Ultrasound-Based Renal Sympathetic Denervation as Adjunctive Upstream Therapy During Atrial Fibrillation Ablation

NCT ID: NCT04182620

Last Updated: 2025-05-08

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

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-08

Study Completion Date

2025-02-26

Brief Summary

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The purpose of the ULTRA-HFIB Pilot is to determine the role of adjunctive renal denervation (RDN) in the prevention of Atrial Fibrillation (AF) recurrence in patients scheduled for an AF ablation procedure. Patients will be randomized to either i) AF ablation (Control) or ii) AF ablation + renal sympathetic denervation (Intervention).

Detailed Description

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The purpose of the ULTRA-HFIB Pilot is to determine the role of adjunctive renal denervation (RDN) in the prevention of AF recurrence in patients scheduled for an AF ablation procedure. Patients will be randomized to either i) AF ablation (Control) or ii) AF ablation + renal sympathetic denervation (Intervention). This is a prospective, controlled, single-blind, randomized trial. The pilot study will be conducted in up to 11 clinical sites in the United States and Europe.

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

DOUBLE

Participants Outcome Assessors
Patients will be blinded until the 6 month visit, at which time they will be un-blinded prior to the follow up CT/MRI. The Clinical Events Committee and Echo Core Lab will remain blinded throughout the trial. In general, the CEC will be blinded to the treatment arms. However, once the nature of the event has been adjudicated, the blind will be broken for that individual patient as necessary to enable the CEC to determine relatedness to the study device.

Study Groups

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Catheter ablation + renal denervation

Catheter ablation + renal denervation

Group Type EXPERIMENTAL

renal denervation

Intervention Type DEVICE

Renal denervation using the Paradise renal denervation system - a dedicated RDN catheter that delivers a circumferential ring of ablative ultrasound energy

Catheter ablation

Intervention Type DEVICE

Catheter ablation - one of the most common procedures performed by Cardiac Electrophysiologists for atrial fibrillation

Catheter ablation only

Catheter ablation

Group Type ACTIVE_COMPARATOR

Catheter ablation

Intervention Type DEVICE

Catheter ablation - one of the most common procedures performed by Cardiac Electrophysiologists for atrial fibrillation

Interventions

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renal denervation

Renal denervation using the Paradise renal denervation system - a dedicated RDN catheter that delivers a circumferential ring of ablative ultrasound energy

Intervention Type DEVICE

Catheter ablation

Catheter ablation - one of the most common procedures performed by Cardiac Electrophysiologists for atrial fibrillation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18
* Planned for a first-ever AF ablation procedure (paroxysmal or persistent); (prior to randomization, a technically successful AF ablation procedure, defined as involving pulmonary vein isolation, as well as bidirectional block of any attempted anatomic lesion sets such as cavotricuspid isthmus line, roofline, mitral line and superior vena cava isolation must have been completed)
* History of hypertension and either:

* Documented history of SBP ≥ 160 or DBP ≥ 100 (Stage III), or
* Receiving ≥ 1 antihypertensive medication
* Willingness to adhere to study restrictions and comply with all post-procedural follow-up requirements

Exclusion Criteria

(if any of the following are YES, subject is not eligible)

* Long-standing persistent AF (\> 12 months)
* Individual with valvular AF or AF due to a reversible cause
* Prior left atrial catheter or surgical ablation for an atrial arrhythmia (before this index procedure)
* Prior left atrial surgery (such as mitral valve surgery or surgical ASD repair)
* Prior treatment with other devices for hypertension including but not limited to ROX Coupler, Mobius stent and/or the CVRx barostimulator device
* NYHA Class IV Congestive Heart Failure
* Individual has renal artery anatomy that is ineligible for treatment (as determined by intra-procedural renal angiography). This includes:

* Main renal artery diameter \< 3.0 mm or \> 8.0 mm
* Main renal artery length \< 20 mm
* Presence of renal artery stenosis of any origin ≥ 30%
* Accessory arteries with diameter ≥ 2 mm and \< 3.0 mm
* Calcification in renal arteries at locations where energy is to be delivered
* Prior renal denervation procedure
* Presence of abnormal kidney tumors
* Renal artery aneurysm
* Pre-existing renal stent or history of renal artery angioplasty
* Pre-existing aortic stent or history of aortic aneurysm
* Fibromuscular disease of the renal arteries
* Iliac/femoral artery stenosis precluding insertion of the Paradise Catheter
* Individual has an estimated glomerular filtration rate (eGFR) of less than 40mL/min/1.73m2
* Inability to undergo AF catheter ablation (e.g., presence of left atrial thrombus, contraindication to all anticoagulation)
* Individual with known allergy to contrast medium not amenable to treatment
* Life expectancy of \< 1 year for any medical condition
* Individual has experienced a myocardial infarction, unstable angina, cerebrovascular accident, or heart failure admission within 3 months of screening visit
* Documented history of chronic active inflammatory bowel disorders such as Crohn's disease or ulcerative colitis
* Female participants who are pregnant or nursing
* Individual has known secondary hypertension
* Individual has a single functioning kidney (either congenitally or iatrogenically)
* Individual has a known, unresolved history of drug use or alcohol dependency, lacks the ability to comprehend or follow instructions, or would be unlikely or unable to comply with study follow-up requirements
* Patients concurrently enrolled in any other investigational drug or device trial that would interfere with the conduction of this trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vivek Reddy

OTHER

Sponsor Role lead

Responsible Party

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Vivek Reddy

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Vivek Reddy, MD

Role: PRINCIPAL_INVESTIGATOR

Icahn School of Medicine at Mount Sinai

Locations

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University of Arizona - Banner University Medical Center

Phoenix, Arizona, United States

Site Status

Arizona Heart Institute

Phoenix, Arizona, United States

Site Status

Arrhythmia Research Group

Jonesboro, Arkansas, United States

Site Status

Loma Linda University Medical

Loma Linda, California, United States

Site Status

Pacific Heart Institute

Santa Monica, California, United States

Site Status

Hartford Healthcare

Hartford, Connecticut, United States

Site Status

Naples Community Hospital

Naples, Florida, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Mount Sinai Hospital

New York, New York, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Texas Cardiac Arrhythmia Research Foundation

Austin, Texas, United States

Site Status

Bellin Memorial Hospital Inc.

Green Bay, Wisconsin, United States

Site Status

Countries

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United States

Other Identifiers

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IRB 19-02659

Identifier Type: OTHER

Identifier Source: secondary_id

GCO 40-5118

Identifier Type: -

Identifier Source: org_study_id

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