A Study on the Therapeutic Value of Additional Left Atrial Posterior Wall Isolation Guided by Voltage Mapping in Persistent Atrial Fibrillation.
Prospective, Multicenter, Randomized Controlled Study on the Therapeutic Value of Additional Left Atrial Posterior Wall Isolation Guided by Voltage Mapping in Persistent Atrial Fibrillation.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: GUODONG NIU
- Telefonnummer: +86 0871-68279999
- E-Mail: guodniu@163.com
Studienorte
-
-
Yunnan
-
Kunming, Yunnan, China
- Fuwai Yunnan Hospital
-
Kontakt:
- Guodong Niu, PhD
- Telefonnummer: +860871-68279999
- E-Mail: guodniu@163.com
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Older than 18 years.
- Diagnosed as persistent atrial fibrillation (AF); Definition: At least one episode of persistent AF was recorded on dynamic electrocardiogram (ECG) data within 12 months prior to enrollment, or other clinical evidence supporting persistent AF episodes lasting more than 7 days.
- 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 is secondary to thyroid disease or other reversible factors.
- Evidence of left atrial or left atrial appendage thrombus on imaging examination.
- Rheumatic heart disease or the presence of moderate to severe mitral stenosis or regurgitation.
- Left ventricular ejection fraction <40% or New York Heart Association (NYHA) class III/IV.
- Left atrial anteroposterior diameter >55 mm.
- Unstable angina.
- Myocardial infarction (MI), coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI) within 3 months prior to enrollment.
- Previous catheter ablation or surgical ablation for atrial fibrillation.
- History of prior left atrial appendage closure, patent foramen ovale closure, atrial septal defect closure, or repair surgery.
- Implantation of a mechanical mitral valve prosthesis or metallic annuloplasty rings.
- Presence of intracardiac thrombus, space-occupying lesions, or other abnormalities that preclude vascular access or catheter manipulation.
- Contraindications to anticoagulation or history of coagulation disorders/abnormal bleeding.
- Active systemic infection.
- Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m² or history of renal dialysis.
- Severe hepatic dysfunction.
- Pregnancy or breastfeeding.
- Life expectancy <12 months (e.g., advanced malignancy).
- Current or anticipated participation in other drug or device clinical trials.
- Any other condition or abnormality deemed by the investigator to warrant exclusion.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: superior vena cava isolation
Left atrial substrate mapping is performed after pulmonary vein ablation.
For patients with abnormal left atrial substrate, superior vena cava isolation and left atrial posterior wall isolation will be conducted in the experimental group.
|
Left atrial substrate mapping is performed after pulmonary vein ablation.
For patients with abnormal left atrial substrate, superior vena cava isolation isolation will be conducted in the experimental group.
|
|
Aktiver Komparator: superior vena cava and left atrial posterior wall isolation
Left atrial substrate mapping is performed following pulmonary vein ablation.
For patients with abnormal left atrial substrate, superior vena cava and left atrial posterior wall isolation will be carried out in the control group.
|
Left atrial substrate mapping is performed after pulmonary vein ablation.
For patients with abnormal left atrial substrate, superior vena cava isolation isolation will be conducted in the experimental group.
Left atrial substrate mapping is performed following pulmonary vein ablation.
For patients with abnormal left atrial substrate, superior vena cava isolation will be carried out in the control group.
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
12-Monats-Vorhofflimmern (AF) Ablationserfolgsrate
Zeitfenster: 12 Monate nach dem Einsatz
|
Definiert als das Fehlen von AF-, Vorhofflattern (AFL) oder atrialer Tachykardie (AT) -Episoden ≥ 30 Sekunden zur Überwachung der dynamischen Elektrokardiogramm (EKG) nach der Blankingzeit (90 Tage nach der Katheterablation)
|
12 Monate nach dem Einsatz
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Acute pulmonary vein ablation success rate and superior vena cava isolation rate.
Zeitfenster: Immediately post-procedure
|
Twenty minutes after completion of ablation, under three-dimensional electroanatomical mapping, the ablated area presents as an electrically silent region (voltage < 0.1 mV).
Alternatively, a circular mapping catheter or ablation catheter is positioned within the ablation line: (1) disappearance of intracatheter potentials within the ablation line (entrance block); (2) no local potential capture during pacing of the pulmonary veins and superior vena cava, or local potential capture without subsequent conduction exit (exit block).
|
Immediately post-procedure
|
|
Immediate Success Rate of Left Atrial Posterior Wall Ablation (Abnormal Substrate Group Only)
Zeitfenster: Immediately post-procedure
|
Twenty minutes after completion of ablation, the ablated area presented as an electrically silent zone (voltage < 0.1 mV) under three-dimensional electroanatomic mapping; no local potential capture was achieved during posterior wall pacing.
|
Immediately post-procedure
|
|
Procedure-related time
Zeitfenster: Immediately post-procedure
|
Total procedure time, catheter manipulation time, pulse discharge time, total fluoroscopy time.
|
Immediately post-procedure
|
|
Early recurrence rate of atrial arrhythmia (within the blanking period)
Zeitfenster: Within 3 months post-procedure
|
Early recurrence rate of atrial arrhythmia (within the blanking period)
|
Within 3 months post-procedure
|
|
Incidence of symptomatic and asymptomatic atrial fibrillation events after the end of the blanking period.
Zeitfenster: Within 12 months post-procedure
|
Incidence of symptomatic and asymptomatic atrial fibrillation events after the end of the blanking period
|
Within 12 months post-procedure
|
|
Incidence of repeat ablation after the blanking period
Zeitfenster: Within 12 months post-procedure
|
Incidence of repeat ablation after the blanking period
|
Within 12 months post-procedure
|
|
Rate of maintenance of pulmonary vein 、left atrial posterior wall and superior vena cava isolation in patients undergoing repeat ablation.
Zeitfenster: Within 12 months post-fist procedure.
|
Rate of maintenance of pulmonary vein 、left atrial posterior wall and superior vena cava isolation in patients undergoing repeat ablation.
|
Within 12 months post-fist procedure.
|
|
Improvement in Atrial fibrillation burden.
Zeitfenster: 3、6 and 12 months post-procedure.
|
Evaluate the improvement in postoperative atrial fibrillation burden via ambulatory electrocardiography.
|
3、6 and 12 months post-procedure.
|
|
Cardiac function assessment by NYHA
Zeitfenster: within 12 months post-procedure
|
Cardiac function was assessed relative to baseline using the NYHA classification.
|
within 12 months post-procedure
|
|
The postoperative quality of life was assessed using the Atrial Fibrillation-Specific Quality of Life Scale.
Zeitfenster: Within 12 months post-procedure
|
Assess the improvement in health-related quality of life after atrial fibrillation surgery using the Atrial Fibrillation Effect on QualiTy of Life score.
|
Within 12 months post-procedure
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- EP-CP-IIS-010
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .