- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04657978
Substrate Guided Ablation Therapy for Atrial Fibrillation (HEAT-AF)
High Density Substrate Evaluation and Guided Ablation Therapy for Atrial Fibrillation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a single-centre, non-randomized study investigating the feasibility, safety and efficacy of substrate guided ablation in persistent AF.
The study population will be patients between the ages of 18 and 80 with symptomatic, persistent atrial fibrillation (≥1 year) referred for catheter ablation on standard clinical grounds.
The catheter ablation procedure will be performed using the Precision Ensite™ three dimensional mapping system and the Advisor High Density Grid™ mapping catheter (Abbott Medical Incorporated). All patients will undergo conventional pulmonary vein isolation (PVI). As an adjunctive strategy to PVI, low voltage areas (used as a surrogate for atrial scar), as derived from the voltage map, will be targeted for ablation in order to isolate or homogenise these areas of the atrium. A pre-procedural cardiac magnetic resonance imaging scan will be performed in all patients.
All patients will undergo 12 months follow-up with an ECG and ambulatory holter monitoring at 3, 6 and 12 months.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Shouvik Haldar, FRCP MD
- Phone Number: 01895826502
- Email: s.haldar@rbht.nhs.uk
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients aged ≥18 years and ≤ 80 with a clinical indication for persistent atrial fibrillation ablation
Exclusion Criteria:
- Contraindication to anticoagulation
- Thrombus in the left atrium despite anticoagulation
- Cerebrovascular accident within the previous 6 months
- Patients actively participating in another research study will be not be permitted to enrol. Patients who have been involved with other research studies will be able to participate after a minimum period of 3 months after completion of prior study follow up
- Females of childbearing potential must have a negative pregnancy test on the day of the ablation procedure due to the radiation exposure during the procedure
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Substrate guided intervention arm
Participants recruited to the study will undergo High Density Wave Solution™ guided substrate mapping of the left atrium.
Ablation will thereafter be performed to comprise wide area circumferential ablation of the pulmonary veins in pairs, followed by ablation of low voltage zones in the left atrium.
|
Ablation therapy targeting areas of low voltage, which may include encirclement, homogenization or targeting of abnormal electrograms and anchored to a non-conducting structure if the region is in close proximity or likely to create an isthmus for arrhythmias.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Freedom from atrial arrhythmias (>30 seconds) after a single procedure without anti-arrhythmic drugs (AADs) within 12 months, measured by ambulatory holter monitoring
Time Frame: 12 month
|
All participants will have an ECG and ambulatory holter monitor performed at 3, 6 and 12 months after the procedure.
|
12 month
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To compare 1-year arrhythmia free clinical outcome with historical control patients matched by propensity score
Time Frame: 12 Months
|
Freedom from AF defined as no documented AF (>30 seconds) following the 3 months blanking period following a single procedure, off anti-arrhythmic drugs.
|
12 Months
|
Safety endpoint evaluating the incidence of intraprocedural (primarily Advisor High Density Grid™ mapping catheter) related adverse events
Time Frame: 12 Months
|
12 Months
|
|
To correlate cardiac MRI derived scar distribution and burden in the left atrium with the baseline voltage map obtained using the Advisor High Density Grid™ catheter
Time Frame: 12 Months
|
The left atrium will be segregated into pre-defined regions and marked for presence or absence of fibrosis as identified on MRI scans and low voltage identified on invasive mapping.
Inter-class correlation will performed to evaluate consistency between modalities.
|
12 Months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Shouvik Haldar, FRCP MD, Royal Brompton and Harefield Hospital
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 263083
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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