Repeat Ablation of Persistent Atrial Fibrillation, Including Mitral Isthmus Catheter Ablation, With the FARAPULSE Pulsed Field Ablation System
NCT ID: NCT06735534
Last Updated: 2025-12-24
Study Results
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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RECRUITING
NA
407 participants
INTERVENTIONAL
2025-06-03
2028-01-31
Brief Summary
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Detailed Description
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Conditions
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Keywords
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Single Arm Prospective
Repeat Ablation of Persistent Atrial Fibrillation, including Mitral Isthmus Catheter Ablation, with the FARAPULSE Pulsed Field Ablation System.
FARAPULSE™ Pulsed Field Ablation System
The FARAPULSE™ Pulsed Field Ablation System is indicated for the treatment of symptomatic atrial fibrillation.
The FARAWAVE Catheter is indicated for the isolation of pulmonary veins and posterior wall in the treatment of drug-refractory, recurrent, symptomatic paroxysmal and persistent atrial fibrillation. The FARAWAVE Catheter is also indicated for the for the isolation of pulmonary veins and posterior wall in the treatment of persistent atrial fibrillation as an alternative to anti-arrhythmic drug (AAD) therapy as an initial rhythm control strategy.
The FARAPOINT™ PFA Catheter is indicated for use as an adjunctive device for 1) the creation of an ablation line between the inferior vena cava and the tricuspid valve and/or 2) Mitral Isthmus, when the FARAWAVE Catheter is used in the endocardial treatment of persistent atrial fibrillation (episode duration no greater than 12 months).
Interventions
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FARAPULSE™ Pulsed Field Ablation System
The FARAPULSE™ Pulsed Field Ablation System is indicated for the treatment of symptomatic atrial fibrillation.
The FARAWAVE Catheter is indicated for the isolation of pulmonary veins and posterior wall in the treatment of drug-refractory, recurrent, symptomatic paroxysmal and persistent atrial fibrillation. The FARAWAVE Catheter is also indicated for the for the isolation of pulmonary veins and posterior wall in the treatment of persistent atrial fibrillation as an alternative to anti-arrhythmic drug (AAD) therapy as an initial rhythm control strategy.
The FARAPOINT™ PFA Catheter is indicated for use as an adjunctive device for 1) the creation of an ablation line between the inferior vena cava and the tricuspid valve and/or 2) Mitral Isthmus, when the FARAWAVE Catheter is used in the endocardial treatment of persistent atrial fibrillation (episode duration no greater than 12 months).
Eligibility Criteria
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Inclusion Criteria
* Single previous AF ablation procedure for Paroxysmal Atrial Fibrillation (PAF) or Persistent AF (PersAF)that minimally included pulmonary vein isolation that occurred within 5 years prior to enrollment.
* Documented (physician's note) diagnosis of PersAF either prior to the subject's Index Procedure OR development of PersAF after the Index Procedure.
* Documented evidence of AF recurrence at least 60 days after the subject's Index Procedure, captured by any regulatory cleared rhythm monitoring device.
OR
* If diagnosed with PersAF prior to the Index Procedure, documented recurrence of AF or atypical AFL at least 60 days after the Index Procedure, captured by any regulatory cleared rhythm monitoring device.
* Willing and capable of providing informed consent
* Willing and capable of participating in all follow-up assessments and testing associated with this clinical investigation at an approved clinical investigational center
Exclusion Criteria
1. Left atrial anteroposterior diameter ≥ 5.5 cm, or if LA diameter not available, non-indexed volume \>100 ml (physician note or imaging)
2. Current atrial myxoma
3. Any PV abnormality, stenosis, or stenting (common and middle PVs are admissible)
4. Current left atrial thrombus
2. Cardiovascular exclusions - Any of the following CV conditions:
1. History of sustained ventricular tachycardia or any ventricular fibrillation
2. AF that is secondary to electrolyte imbalance, thyroid disease, alcohol, or other reversible / non-cardiac causes
3. Current or anticipated pacemaker, implantable cardioverter defibrillator or cardiac resynchronization therapy devices, or implantable loop recorder, other than LUX-Dx.
Prior interatrial baffle, atrial septal patch, atrial septal defect closure device, patent foramen ovale occluder, Amulet devices, or other left atrial appendage closure device if implanted within 90 days of enrollment
4. Presence of any of the following:
* Any prosthetic heart valve, ring or repair
* Moderate to severe mitral valve stenosis
* More than moderate mitral regurgitation (\>3+)
* Moderate to severe aortic stenosis
5. Hypertrophic cardiomyopathy
6. Any IVC filter, known inability to obtain vascular access or other contraindication to femoral access
7. Awaiting cardiac transplantation or other cardiac surgery within the next 12 months
8. Severe right ventricular dysfunction with documented echocardiography and/or hemodynamic data.
3. Any of the following conditions at baseline:
1. Heart failure associated with NYHA Class III or IV
2. Documented LVEF \< 40% as documented within the previous 12 months
3. Uncontrolled hypertension (SBP \> 160 mmHg or DBP \> 95 mmHg on two (2) BP measurements at baseline assessment not attributable to white coat syndrome per Investigator opinion
4. Body Mass Index (BMI) \>45.0
5. CHA2DS2-VASc score ≥5
4. Any of the following events within 90 Days of the Consent Date:
1. Coronary disease: Myocardial infarction (MI), unstable or Prinzmetal angina or coronary intervention within 90 days of consent or any documented history of severe non-revascularize coronary disease
2. Cardiac surgery: Any cardiac surgery
3. Heart failure hospitalization: Heart failure hospitalization
4. Pericardium: Pericarditis or symptomatic pericardial effusion
5. GI bleeding: Gastrointestinal bleeding
6. Neurovascular event: Stroke, TIA, or intracranial bleeding
7. Thromboembolism: Any active non-neurologic thrombus and/or thromboembolic event
8. Carotid intervention: Carotid stenting or endarterectomy
9. Diabetes: Uncontrolled diabetes mellitus or a recorded HgbA1c \> 8.0%
5. Any of the following congenital conditions:
1. Congenital heart disease: Congenital heart disease with any clinically significant residual anatomic or conduction abnormality
2. Methemoglobinemia: History of known congenital methemoglobinemia
3. G6PD deficiency: History of known G6PD deficiency
6. Any of the following conditions:
1. Transplantation: Solid organ or hematologic transplant, or currently being evaluated for a transplant
2. Diaphragmatic abnormality: Any prior history or current evidence of hemi-diaphragmatic paralysis or paresis
3. Pulmonary: Severe lung disease, severe pulmonary hypertension, or any lung disease involving abnormal blood gases or requiring supplemental oxygen
4. Renal: Renal insufficiency if an estimated glomerular filtration rate (eGFR) is \< 30 mL / min / 1.73 m2, or with any history of renal dialysis or renal transplant
5. Malignancy: Active malignancy at enrolment (other than squamous cell carcinoma)
6. Gastrointestinal: Clinically significant gastrointestinal problems involving the esophagus or stomach including severe or erosive esophagitis, uncontrolled gastric reflux, gastroparesis, esophageal candidiasis or active gastroduodenal ulceration
7. Infections: Active systemic infection
8. Sleep apnea: Untreated diagnosed obstructive sleep apnea with apnea hypopnea index classification of severe (\>30 pauses per hour)
9. Medication use: Required use of phosphodiesterase inhibitors within 24 hours of the ablation procedure
10. Nitroglycerin intolerance: Known allergic drug reaction to nitroglycerin (excluding hypotension)
11. Hematologic condition: Known coagulopathy or bleeding disorder (e.g. von Willebrand disease, hemophilia)
12. Contraindication to anticoagulation: Contraindication to, or unwillingness to use, systemic anticoagulation, or acceptable alternatives, pre-, intra- and post-procedure to achieve adequate anticoagulation.
13. Pregnancy: Women of childbearing potential who are pregnant, lactating, not using medical birth control or who are planning to become pregnant during the anticipated study period
14. General health conditions: Health conditions that in the investigator's medical opinion would prevent participation in the study, interfere with assessment or therapy, significantly raise the risk of study participation, or modify outcome data or its interpretation.
15. LUX-Dx ICM intolerance: Unwillingness to receive, or unable to tolerate, a subcutaneous, chronically inserted LUX-Dx ICM device
16. Participation in another trial: Subjects who are currently enrolled in another investigational study or registry that would directly interfere with the current study, except when the subject is participating in a mandatory governmental registry, or a purely observational registry with no associated treatments; each instance must be brought to the attention of the Sponsor to determine eligibility.
17. Life expectancy: Predicted life expectancy less than three (3) years
18 Years
ALL
No
Sponsors
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Boston Scientific Corporation
INDUSTRY
Responsible Party
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Principal Investigators
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Moussa Mansour,, MD
Role: PRINCIPAL_INVESTIGATOR
Massachusetts General Hospital
Locations
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Mobile Infirmary Medical Center
Mobile, Alabama, United States
Arrhythmia Research Group-Research Facility
Jonesboro, Arkansas, United States
University of Southern California Hospital
Los Angeles, California, United States
South Denver Cardiology Associates, PC
Littleton, Colorado, United States
HCA Florida Mercy Hospital
Miami, Florida, United States
Emory University Hospital
Atlanta, Georgia, United States
Memorial Health University Medical Center
Savannah, Georgia, United States
St. Luke's Boise Medical Center
Boise, Idaho, United States
Johns Hopkins Hospital
Baltimore, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Southcoast Physicians Group
Fall River, Massachusetts, United States
Virtua Health Inc.
Marlton, New Jersey, United States
Bethesda North Hospital
Cincinnati, Ohio, United States
Ohio State University Medical Center
Columbus, Ohio, United States
Trident Medical Center
Charleston, South Carolina, United States
Texas Cardiac Arrhythmia Research
Austin, Texas, United States
Christus Trinity Mother Frances Health System
Tyler, Texas, United States
Sentara Norfolk General Hospital
Norfolk, Virginia, United States
Victorian Heart Hospital
Clayton, Victoria, Australia
The Royal Melbourne Hospital
Parkville, Victoria, Australia
National Taiwan University Hospital
Taipei, , Taiwan
Taipei Veterans General Hospital
Taipei, , Taiwan
Countries
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Central Contacts
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Facility Contacts
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Rhonda Dickinson
Role: primary
Tiffany Warhurst
Role: primary
Silvia Perez
Role: primary
Rebecca Wimmer
Role: primary
Isabel Vital
Role: primary
Ana Portela
Role: backup
Paige Smith
Role: primary
Samir Patel
Role: primary
Sharon LaMott
Role: primary
Ann Heller
Role: primary
Michele Martucci
Role: backup
Grace Ha
Role: primary
Debra Benevides
Role: primary
Kristin Broderick
Role: primary
Jillian Stanley
Role: backup
Laurie Freel
Role: primary
Kalyn Ferguson
Role: primary
Molly Harper
Role: primary
Deb Cardinal
Role: primary
Adrian Maples
Role: primary
Cassandra Kinne
Role: primary
Mauro Baldi
Role: primary
Laura Chen
Role: primary
Hui-Ching Huang
Role: primary
Yu-Hui Chou
Role: primary
Other Identifiers
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PF313
Identifier Type: -
Identifier Source: org_study_id