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Efficacy and Safety of Superior Vena Cava Isolation and Pulmonary Vein Isolation for Treatment of Atrial Fibrillation (SAVE-AF)

2026年7月23日 更新者:Qiang Hu

Efficacy and Safety of Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation by Pulsed Field Ablation for Treatment of Atrial Fibrillation

Atrial fibrillation (AF) is one of the most concerning diseases in the field of cardiac arrhythmias. It is a type of rapid supraventricular arrhythmia characterized by rapid and disorganized contraction of the atria, which leads to ventricular rate disturbance, impaired cardiac function, and an increased risk of atrial mural thrombus formation. AF severely reduces patients' quality of life and can cause complications such as heart failure, stroke, and sudden death. Currently, the vast majority of AF episodes are triggered by pulmonary vein (PV) ectopic foci. Therefore, catheter ablation is the preferred treatment strategy, with pulmonary vein isolation (PVI) being the cornerstone procedure. However, a small proportion of patients may have non-PV triggers, particularly originating from the superior vena cava (SVC). Conventional radiofrequency ablation (RFA) for SVC isolation carries unpredictable risks, including damage to the sinus node and the phrenic nerve. Therefore, this study aims to investigate the impact of empirical SVC electrical isolation in addition to PVI on the success rate of AF ablation, using pulsed field ablation (PFA)-a non-thermal ablation modality with tissue selectivity and a favorable safety profile.

調査の概要

研究の種類

介入

入学 (推定)

200

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • Sichuan
      • Chengdu、Sichuan、中国、610000
        • 募集
        • Qiang Hu
        • コンタクト:

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria:

  • Age ≥ 18 years;
  • Patients with documented atrial fibrillation (AF), confirmed by at least one episode of AF recorded on a 12-lead surface electrocardiogram (ECG) or ambulatory ECG monitoring within the past 12 months;
  • Subjects who agree to undergo treatment for AF using a pulsed field ablation (PFA) system that is currently commercially available in China;
  • Patients who have shown an inadequate response to, or intolerance of, at least one class of antiarrhythmic drug therapy;
  • Subjects or their legally authorized representatives who have been informed of the nature of this study, have agreed to all terms and conditions of the study, and have provided written informed consent, and who are willing to complete all required clinical follow-up visits in accordance with the study protocol.

Exclusion Criteria:

  • Prior surgical or catheter ablation for any type of cardiac arrhythmia;
  • AF secondary to electrolyte imbalance, valvular heart disease, thyroid disease, or other reversible causes;
  • Known requirement for ablation outside the pulmonary vein ostia or beyond the cavotricuspid isthmus;
  • Sinus node dysfunction or other indications for permanent pacemaker implantation;
  • Myocardial infarction, or prior coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) within the past 6 months;
  • Left atrial anteroposterior diameter ≥ 50 mm;
  • Evidence of left atrial or left atrial appendage thrombus confirmed by transesophageal echocardiography (TEE) or left atrial computed tomography (CT) within 24 hours prior to the procedure;
  • Serum creatinine > 2 times the upper limit of normal, or currently on dialysis;
  • History of prior cardiothoracic surgery;
  • History of permanent pacemaker implantation;
  • History of malignancy;
  • Long-term use of a central venous catheter;
  • Contraindications to anticoagulation therapy (including allergy to anticoagulants, thrombocytopenia, severe bleeding tendency, or coagulation disorders);
  • History of allergy to contrast;
  • Women who are pregnant, lactating, or who are unwilling to use adequate contraception during the study period;
  • Subjects or their legally authorized representatives who are unwilling to provide written informed consent;
  • Subjects who, for any reason, are unable to comply with the study protocol or complete all required clinical follow-up visits;
  • Subjects deemed by the investigator to be unsuitable for PFA treatment of AF.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:トリプル

武器と介入

参加者グループ / アーム
介入・治療
実験的:superior vena cava isolation plus pulmonary vein isolation
Eligible patients with atrial fibrillation who are randomized to the experimental group will undergo superior vena cava (SVC) electrical isolation in addition to pulmonary vein isolation (PVI) during the pulsed field ablation procedure
アクティブコンパレータ:pulmonary vein isolation
Eligible patients with atrial fibrillation who are randomized to the control group will undergo pulmonary vein isolation (PVI) during the pulsed field ablation procedure

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
the success rate of atrial fibrillation ablation
時間枠:at 3 month
it is assessed by 7-day Holter monitoring
at 3 month

二次結果の測定

結果測定
メジャーの説明
時間枠
the success rate of atrial fibrillation ablation
時間枠:at 6 month and 12 month
it is assessed by 7-day Holter monitoring
at 6 month and 12 month
left ventricular end-systolic diameter
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left ventricular end-diastolic diameter
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left ventricular posterior wall thickness
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
interventricular septal thickness
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left ventricular ejection fraction
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
E/A
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
E/e'
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left atrial volume index
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left atrial anteroposterior diameter
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left atrial strain
時間枠:at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
New York Heart Association class
時間枠:at 3 month, 6 month and 12 month
The NYHA is measured by Classification of NYHA heart function
at 3 month, 6 month and 12 month
Major adverse events
時間枠:at 3 month, 6 month and 12 month
Major adverse events is a composite endpoint of death, stroke, and myocardial infarction.
at 3 month, 6 month and 12 month
6-min walk distance
時間枠:at 3 month, 6 month and 12 month
During the test, patients were asked to walk for 6 minutes on a long corridor with a length of 37.5 meters between the 2 marks
at 3 month, 6 month and 12 month
red blood cell count
時間枠:at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
hemoglobin
時間枠:at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
white blood cell count
時間枠:at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
platelet count
時間枠:at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
alanine aminotransferase
時間枠:at 3 month, 6 month and 12 month
It is obtained from the liver function test.
at 3 month, 6 month and 12 month
aspartate aminotransferase
時間枠:at 3 month, 6 month and 12 month
It is obtained from the liver function test.
at 3 month, 6 month and 12 month
creatinine
時間枠:at 3 month, 6 month and 12 month
It is obtained from the renal function test
at 3 month, 6 month and 12 month
urea
時間枠:at 3 month, 6 month and 12 month
It is obtained from the renal function test
at 3 month, 6 month and 12 month
estimated glomerular filtration rate
時間枠:at 3 month, 6 month and 12 month
It is obtained from the renal function test
at 3 month, 6 month and 12 month
activated partial thromboplastin time
時間枠:at 3 month, 6 month and 12 month
It is obtained from the coagulation function test
at 3 month, 6 month and 12 month
prothrombin time
時間枠:at 3 month, 6 month and 12 month
It is obtained from the coagulation function test
at 3 month, 6 month and 12 month
international normalized ratio
時間枠:at 3 month, 6 month and 12 month
It is obtained from the coagulation function test
at 3 month, 6 month and 12 month
B-type natriuretic peptide
時間枠:at 3 month, 6 month and 12 month
It is obtained from a blood sample.
at 3 month, 6 month and 12 month
Atrial Fibrillation Effect on Quality of Life Questionnaire
時間枠:at 3 month, 6 month and 12 month
AFEQT questionnaire was used to assess the quality of life of patients with atrial fibrillation.
at 3 month, 6 month and 12 month
readmission
時間枠:at 3 month, 6 month and 12 month
Rehospitalization was indicated for atrial fibrillation.
at 3 month, 6 month and 12 month

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研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年7月20日

一次修了 (推定)

2029年3月31日

研究の完了 (推定)

2029年3月31日

試験登録日

最初に提出

2026年7月21日

QC基準を満たした最初の提出物

2026年7月21日

最初の投稿 (実際)

2026年7月24日

学習記録の更新

投稿された最後の更新 (実際)

2026年7月27日

QC基準を満たした最後の更新が送信されました

2026年7月23日

最終確認日

2026年7月1日

詳しくは

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医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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