). However, in cases requiring a ...

Detailed Description

All participating patients are required to provide written (or equivalent) informed consent, indicated by a dated signature of the subject or legal representative. The consent process must comply with...

Eligibility Criteria

Inclusion

  • Subjects who meet all of the following inclusion criteria at screening will be eligible for enrolment:
  • Patient had 1 previous PVI with either cryoballoon, RF ablation or PFA
  • Index PVI occurred within \<5 years prior to enrolment
  • Documented AF recurrence \>30 seconds
  • Symptomatic AF
  • Paroxysmal AF
  • Age \>18 and \<80 years
  • Willing and capable to provide informed consent
  • Able and willing to participate in all examinations and follow-up visits and tests associated with this clinical study
  • Subjects who meet ANY of the following exclusion criteria will be excluded from the study:
  • Persistent AF (by diagnosis of duration \>7 days)
  • Concomitant/ prior diagnosis for atrial tachycardia (AT) and/or atrial flutter (AFl). Note typical cavotricuspid isthmus dependent flutter is not an exclusion criterium.
  • Underwent additional ablations outside the pulmonary veins during index AF ablation
  • AF secondary to electrolyte imbalance, thyroid disease, alcohol abuse, or other reversible/non-cardiac causes
  • Contraindication to, or unwillingness to use, systematic anticoagulation
  • Left ventricular ejection fraction (LVEF) \<30% as documented by transthoracic echo (TTE) (within \<3 months prior)
  • Left atrial volume index \>60 ml/m2
  • Clinically significant arrhythmias other than AF
  • Previous surgery for AF
  • New York Heart Association (NYHA) Functional Class III or IV
  • Presence of intramural thrombus, tumour or other abnormality that precludes safe catheter introduction or manipulation
  • BMI \>35 kg/m2
  • Significant or symptomatic hypotension, bradycardia, or chronotropic incompetence
  • Chronic renal insufficiency of \<15 mL/min/1.73 m2 or any history of renal dialysis, or history of renal transplant
  • Hemodynamically significant valvular disease
  • Presence of patent foramen ovale (PFO) or atrial septal defect (ASD) closure device
  • History of abnormal bleeding and/or clotting disorder
  • History of rheumatic fever
  • Severe lung disease, pulmonary hypertension, or any lung disease. Only if involving abnormal blood gases or significant dyspnoea
  • Clinically significant systemic infection or sepsis
  • Life expectancy \<1 year
  • Sensitivity to contrast media not controlled by pre-medication
  • Any of the following within the 3 months prior to enrolment:
  • Myocardial infarction
  • Unstable angina
  • Percutaneous coronary intervention
  • Heart failure hospitalization
  • Stroke or TIA
  • Significant bleeding
  • Pericarditis/effusions
  • Left atrial thrombus
  • Coronary artery bypass grafting/atriotomy within 6 months prior
  • Organ or haematologic transplant, or currently being evaluated for an organ transplant
  • Women who are pregnant or breastfeeding

Exclusion

    Key Trial Info

    Start Date :

    September 20 2024

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    September 1 2028

    Estimated Enrollment :

    154 Patients enrolled

    Trial Details

    Trial ID

    NCT06199180

    Start Date

    September 20 2024

    End Date

    September 1 2028

    Last Update

    December 10 2024

    Active Locations (1)

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    UMCG

    Groningen, Netherlands, 9713GZ