Atrial Fibrillation Clinical Trial
Official title:
A Prospective Multi Centre Trial on Bipolar Radiofrequency Ablation of Atrial Fibrillation
The study is a prospective multi-centre study to investigate the effect of a new bipolar ablation strategy of the left atrium in patients with paroxysmal or permanent atrial fibrillation over time.
Atrial fibrillation (AF) is the most common persistent arrhythmia, prevalent in about 6% of
the population over 65 years of age. AF reduces the quality of life and increases mortality.
AF is particularly common in combination with mitral valve disease, but is also detected in
about 5% of patients with aortic valve and coronary artery disease. Surgical treatment of AF
with the Cox-maze III operation was developed by J. Cox during the 80ies. The aim of the
operation is to block spread of irregular electrical activity by creating lines of isolation
in the atrial musculature. The operation achieves sinus rhythm in over 90% in selected
patients. Nevertheless the method was only used in few heart surgical centres, because it is
complex and time consuming.In recent years alternative energy sources have been developed to
create isolating lines without cutting the tissue and thus making ablation treatment easier.
Bipolar radiofrequency ablation is special because the energy is delivered feedback
controlled until transmurality is achieved. This is a prerequisite for a good result and
makes using the equipment safer.
Since the development of the Cox-maze procedure, our knowledge of atrial fibrillation and
its treatment has increased considerably. There is a consensus that the posterior part of
the left atrium and in particular the pulmonary veins are an important target for treatment.
Surgical ablation with alternative energy sources is a new method under continued
development and evaluation.
The optimal ablation treatment is unknown. A balance between invasiveness and achieving
sinus rhythm in as many as possible has to be found. Creating numerous ablation lines in
both atria is time consuming and leads probably to an increased need for permanent pacemaker
implantation and reduced contractility of the atrial tissue. On the other hand can a simple
bipolar ablation of pulmonary veins performed easily, but this is probably an insufficient
treatment for most patients. In the protocol a new method using solely bipolar ablation for
creation of several ablation lines in the left atrium is described.
The study is a prospective multi-centre study to investigate the effect of a new bipolar
ablation strategy of the left atrium in patients with paroxysmal or permanent AF over time.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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