Safety and Efficacy of Pulmonary Vein Isolation Using Pulsed-field Ablation (PFA) Combined with Either PFA-based Left Atrial Posterior Wall Isolation or Vein of Marshall Ethanol Ablation in Patients with Persistent Atrial Fibrillation

NCT ID: NCT06878924

Last Updated: 2025-03-17

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

Total Enrollment

162 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-05-31

Study Completion Date

2027-12-31

Brief Summary

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This study is designed to directly compare the safety and efficacy of PFA-based PVI+PWI vs PFA-based PVI+ VoM alcohol ablation in patients with Persistent AF.

Detailed Description

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Conditions

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Atrial Fibrillation (AF)

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Persistent AF patients receiving PVI (PFA)+ VoM alcohol ablation

PVI:

General periprocedural guidance includes target activated clotting time (ACT) ≥350, catheter exchange ≤2, \>10s spacing of consecutive applications, and minimization of number of PF applications per the recommended procedures below:

For each pulmonary vein, a concentric ring of applications will be created using 12 (6 ostial and 6 antral) applications In case of visual gaps, additional 8 applications will be added

PWI:

Concentric overlapping ablations will be placed throughout the posterior wall deliberately. The catheter will be rotated once between a pair of applications; briefly, rotation is performed such that, post-rotation, the splines are situated midway between the splines' pre- rotation positions. The number of applications will be at the operator's discretion.

VoM:

VoM alcohol ablation procedure will be conducted before the catheter ablation. VoM will be visualized by coronary sinus venography, cannulated with an angioplasty wire and balloon and 1 cc of 98% ethanol will

No interventions assigned to this group

PFA-based PVI+ left atrial posterior wall isolation

PVI:

General periprocedural guidance includes target activated clotting time (ACT) ≥350, catheter exchange ≤2, \>10s spacing of consecutive applications, and minimization of number of PF applications per the recommended procedures below:

For each pulmonary vein, a concentric ring of applications will be created using 12 (6 ostial and 6 antral) applications In case of visual gaps, additional 8 applications will be added

PWI:

Concentric overlapping ablations will be placed throughout the posterior wall deliberately. The catheter will be rotated once between a pair of applications; briefly, rotation is performed such that, post-rotation, the splines are situated midway between the splines' pre- rotation positions. The number of applications will be at the operator's discretion.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Symptomatic persistent AF; 1st or redo ablation with PVI-only in the earlier procedure
* Willing to provide informed consent
* Age: 18-85 years

Exclusion Criteria

* • Previous PWI or VoM ablation procedure

* Left ventricular ejection fraction \<40%
* Left atrial thrombus
* Myocardial infarction within last 60 days
* Cardiac surgery in the last 6 months
* Advanced renal failure
* Life expectancy \<1 year
* Pregnant women
* Unable or unwilling to provide informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Texas Cardiac Arrhythmia Research Foundation

OTHER

Sponsor Role lead

Responsible Party

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Andrea Natale

Executive Medical Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Andrea Natale, MD

Role: CONTACT

5125448186

Mitra Mohanty, MD MS

Role: CONTACT

512-544-8198

Other Identifiers

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TCAI_SAVIOR

Identifier Type: -

Identifier Source: org_study_id

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