Atrial Fibrillation Clinical Trial
Official title:
A Pilot Study on the Role pf Ganglionated Plexus Ablation for Catheter Ablation of Atrial Fibrillation.
This study evaluates the effect of catheter ablation of ganglionated plexi (GP) for the treatment of adult patients with atrial fibrillation heart arrhythmias. The location of GP will be demonstrated by a novel nuclear imaging cardiac camera. 3D images from the cardiac camera will guide the GP ablation procedure.
Catheter ablation procedures are nowadays routine procedures in patients with drug-refractory
atrial fibrillation (AF). However, ablation success for patients even in the early stages of
AF is currently only around 70% and may require multiple procedures.
The intrinsic cardiac autonomic nervous system (ANS), which forms a neural network, has been
shown to be a critical element responsible for the initiation and maintenance of AF.
Autonomic inputs to the heart converge at several locations; these convergence points are
typically embedded in the epicardial fat pads and form ganglionated plexi (GP) that contain
autonomic ganglia and nerves. In human hearts, there are at least 7 GP and the 4 major left
atrial GP are located around the antrum of the pulmonary veins (PVs). High-frequency
stimulation (HFS; 20 Hz, 10-150 V and pulse width 1-10 ms) can localize GP during an invasive
electrophysiology (EP) study.
A novel dedicated cardiac nuclear imaging camera with solid-state detectors (D-SPECT,
Spectrum Dynamics) has demonstrated significantly improved sensitivity and image resolution
and can provide novel imaging information on previously 'invisible' structures like the GP.
Using this 3D image information to guide GP ablation could significantly facilitate AF
ablation and result in improved ablation outcomes.
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