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Single-Use Spherical Pulsed Ablation Catheter for Paroxysmal Atrial Fibrillation

2026年9月3日 更新者:Shanghai Shineyo Medical Co., Ltd.

A Prospective, Multicenter, Randomized Controlled, Non-inferiority Clinical Trial Evaluating the Safety and Efficacy of Cardiac Pulsed Field Ablation Devices Combined With Single-use Spherical Pulsed Ablation Catheters in Treating Paroxysmal Atrial Fibrillation

The goal of this clinical trial is to learn if the cardiac pulsed field ablation system, composed of the cardiac pulsed field ablation device, the single-use spherical pulsed ablation catheter, and the optional cardiac three-dimensional mapping system, works to treat symptomatic, recurrent, drug-refractory paroxysmal atrial fibrillation. It will also learn about the safety of this set of investigational medical devices. The main questions it aims to answer are:

Does the combination of the cardiac pulsed field ablation device and the single-use spherical pulsed ablation catheter improve the 12-month post-procedure treatment success rate for participants with paroxysmal atrial fibrillation? What adverse events and medical problems do participants experience after receiving the investigational pulsed field ablation treatment? Researchers will compare the investigational pulsed field ablation therapy to the clinically recognized radiofrequency ablation therapy using the marketed Diagnostic/Ablation Deflectable Tip Catheter to verify the non-inferior effectiveness and safety of the test devices for treating paroxysmal atrial fibrillation.

Participants will:

Undergo screening assessments within 14 days before the procedure, including signing informed consent, completing medical history collection, physical vital sign checks, laboratory tests, 12-lead ECG, echocardiogram, baseline quality of life score evaluation, and confirmation of meeting all inclusion criteria without any exclusion criteria Be randomly assigned to either the investigational pulsed field ablation group or the control radiofrequency ablation group on the day of surgery Receive the assigned ablation procedure, with intra-operative recordings of core surgical parameters, pain score assessment, and investigational device performance evaluation Complete post-procedure assessments before discharge (within 7 days after surgery), including post-operative laboratory tests, pain follow-up, and recording of re-ablation, electrical cardioversion, readmission events, adverse events and concomitant medications Return for follow-up visits or complete telephone follow-ups at 1 month (±7 days), 3 months (±15 days), 6 months (±30 days) and 12 months (±30 days) after the procedure, which include physical vital sign checks, remote ECG monitoring (daily for the first 3 months after surgery, weekly from month 4 to month 12, and as needed when symptoms occur), 72-hour Holter and 12-lead ECG tests at the 6-month and 12-month visits, echocardiogram reexamination, repeated quality of life scoring, and continuous recording of arrhythmia recurrence, subsequent treatment events, adverse events and medication status Keep a symptom and ECG monitoring diary for the entire 12-month follow-up period after the procedure, as required by the trial protocol

調査の概要

研究の種類

介入

入学 (推定)

284

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

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 and ≤75 years, without gender restriction
  • Patients with symptomatic, recurrent, drug-refractory paroxysmal atrial fibrillation
  • Subjects scheduled for atrial fibrillation catheter ablation
  • Subjects who agree to participate in this study and voluntarily sign the informed consent form

Exclusion Criteria:

  • Persistent atrial fibrillation, or atrial fibrillation secondary to electrolyte disturbance, thyroid disease, alcohol or other reversible/non-cardiac causes
  • Anterior-posterior left atrial diameter (measured by MRI, CT or TTE) ≥55 mm
  • Prior history of any atrial surgery or atrial endocardial/epicardial ablation, except cavotricuspid isthmus ablation or right-sided supraventricular tachycardia ablation
  • Existing left atrial thrombus, atrial myxoma, atrial septal patch or shunt device
  • Prior or planned concomitant left atrial appendage closure procedure at index procedure
  • Diagnosis of hypertrophic cardiomyopathy
  • History of congenital heart disease with residual anatomical or conduction abnormalities
  • Hemodynamically significant valvular heart disease judged by investigator to be ineligible for enrollment
  • Prior valve repair or valve replacement surgery
  • Implanted pacemaker, implantable cardioverter-defibrillator or cardiac resynchronization therapy device
  • NYHA functional class Ⅲ-Ⅳ
  • Left ventricular ejection fraction (LVEF) ≤40%
  • Symptomatic hypotension or uncontrolled hypertension (systolic blood pressure >160 mmHg or diastolic blood pressure >95 mmHg in two baseline measurements)
  • Symptomatic resting bradycardia or type-second-degree or third-degree atrioventricular block
  • Contraindication to systemic anticoagulation, or unwillingness to receive systemic anticoagulation
  • Medical conditions that may interfere with study participation, assessment or treatment, significantly increase study-related risk, or alter study outcomes, including but not limited to: moderate-to-severe COPD, moderate-to-severe pulmonary hypertension, or diseases causing severe dyspnea or resting hypoxemia; renal insufficiency (eGFR<30 ml/min/1.73 m²) or history of hemodialysis or renal transplantation; active malignancy or treated malignancy within 24 months prior to enrollment (excluding basal cell or squamous cell skin carcinoma); active systemic infection
  • Myocardial infarction, unstable angina, heart failure hospitalization within 3 months prior to enrollment; any cardiac interventional or open-heart surgery within 1 month prior to enrollment (coronary angiography excluded)
  • Stroke (excluding silent stroke), transient ischemic attack or any thromboembolic event within 3 months prior to enrollment
  • Expected survival less than 1 year
  • Female subjects who are pregnant, lactating, or planning pregnancy during study period
  • Participation in another interventional device clinical trial within 1 month before enrollment, or within 5 half-lives of last study drug for drug clinical trials
  • Any other condition judged by investigator to make the subject unsuitable for this clinical trial

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:4倍

武器と介入

参加者グループ / アーム
介入・治療
実験的:Investigational Cardiac Pulsed Field Ablation (PFA) Arm
Intervention group receiving cardiac pulsed field ablation for paroxysmal atrial fibrillation
It consists of a cardiac pulsed electric field ablation apparatus and a single-use spherical pulsed ablation catheter, which can be paired with an optional cardiac three-dimensional mapping system to complete pulsed electric field ablation in the pulmonary vein antrum region, achieve pulmonary vein electrical isolation, and is indicated for the treatment of symptomatic, recurrent, drug-refractory paroxysmal atrial fibrillation.
アクティブコンパレータ:Control Radiofrequency (RF) Catheter Ablation Arm
Control group receiving conventional radiofrequency catheter ablation for paroxysmal atrial fibrillation
Using the commercially available diagnostic/ablation steerable-tip catheter in combination with a conventional clinical radiofrequency ablation device, point-by-point radiofrequency ablation is performed on the pulmonary vein antrum to achieve pulmonary vein electrical isolation. This is the current standard clinical treatment for paroxysmal atrial fibrillation.

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
Proportion of participants with freedom from atrial fibrillation at 12 months post-index ablation (90-day post-procedure blanking period)
時間枠:12 months post-index ablation
Treatment success at 12 months post-index ablation is defined as no amiodarone use and no repeat ablation during the 3-month post-procedure blanking period, except repeat ablation for CTI-dependent atrial flutter. Following the end of the blanking period (i.e., 3 months to 12 months after the procedure), subjects shall have no use of Class I/III antiarrhythmic drugs, no repeat ablation, no electrical cardioversion (interventions for CTI-dependent atrial flutter excluded), and no episodes of atrial fibrillation, atrial flutter, or atrial tachycardia lasting ≥30 seconds confirmed by electrocardiogram or Holter monitoring (CTI-dependent atrial flutter excluded).
12 months post-index ablation

二次結果の測定

結果測定
メジャーの説明
時間枠
Proportion of participants with treatment success at 12 months post-index ablation
時間枠:From the end of 30-day post-procedure blanking period to 12 months after the index ablation
From the end of 30-day post-procedure blanking period to 12 months after the index ablation
Acute procedural success rate on the day of index ablation
時間枠:On the day of index ablation (intra-procedure completion)
On the day of index ablation (intra-procedure completion)
Atrial fibrillation burden assessed by 72-hour Holter monitoring
時間枠:6-month and 12-month follow-up; daily monitoring 1-3 months post-procedure, weekly monitoring 4-12 months post-procedure, additionally upon symptom occurrence
6-month and 12-month follow-up; daily monitoring 1-3 months post-procedure, weekly monitoring 4-12 months post-procedure, additionally upon symptom occurrence
Pain score at 2-hours and 24-hours after index ablation
時間枠:2 hours after recovery from anesthesia; 24 hours post-index ablation
2 hours after recovery from anesthesia; 24 hours post-index ablation
Recurrence rate of early atrial tachyarrhythmias (atrial fibrillation / atrial flutter / atrial tachycardia)
時間枠:1-month and 3-month post-index ablation
1-month and 3-month post-index ablation
Proportion of participants receiving electrical cardioversion, repeat ablation, emergency department visit or hospitalization due to documented recurrent atrial arrhythmia
時間枠:Prior to hospital discharge, 1-month, 3-month, 6-month, 12-month post-index ablation
Prior to hospital discharge, 1-month, 3-month, 6-month, 12-month post-index ablation
Proportion of participants with re-initiation of antiarrhythmic drugs
時間枠:1-month, 3-month, 6-month, 12-month post-index ablation
1-month, 3-month, 6-month, 12-month post-index ablation
Time from index ablation to first documented recurrence of atrial fibrillation, atrial flutter or atrial tachycardia
時間枠:Up to 12-month post-index ablation, assessed at 1-,3-,6-,12-month visits
Up to 12-month post-index ablation, assessed at 1-,3-,6-,12-month visits
Symptom-free survival of participants
時間枠:1-month, 3-month, 6-month, 12-month post-index ablation
1-month, 3-month, 6-month, 12-month post-index ablation
Change in Atrial Fibrillation Effect on Quality-of-Life (AFEQT) total score from baseline
時間枠:Baseline, 1-month, 3-month, 6-month, 12-month post-index ablation
The change from baseline in the total score of the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire. Measurement tool: AFEQT questionnaire. Unit: score.
Baseline, 1-month, 3-month, 6-month, 12-month post-index ablation
Performance evaluation of investigational device
時間枠:On the day of index ablation
On the day of index ablation
Incidence of major adverse events
時間枠:Within 7 days post-index ablation and up to 12 months post-index ablation
Within 7 days post-index ablation and up to 12 months post-index ablation
Incidence of device- or procedure-related stroke or transient ischemic attack (TIA)
時間枠:Through study completion, average of 12-month follow-up
Number of subjects experiencing device- or procedure-related stroke or transient ischemic attack (TIA). Unit: percentage of subjects.
Through study completion, average of 12-month follow-up
Incidence of device- related serious adverse events (SAE)
時間枠:Through study completion, average of 12-month follow-up
Number of device-related serious adverse events divided by the total number of serious adverse events that occurred during follow-up. Measurement tool: clinical adverse-event reporting. Unit: percentage of SAE events.
Through study completion, average of 12-month follow-up
Laboratory values of myocardial injury biomarkers
時間枠:Within 48-hours post-index ablation
Laboratory values of myocardial injury biomarkers collected within 48-hours post-index ablation or prior to hospital discharge, whichever comes first. Unit: laboratory value.
Within 48-hours post-index ablation
Incidence of hemolysis-associated renal injury
時間枠:Within 48-hours post-index ablation
Number of subjects with hemolysis-associated renal injury occurring within 48-hours post-index ablation or prior to hospital discharge, whichever comes first. Unit: percentage of subjects.
Within 48-hours post-index ablation
Incidence of other adverse events (AE)
時間枠:Through study completion, average of 12-month follow-up
Number of subjects experiencing other adverse events (AEs) throughout the study period. Unit: percentage of subjects.
Through study completion, average of 12-month follow-up
Total index ablation procedure duration
時間枠:Periprocedural
Total time duration of the index ablation procedure. Unit: minutes.
Periprocedural
Left-atrial device dwell time during index ablation
時間枠:Periprocedural
Total dwell time of investigational device within left atrium during index ablation. Unit: minutes.
Periprocedural
Pulmonary vein isolation (PVI) procedural time
時間枠:Intra-procedural
Time spent for pulmonary vein isolation (PVI) manipulation during index ablation. Unit: minutes.
Intra-procedural
Total fluoroscopy time during index ablation
時間枠:Intra-procedural
Total fluoroscopy exposure time during index ablation. Unit: minutes.
Intra-procedural
Total contrast media volume administered
時間枠:Intra-procedural
Total volume of contrast media used during index ablation. Unit: mL.
Intra-procedural
Number of ablation energy deliveries
時間枠:Intra-procedural
Total count of ablation energy deliveries applied during index ablation. Unit: number of subjects (count).
Intra-procedural
Incidence of other serious adverse events (SAE) throughout the study period
時間枠:Through study completion, average of 12-month follow-up
Number of subjects with other serious adverse events occurring during the entire study period. Measurement tool: serious adverse-event reporting. Unit: percentage of subjects.
Through study completion, average of 12-month follow-up
Laboratory values of inflammatory biomarkers
時間枠:Within 48-hours post-index ablation
Laboratory values of inflammatory biomarkers collected within 48-hours post-index ablation or prior to hospital discharge, whichever comes first. Unit: laboratory value.
Within 48-hours post-index ablation
Change in EuroQol 5-Dimension 5-Level (EQ-5D-5L) utility score from baseline
時間枠:Baseline, 1-month, 3-month, 6-month, 12-month post-index ablation
The change from baseline in the utility index score calculated from the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. Measurement tool: EQ-5D-5L questionnaire. Unit: index score.
Baseline, 1-month, 3-month, 6-month, 12-month post-index ablation
Proportion of procedure-related serious adverse events (SAEs) among all SAEs
時間枠:Through study completion, average of 12-month follow-up
Number of procedure-related serious adverse events divided by the total number of serious adverse events that occurred during follow-up. Measurement tool: clinical adverse-event reporting. Unit: percentage of SAE events.
Through study completion, average of 12-month follow-up

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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 (推定)

2026年9月1日

一次修了 (推定)

2028年3月1日

研究の完了 (推定)

2028年6月1日

試験登録日

最初に提出

2026年8月20日

QC基準を満たした最初の提出物

2026年9月3日

最初の投稿 (実際)

2026年9月10日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月10日

QC基準を満たした最後の更新が送信されました

2026年9月3日

最終確認日

2026年8月1日

詳しくは

本研究に関する用語

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

Individual-participant-level data will not be shared with other researchers.

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米国FDA規制機器製品の研究

いいえ

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いいえ

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