Dual Energy Focal Ablation of Premature Ventricular Complexes (DUAL-PVC)

November 8, 2026 updated by: Konstantinos Siontis

Dual Energy (RF/PF) Focal Ablation of Premature Ventricular Complexes: the DUAL-PVC Prospective Clinical Trial

The purpose of this research is to understand whether a dual-energy catheter ablation system that uses radiofrequency (RF) and pulsed-field (PF) energy can safely and effectively treat premature ventricular contractions (PVCs).

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Minnesota
      • Rochester, Minnesota, United States, 55905
        • Mayo Clinic

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • ≥10% burden of the target PVC on ambulatory rhythm monitoring within 3 months prior to enrollment. The qualifying ambulatory monitor may be of any duration (1-30 days) per standard of care and may be distinct from the baseline 12-lead Holter required within 30 days before ablation

  • Guideline-supported indication for first-time or redo catheter ablation of PVCs at the judgment of the electrophysiologist. Specifically:

    • Patients with symptomatic PVCs for whom antiarrhythmic medications are ineffective, not tolerated, or not the patient's preference.
    • Suspected or confirmed PVC-induced cardiomyopathy
    • Enrollment of patients requiring a redo procedure will be capped at 30% of planned enrollment (n=18) if the target PVC is the same or similar to that targeted in previous procedure(s), per review of the study investigator
  • Patients with and without known structural heart disease are eligible

  • Ability to undergo study-directed cardiac MRI pre- and post-procedure

  • Ability to undergo study-directed post-ablation coronary CT angiography

  • Ability to provide written informed consent

Exclusion Criteria:

  • LVEF <35%
  • NYHA class IV
  • Presence of multifocal PVCs (>=3 distinct morphologies) on available pre-baseline standard-of-care ambulatory monitor and ECG tracings per the review of the study team.
  • PVCs attributable to a reversible or non-cardiac cause (e.g., electrolyte imbalance or active thyroid disease).
  • History of sustained VT or VF.
  • Current or recent (<4 weeks) decompensated heart failure.
  • Active systemic infection.
  • Contraindication to LGE-MRI or contrast CT.
  • Known allergy to iodinated contrast dye that cannot be adequately managed with pre-medication protocol.
  • Thrombocytopenia (platelet count <50,000/mm³) or known coagulopathy.
  • Contraindication to systemic anticoagulation.
  • Severe valvular disease requiring future intervention.
  • Mechanical valve prosthesis.
  • Pregnancy.
  • Recent acute coronary syndrome (<6 months).
  • Un-revascularized coronary artery disease.
  • Presence of left ventricular assist device (LVAD) or transplanted heart.
  • Presence of intracardiac thrombus.
  • Current use of inotropes.
  • Recent stroke or TIA (<6 months).
  • Presence of a systemic illness likely to limit survival to <1 year.
  • Patient enrollment in other clinical study that could conflict with the current investigation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: RF-PF Sequential Ablation

Participants are assigned to receive radiofrequency (RF) followed by pulsed-field (PF) at each selected treatment site. For each PF treatment, 24 PF bursts are delivered. Up to three stacked lesions may be performed at the same location.

The THERMOCOOL SMARTTOUCH™ SF Bi-Directional Navigation Catheter is an irrigated, contact-force-sensing catheter used to map the heart and deliver radiofrequency (RF) or pulsed-field (PF) energy to selected treatment sites. The catheter is connected to the TRUPULSE™ Generator, which provides both energy types, and to the nGEN™ Pump, which controls saline irrigation. The system is used with the CARTO™ 3 electroanatomic mapping system and workstation with the VISITAG SURPOINT™ Module to display heart anatomy, catheter location, catheter-to-tissue contact, and treatment information during the procedure.

Experimental: PF-Only Ablation

Participants are assigned to receive pulsed-field (PF) alone at each selected treatment site. For each PF treatment, 24 PF bursts are delivered. Up to three stacked lesions may be performed at the same location.

The THERMOCOOL SMARTTOUCH™ SF Bi-Directional Navigation Catheter is an irrigated, contact-force-sensing catheter used to map the heart and deliver radiofrequency (RF) or pulsed-field (PF) energy to selected treatment sites. The catheter is connected to the TRUPULSE™ Generator, which provides both energy types, and to the nGEN™ Pump, which controls saline irrigation. The system is used with the CARTO™ 3 electroanatomic mapping system and workstation with the VISITAG SURPOINT™ Module to display heart anatomy, catheter location, catheter-to-tissue contact, and treatment information during the procedure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Successful Delivery of Ablation Lesions Using the Dual-Energy THERMOCOOL SMARTTOUCH SF Catheter With the TRUPULSE Generator
Time Frame: During the index ablation procedure

Feasibility is defined as successful delivery of ablation energy at the targeted premature ventricular complex (PVC) site. Delivery counts as successful only if there is no study device deficiency or malfunction that prevents energy delivery, and no need to convert to a bailout ablation approach.

During the index ablation procedure

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Acute procedural success
Time Frame: End of the ablation procedure

Number of participants with elimination of the target premature ventricular contraction by the end of the procedure.

End of the ablation procedure
Participants with greater than 80% reduction in target PVC burden
Time Frame: 1 month, 6 months

Number of participants with greater than 80% reduction from baseline in the burden of the target premature ventricular contraction on Holter monitoring.

1 month, 6 months
Change in Short Form Health Survey (SF-36) score
Time Frame: Baseline, 1 month, 6 months

The 36-Item Short Form Health Survey (SF-36) is a participant-reported questionnaire that assesses health-related quality of life across eight domains: physical functioning, role limitations due to physical health, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems, and mental health. Total scores range from 0 to 100. Higher scores indicate better health status.

Baseline, 1 month, 6 months
Change in EQ-5D score
Time Frame: Baseline, 1 month, 6 months

The EQ-5D is a participant-reported measure of health-related quality of life covering five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Responses across the five dimensions define the participant's health state. Higher scores indicate better health.

Baseline, 1 month, 6 months
Number of Participants With New Coronary Artery Stenosis on Coronary CT Angiography at 6 Months After Ablation
Time Frame: 6 months

Total number of patients with new-onset coronary luminal stenosis found on CT coronary angiography

6 months
Total Procedure Time
Time Frame: From start to finish of index ablation procedure

Total procedure time will be reported in minutes

From start to finish of index ablation procedure
Electrogram endpoints
Time Frame: Intraprocedure

EGM amplitude changes after PF, RF, and RF-PF lesion delivery

Intraprocedure
Ablation Lesion Depth
Time Frame: 1 month and 6 months after ablation

Maximum depth of the ablation lesion at the target premature ventricular complex (PVC) site. Depth is measured from the endocardial surface on late gadolinium enhancement (LGE) cardiac MRI. Only participants with an evaluable post-ablation MRI are analyzed. Reported in millimeters.

1 month and 6 months after ablation
Ablation Lesion Width
Time Frame: 1 month and 6 months after ablation

Maximum width of the ablation lesion at the target PVC site, measured on LGE cardiac MRI. Only participants with an evaluable post-ablation MRI are analyzed. Reported in millimeters.

1 month and 6 months after ablation
Ablation Lesion Volume
Time Frame: 1 month and 6 months after ablation

Total volume of the ablation lesion at the target PVC site, measured on LGE cardiac MRI. Only participants with an evaluable post-ablation MRI are analyzed. Reported in cubic centimeters.

1 month and 6 months after ablation
Number of Radiofrequency (RF) Lesions Delivered per Participant
Time Frame: During the index ablation procedure

Total number of RF lesions delivered with the study catheter during the index procedure

During the index ablation procedure
Number of Pulsed-Field (PF) Lesions Delivered per Participant
Time Frame: During the index ablation procedure

Total number of PF lesions delivered with the study catheter during the index procedure

During the index ablation procedure

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Konstantinos Siontis, MD, Mayo Clinic

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2027

Primary Completion (Estimated)

January 1, 2029

Study Completion (Estimated)

June 1, 2029

Study Registration Dates

First Submitted

October 21, 2026

First Submitted That Met QC Criteria

November 8, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 8, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 25-013930

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.