Study on the Ablation of Persistent Atrial Fibrillation Using Pulsed Electric Fields Under Different Surgical Procedures

NCT ID: NCT06671197

Last Updated: 2025-03-14

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 436 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-03-31
• Study Completion Date: 2027-03-31

Brief Summary

Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice, and there are more than 20 million AF patients in my country. Currently, rhythm control has become the main treatment option for AF, but there is still controversy over the best ablation procedure, especially whether other auxiliary ablation lines need to be added. Based on the existing clinical evidence, the durability and permeability of ablation damage are the main reasons for the differences. Pulsed electric field is a new ablation energy source based on the principle of cell electroporation. It has the characteristics of damage safety and permeability, so it is expected to solve the above dilemma. The study was divided into PVI (PVI-only) group according to the ratio of 1: 1, PVI + PWI + SVCI (posterior left atrial wall isolation and superior vena cava isolation) group. Through one-year follow-up of two groups of patients, the role of left atrial posterior wall and superior vena cava in the maintenance mechanism of persistent atrial fibrillation was explored, and the safety and effectiveness of domestic pulse ablation system were verified, which provided intellectual support for further medical and engineering integration

Conditions

Persistent Atrial Fibrillation

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: PROSPECTIVE

Study Groups

PVI-only

Pulmonary vein isolation

Intervention Type: DEVICE

Pulsed field ablation

PVI + PWI + SVCI

posterior left atrial wall isolation and superior vena cava isolation

Pulmonary vein isolation+posterior left atrial wall line+superior vena cava isolation

Intervention Type: DEVICE

Pulsed field ablation

Interventions

Pulmonary vein isolation

Pulsed field ablation

Intervention Type: DEVICE

Pulmonary vein isolation+posterior left atrial wall line+superior vena cava isolation

Pulsed field ablation

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• 18 years old and above, regardless of gender;
• Patients with symptomatic drug-refractory persistent atrial fibrillation (diagnosis time exceeding ≤ 3 years);
• Agree to participate in the study and be able and willing to comply with all follow-up requirements;-

Exclusion Criteria

• Left ventricular ejection fraction (LVEF) ≤ 35%
• Left atrial diameter (echocardiography) ≥ 55mm
• Patients with a definite thrombus in the left atrium or a definite thrombus in the heart before surgery
• Patients with cardiac function classification (NYHA) III-IV
• Patients with second-degree (type II) or third-degree atrioventricular block
• Persons with obvious congenital heart defects (such as atrial septal defect or severe pulmonary vein stenosis, but excluding patent foramen ovale)
• Patients with prosthetic valve implantation
• Patients with implanted cardiac pacemaker or cardiac defibrillator (ICD)
• Diagnosed with hypertrophic cardiomyopathy, chronic obstructive pulmonary disease, myxoma
• Patients with preoperatively known symptomatic carotid stenosis
• Patients with untreated or controlled hyperthyroidism or hypothyroidism
• Patients with systemically active infections
• Patients with renal failure who have significant bleeding tendency or are undergoing hemodialysis
• Patients with myocardial infarction or any cardiac intervention/open surgery within 3 months
• Patients who have had a stroke or transient ischemic attack within 6 months
• Patients with obvious contraindications to interventional surgery and who are judged by the investigator to be unable to undergo ablation surgery
• Women who are pregnant or breastfeeding or who have a family planning during the study period
• Patients who have participated in clinical trials of other drugs or medical devices within 3 months
• Patients considered inappropriate by the investigator to participate in this clinical trial -

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Sichuan Jinjiang Electronic Medical Device Technology Co., Ltd

Chengdu, Sichuan, China

Countries

China

Central Contacts

Youqi FAN, Chief physician

Role: CONTACT

fanyq@zju.edu.cn

+86 13867482684

Facility Contacts

XINlin Yang

Role: primary

15258090991@163.com

15258090991

Other Identifiers

20240926

Identifier Type: -

Identifier Source: org_study_id