Efficacy and Safety of Pulsed Field Ablation in Refractory Mitral Isthmus-dependent Atrial Flutter: Pulsed Field Ablation Vs. Radiofrequency Ablation: a Preliminary Randomized Controlled Study

NCT ID: NCT06850064

Last Updated: 2025-02-27

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-24

Study Completion Date

2025-12-01

Brief Summary

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Efficacy and safety of pulsed field ablation in refractory mitral isthmus-dependent atrial flutter: pulsed field ablation vs. radiofrequency ablation: a preliminary randomized controlled study

Detailed Description

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This study aims to compare the effectiveness of pulse field ablation (PFA) versus radiofrequency ablation (RFCA) in improving mitral valve commissural block rate and atrial tachycardia recurrence rate in patients with refractory mitral valve commissural-dependent atrial flutter.

Study Design:

Randomized Groups: Patients will be randomly assigned to two groups:

Pulse Field Ablation (PFA) Group Radiofrequency Ablation (RFCA) Group

Conditions

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Atrial Fibrillation (AF)

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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Radiofrequency ablation unit

The patient underwent radiofrequency ablation treatment. After electrophysiological examination, radiofrequency ablation was performed.

Group Type ACTIVE_COMPARATOR

Radiofrequency ablation

Intervention Type PROCEDURE

In the radiofrequency ablation group, patients will undergo radiofrequency ablation targeted at the mitral valve commissure.

The pulse field ablation group

The pulse field ablation group will undergo pulse field ablation of the mitral valve commissure.

Group Type EXPERIMENTAL

Pulse Field Ablation (PFA)

Intervention Type PROCEDURE

The pulse field ablation group will undergo pulse field ablation of the mitral valve commissure.

Interventions

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Pulse Field Ablation (PFA)

The pulse field ablation group will undergo pulse field ablation of the mitral valve commissure.

Intervention Type PROCEDURE

Radiofrequency ablation

In the radiofrequency ablation group, patients will undergo radiofrequency ablation targeted at the mitral valve commissure.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1.Patients aged ≥18 years. 2.Diagnosed with persistent symptomatic refractory mitral valve commissural-dependent atrial flutter. Refractory mitral valve commissural-dependent atrial tachycardia is defined as:

1. Failure of drug therapy: At least one Class I or III antiarrhythmic drug (e.g., propafenone, amiodarone) fails to effectively control or prevent episodes.
2. Failure of catheter ablation: At least one previous attempt at radiofrequency catheter ablation (RFCA) targeting the mitral valve commissure has been unsuccessful (either due to recurrence post-procedure or failure to achieve bidirectional block at the commissure).

3.Intolerant to at least one antiarrhythmic drug (AAD). 4.The patient must be capable of and willing to provide written informed consent to participate in this study.

Exclusion Criteria

1. Pregnant or breastfeeding women.
2. Presence of left atrial thrombus on preoperative imaging.
3. Life expectancy less than 1 year.
4. Coagulation disorders or contraindications to anticoagulant therapy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Chest Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xu Liu

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Shanghai Chest Hospital

Shanghai, , China

Site Status

Countries

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China

Central Contacts

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Xu Liu

Role: CONTACT

18367527058

Facility Contacts

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Xu Liu

Role: primary

18367527058

Other Identifiers

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MIDAF-PFA vs RF

Identifier Type: -

Identifier Source: org_study_id

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