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A Comparative Study of Percutaneous Pulsed Field Ablation Guided by Ultrasound Alone Versus Fluoroscopy in Patients With Atrial Fibrillation

This prospective, randomized, multicenter, open-label, non-inferiority interventional study aims to compare the therapeutic efficacy of percutaneous pulsed field ablation (PFA) guided by ultrasound alone versus fluoroscopy in patients with paroxysmal atrial fibrillation (AF). The success rate of complete electrical isolation of pulmonary veins during the procedure was compared to verify that ultrasound-only guidance is non-inferior to fluoroscopic guidance.

Studieoversigt

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

276

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adult patients aged 18 to 75 years (including 18 years and 75 years of age).
  • Patients diagnosed with paroxysmal atrial fibrillation via 12-lead electrocardiography or ambulatory electrocardiography and scheduled to undergo pulsed field ablation.
  • Subjects are able to understand the purpose of the study, voluntarily participate in the study and sign the informed consent, and are willing to complete the follow-up according to the requirements of the program.

Exclusion Criteria:

  • Atrial fibrillation secondary to electrolyte imbalance, thyroid disorders, or reversible non-cardiac causes;
  • Previous history of catheter ablation or cardiac surgery for atrial fibrillation;
  • Prior surgical history including patent foramen ovale closure, atrial septal defect closure or repair;
  • Implantation of left atrial appendage occluder, mechanical mitral valve prosthesis, or valvuloplasty ring containing metallic materials;
  • Concomitant other tachyarrhythmias requiring catheter ablation (e.g., atrioventricular reentrant tachycardia, atrioventricular nodal reentrant tachycardia, atrial tachycardia, atrial flutter, Wolff-Parkinson-White syndrome, etc.);
  • Persistent atrial fibrillation;
  • Left atrial anteroposterior diameter (LAD) > 55 mm on transthoracic echocardiography;
  • Women who are pregnant, breastfeeding, or of childbearing age with plans to become pregnant during the clinical trial;
  • Current participation in another pharmaceutical or medical device clinical study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Percutaneous pulsed field ablation performed under ultrasound-only guidance.
Percutaneous pulsed field ablation is performed under ultrasound-only guidance in patients with paroxysmal atrial fibrillation.
Percutaneous pulsed field ablation is performed under ultrasound-only guidance in patients with paroxysmal atrial fibrillation.
Aktiv komparator: Pulsed field ablation performed under fluoroscopic guidance
Patients with paroxysmal atrial fibrillation underwent percutaneous pulsed field ablation under fluoroscopic guidance.
Patients with paroxysmal atrial fibrillation underwent percutaneous pulsed field ablation under fluoroscopic guidance.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Success rate of complete electrical isolation of pulmonary veins during the procedure
Tidsramme: Immediately post-procedure
The proportion of all pulmonary veins maintaining bidirectional block across ablation lines at 20 minutes after ablation completion.
Immediately post-procedure

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The incidence of complications within 30 days after the procedure
Tidsramme: Within 30 days post-procedure
Observe the proportion of complications occurring within 30 days after the procedure. Such complications include pericardial effusion or cardiac tamponade requiring drainage, phrenic nerve palsy lasting more than 24 hours, severe vascular complications requiring intervention, stroke/transient ischemic attack, atrioesophageal fistula, and death.
Within 30 days post-procedure
Success rate of atrial fibrillation ablation at 12 months post-procedure.
Tidsramme: 12 months post-procedure
Defined as the absence of AF, atrial flutter (AFL), or atrial tachycardia (AT) episodes ≥30 seconds on dynamic electrocardiogram (ECG) monitoring after the blanking period (90 days post-catheter ablation)
12 months post-procedure
The proportion of patients admitted to hospital or emergency departments due to atrial fibrillation recurrence within 12 months after the procedure.
Tidsramme: 12 months post-procedure
The proportion of patients admitted to hospital or emergency departments due to atrial fibrillation recurrence within 12 months after the procedure.
12 months post-procedure
The proportion of patients who received electrical cardioversion due to atrial fibrillation recurrence within 12 months after the procedure
Tidsramme: 12 months post-procedure
The proportion of patients who received electrical cardioversion due to atrial fibrillation recurrence within 12 months after the procedure.
12 months post-procedure
The proportion of patients undergoing repeat ablation surgery owing to atrial fibrillation within 12 months after the procedure
Tidsramme: 12 months post-procedure
The proportion of patients undergoing repeat ablation surgery owing to atrial fibrillation within 12 months after the procedure
12 months post-procedure
The proportion of patients who resumed antiarrhythmic drug therapy during follow-up after the blanking period
Tidsramme: From the end of the blanking period (within 90 days after catheter ablation) to 12 months post-procedure
The proportion of patients who resumed antiarrhythmic drug therapy during follow-up after the blanking period
From the end of the blanking period (within 90 days after catheter ablation) to 12 months post-procedure
Improvement in the total EQ-5D quality-of-life questionnaire score at 12 months post-procedure compared with baseline
Tidsramme: 12 months post-procedure
The degree of improvement in total EQ-5D scores at 12 months after ablation relative to baseline levels
12 months post-procedure
Statistical analysis was performed to evaluate differences in fluoroscopic exposure dose between the two groups.
Tidsramme: Immediately post-procedure
Statistical analysis was performed to evaluate differences in fluoroscopic exposure dose between the two groups.
Immediately post-procedure
Compare the length of hospital stay and postprocedural ICU/CCU stay duration between the two groups.
Tidsramme: through study completion, an average of 1 year
After hospital discharge, the length of hospital stay for this admission and the duration of postoperative observation in CCU/ICU were compared between the two groups of patients.
through study completion, an average of 1 year
Compare the procedural time and DSA fluoroscopy time between the two groups.
Tidsramme: Immediately post-procedure
Statistical analyses were performed to compare procedural duration and DSA fluoroscopy duration across the two groups.
Immediately post-procedure
Compare the differences in costs between the two groups, including medical equipment costs, personnel costs, and patient hospitalization expenses.
Tidsramme: through study completion, an average of 1 year
Total hospitalization costs incurred during this admission were compared between the two groups after hospital discharge.
through study completion, an average of 1 year

Samarbejdspartnere og efterforskere

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Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

15. august 2026

Primær færdiggørelse (Anslået)

28. februar 2029

Studieafslutning (Anslået)

28. februar 2029

Datoer for studieregistrering

Først indsendt

29. juli 2026

Først indsendt, der opfyldte QC-kriterier

11. august 2026

Først opslået (Faktiske)

13. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. august 2026

Sidst verificeret

1. juli 2026

Mere information

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