CLOSE-guided Pulmonary Vein Isolation Using High Power and Stable RF Applications

NCT ID: NCT04122963

Last Updated: 2021-02-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-15

Study Completion Date

2020-06-30

Brief Summary

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In this prospective, randomised, controlled, unblinded,monocentric study, we aim to evaluate the safety and efficacy of higher power CLOSE-guided PVI in patients referred for a first ablation for paroxysmal AF. We aim to include 100 patients into two groups (1:1). The experimental group will receive AF ablation with 45 Watt and stricter stability criteria (3 mm for 3 seconds) compared to the control group which will receive AF ablation according to the standard CLOSE-protocol (35 Watt and stability criteria of 3 mm for 8 seconds).

Detailed Description

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BACKGROUND: In a population of paroxysmal AF 'CLOSE'-guided PVI (Target Ablation index (AI) \>550 and \>400 for anterior and posterior wall respectively, interlesion distance ≤6mm) has been shown to obtain single-procedure durable PV isolation. However, the optimal RF power and stability criteria is unknown.

OBJECTIVES: With this study, we aim at evaluation the efficacy and the safety of higher power (45 watts) and stricter stability criteria (3 mm for 3 sec) as compared to a standard CLOSE protocol (35 watts with stability of 3 mm for 8 sec) in patients referred for a first ablation for paroxysmal AF.

POPULATION: Eligible patients are patients with paroxysmal AF who are planned for a 'CLOSE'-guided PV isolation for paroxysmal AF. At the time of the procedrual planning, we will ask the patient his/her consent for collectio of data. We aim at including 100 patients.

Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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High power group

The experimental group will receive AF ablation with 45 Watt and stricter stability criteria (3 mm for 3 seconds).

Group Type ACTIVE_COMPARATOR

High power CLOSE-guided PVI ablation

Intervention Type PROCEDURE

CLOSE-guided PVI ablation with 45 Watt and stricter stability criteria (3 mm for 3 seconds)

Standard group

The control group will receive AF ablation according to the standard CLOSE-protocol (35 Watt and stability criteria of 3 mm for 8 seconds)

Group Type ACTIVE_COMPARATOR

Standard CLOSE-guided PVI ablation

Intervention Type PROCEDURE

Standard AF ablation according to the CLOSE-protocol

Interventions

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High power CLOSE-guided PVI ablation

CLOSE-guided PVI ablation with 45 Watt and stricter stability criteria (3 mm for 3 seconds)

Intervention Type PROCEDURE

Standard CLOSE-guided PVI ablation

Standard AF ablation according to the CLOSE-protocol

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All patients referred for symptomatic paroxysmal AF and without advanced structural heart disease
* Signed Patient Informed Consent Form
* Age 18 years or older
* Able and willing to comply with all follow-up testing and requirements

Exclusion Criteria

* Persistent atrial fibrillation (history of AF\>7days or history of cardioversion \> 48h of AF)
* Previous ablation for AF
* LA antero-posterior diameter\>50 mm (parasternal long axis view , PLAX)
* LVEF \<35% (ejection fraction)
* AF secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause
* CABG procedure within the last three months
* Awaiting cardiac transplantation or other cardiac surgery
* Documented left atrial thrombus on imaging
* Diagnosed atrial myxoma
* Women who are pregnant or breastfeeding
* Acute illness or active systemic infection or sepsis
* Unstable angina
* Uncontrolled heart failure
* Myocardial infarction within the previous two months
* History of blood clotting or bleeding abnormalities
* Contraindication to anticoagulation therapy (ie, heparin or warfarin)
* Life expectancy less than 12 months
* Enrollment in any other study evaluating another device or drug
* Presence of intramural thrombus, tumor or other abnormality that precludes catheter introduction
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AZ Sint-Jan AV

OTHER

Sponsor Role lead

Responsible Party

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Sebastien Knecht

Professor Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Cardiology

Bruges, , Belgium

Site Status

Countries

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Belgium

References

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Wielandts JY, Kyriakopoulou M, Almorad A, Hilfiker G, Strisciuglio T, Phlips T, El Haddad M, Lycke M, Unger P, Le Polain de Waroux JB, Vandekerckhove Y, Tavernier R, Duytschaever M, Knecht S. Prospective Randomized Evaluation of High Power During CLOSE-Guided Pulmonary Vein Isolation: The POWER-AF Study. Circ Arrhythm Electrophysiol. 2021 Jan;14(1):e009112. doi: 10.1161/CIRCEP.120.009112. Epub 2020 Dec 10.

Reference Type RESULT
PMID: 33300809 (View on PubMed)

Other Identifiers

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2406

Identifier Type: -

Identifier Source: org_study_id

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