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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06183619
Other study ID # T2020-ZX019
Secondary ID
Status Not yet recruiting
Phase
First received
Last updated
Start date January 1, 2024
Est. completion date December 31, 2024

Study information

Verified date December 2023
Source Chinese Academy of Medical Sciences, Fuwai Hospital
Contact Jun Liu, MD, PhD
Phone +8615810319596
Email liujundoctor@163.com
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) has limited success. The superior vena cava (SVC) has been identified as one of the most common non-pulmonary vein triggers for PAF. It is estimated that SVC isolation (SVCI) could improve the clinical results of patients with PAF. However, results from previous studies about SVCI remain controversial. Safety concerns for SVCI may outweigh its benefits and lead to inadequate ablation. To address this issue, the introduction of a quantitative ablation index (AI) for SVCI may provide a solution. Therefore, the investigators sought to initiate a retrospective, multi-center study, to explore the efficacy and safety of quantitative SVCI in addition to PVI in PAF.


Description:

Catheter ablation has emerged as an effective treatment for drug-refractory PAF and is recommended as first-line therapy by current guidelines. PVI is considered the cornerstone of catheter ablation for atrial fibrillation (AF). However, despite persistent PVI, a subgroup of patients may experience recurrent AF due to focal ectopic discharges originating outside the pulmonary veins. Among the non-pulmonary vein triggers, the SVC stands out as a common culprit, making it a promising ablation target for maintaining sinus rhythm. Nevertheless, results from previous studies that evaluated the efficacy of SVCI showed conflicting results. One possible explanation is that SVC is adjacent to critical anatomical structures (such as the sinus node and the phrenic nerve), which raises safety concerns and often leads to inadequate ablation. Therefore, it is necessary to establish a standardized ablation procedure for SVCI, ensuring both safety and efficacy. To address this issue, the investigators proposed the concept of "quantitative ablation for SVCI." By introducing AI as a quantitative measure, it is possible to achieve precise catheter ablation while minimizing the risk of procedure-related complications. This study aimed to investigate the safety and feasibility of quantitative AI-guided SVCI in addition to PVI. Participants with PAF who required catheter ablation will be consecutively enrolled in three hospitals in China.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 400
Est. completion date December 31, 2024
Est. primary completion date March 30, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Symptomatic paroxysmal AF that are unresponsive to antiarrhythmic drugs (one or more than one). - Willing to undergo catheter ablation for AF. Exclusion Criteria: - History of any type of catheter ablation for cardiac arrhythmias. - Sinus node dysfunction that requires permanent pacemaker implantation.

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Pulmonary vein isolation plus superior vena cava isolation
Pulmonary vein isolation plus superior vena cava isolation
Pulmonary vein isolation
Pulmonary vein isolation only

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
Chinese Academy of Medical Sciences, Fuwai Hospital

Outcome

Type Measure Description Time frame Safety issue
Primary AT/AF recurrence atrial fibrillation, atrial flutter, atrial tachycardia over 30s 12 months
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