Efficacy Rate of Unipolar Polarity Switch for Lesion Assessment in Pulmonary Vein Isolation

NCT ID: NCT05464537

Last Updated: 2025-03-05

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

TERMINATED

Clinical Phase

NA

Total Enrollment

8 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-28

Study Completion Date

2024-11-27

Brief Summary

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The technique of intraprocedural electrogram morphology as a measure of lesion effectiveness in an attempt to achieve durable PVI, clearly led to shortened procedural time, radiation exposure, and superiority in outcomes, with the implementation of a reproducible, readily available intraprocedural tool that can be applied universally.

Detailed Description

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One initial study reported that unipolar atrial EGM modification was a useful end point for RF energy delivery. They compared 2 groups of patients with paroxysmal AF undergoing PVI facilitated by an electroanatomic mapping system, merged preprocedural LA computed tomographic scan, and a circular mapping catheter.

They were the first to use intraprocedural electrogram morphology as a measure of lesion effectiveness in an attempt to achieve durable PVI. The technique, clearly led to shortened procedural time, radiation exposure, and superiority in outcomes, with the implementation of a reproducible, readily available intraprocedural tool that can be applied universally.

As there is scant data is this area with lack of randomized human trials, planned on building and further validating evidence from Bortone et al in demonstrating that loss of unipolar negative component during PVI can serve a great adjuvant tool for achieving durability of PVI with overall lesser procedural time and no significant increase in adverse events.

Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Unipolar Polarity Switch Left and CAI-OPR-LAAP Right

Group Type ACTIVE_COMPARATOR

Unipolar Polarity Switch Left

Intervention Type OTHER

10-15 Left veins are randomized to Unipolar Polarity Shift, right veins are randomized to CAI-OPR-LAAP

CAI-OPR-LAAP Left and Unipolar Polarity Switch Right

Group Type ACTIVE_COMPARATOR

Unipolar Polarity Switch Right

Intervention Type OTHER

10-15 cases randomized to CAI-OPR-LAAP on left veins, and Unipolar Polarity Switch on right veins

Interventions

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Unipolar Polarity Switch Left

10-15 Left veins are randomized to Unipolar Polarity Shift, right veins are randomized to CAI-OPR-LAAP

Intervention Type OTHER

Unipolar Polarity Switch Right

10-15 cases randomized to CAI-OPR-LAAP on left veins, and Unipolar Polarity Switch on right veins

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All Patients ≥ 18 years of age
* Undergoing pulmonary vein isolation for De-Novo Atrial Fibrillation.

Exclusion Criteria

* Patients unable to give consent
* Who do not have De-novo AF.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kansas City Heart Rhythm Institute, Overland Park, KS

UNKNOWN

Sponsor Role collaborator

Kansas City Heart Rhythm Research Foundation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dhanunjaya Lakkireddy

Role: PRINCIPAL_INVESTIGATOR

Kansas City Heart Rhythm Institute

Locations

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Kansas City Heart Rhythm Institute

Overland Park, Kansas, United States

Site Status

Overland Park Regional Medical Center

Overland Park, Kansas, United States

Site Status

Countries

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United States

References

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Bortone A, Brault-Noble G, Appetiti A, Marijon E. Elimination of the negative component of the unipolar atrial electrogram as an in vivo marker of transmural lesion creation: acute study in canines. Circ Arrhythm Electrophysiol. 2015 Aug;8(4):905-11. doi: 10.1161/CIRCEP.115.002894. Epub 2015 Jun 19.

Reference Type BACKGROUND
PMID: 26092576 (View on PubMed)

Pambrun T, Durand C, Constantin M, Masse A, Marra C, Meillet V, Haissaguerre M, Jais P, Bortone A. High-Power (40-50 W) Radiofrequency Ablation Guided by Unipolar Signal Modification for Pulmonary Vein Isolation: Experimental Findings and Clinical Results. Circ Arrhythm Electrophysiol. 2019 Jun;12(6):e007304. doi: 10.1161/CIRCEP.119.007304. Epub 2019 Jun 5.

Reference Type BACKGROUND
PMID: 31164003 (View on PubMed)

Bortone A, Appetiti A, Bouzeman A, Maupas E, Ciobotaru V, Boulenc JM, Pujadas-Berthault P, Rioux P. Unipolar signal modification as a guide for lesion creation during radiofrequency application in the left atrium: prospective study in humans in the setting of paroxysmal atrial fibrillation catheter ablation. Circ Arrhythm Electrophysiol. 2013 Dec;6(6):1095-102. doi: 10.1161/CIRCEP.113.000749. Epub 2013 Oct 4.

Reference Type BACKGROUND
PMID: 24097371 (View on PubMed)

Other Identifiers

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KCHRRF-UNIPOLAR SWITCH-0013

Identifier Type: -

Identifier Source: org_study_id

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