- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT04832646
VOLTage Mapping in Atrial Fibrillation (VOLT-AF)
The purpose of this study is to retrospectively analyze electroanatomical data collected during persistent atrial fibrillation ablation procedures, combined with pre-ablation cardiac CT data, in order to:
- define a new method for quantifying left atrial voltage in atrial fibrillation via a total energy map instead of a peak-to-peak amplitude map
- confirm the association between epicardial fat localization and atrial conduction slowing
연구 개요
상세 설명
Background:
Atrial fibrillation (AF) is the most common arrhythmia, with an estimated prevalence in 2010 of 33.5 million people (3% of the world population). It is now estimated that 1 in 4 middle-aged adults in Europe and the United States will develop AF in their lifetime. Of course, the aging of the population is considered one of the major explanations for this pandemic phenomenon, as well as the ever-increasing prevalence of overweight and obesity. Complications related to this arrhythmia are numerous and frequent, with thromboembolic events having a major impact on morbidity. Thus, it is estimated that AF is responsible for a quarter of ischemic strokes and increases the risk of stroke fivefold. At the same time, there is an increased risk of long-term heart failure, which is responsible for excess mortality. Finally, patients with AF frequently have an impaired quality of life and a higher rate of hospitalization than patients in sinus rhythm (10 to 40% of patients with AF are hospitalized at least once a year). An association between AF and cognitive decline and risk of vascular dementia (even in patients treated with anticoagulants) has also been described. Depending on the temporality of AF, it is referred to as paroxysmal, persistent, or permanent AF.
Endocavitary ablation for the treatment of atrial fibrillation was first described by the Bordeaux team of Prof. Michel Haïssaguerre in the early 1990s, who demonstrated the role of electrical discharges from the pulmonary veins in the initiation of (paroxysmal) AF. The following years therefore saw the development of tools to electrically isolate the pulmonary veins from the left atrium, and then to try to identify and treat additional pathological areas in the atria for more advanced (persistent) forms of AF. The advent of three-dimensional modeling technologies has made it possible to develop intracardiac navigation systems to guide AF ablation in 3D, while limiting fluoroscopy time for the patient and staff.
In persistent AF, unlike paroxysmal AF, the technique used and the ablation targets are less codified, with success rates lower than those obtained in paroxysmal AF. Indeed, unlike paroxysmal AF, the pathophysiology of which is well understood, there is no unicist consensus theory for persistent AF. Based on the hypothesis of the predominance of the substrate over the pulmonary venous trigger in the self-maintenance of persistent AF, teams have highlighted the major role of left atrial fibrosis in this pathology, which is the cause of conduction heterogeneity in the left atrium. Work to elucidate the triggers of this fibrotic disease emphasizes the key role of periatrial epicardial fat, which secretes pro-fibrotic mediators and deregulates the atrial ganglionic plexi. An association has also been made between epicardial fat volume and the incidence and maintenance of atrial fibrillation. In addition, recent work demonstrates that the peri-atrial adipocyte environment modulates not only fibrosis but also the conductive properties of atrial cells.
During endocavitary ablation of atrial fibrillation, multi-electrode diagnostic catheters allow precise electroanatomical reconstruction of the left atrium, quantifying its geometry but also the local electrical signals (electrograms), in terms of amplitude (voltage map) and temporality relative to a reference (activation map). It is therefore theoretically possible to build a map of conduction velocities in sinus rhythm or electroentrainment in the atrium, by calculating the velocity and vector of electrical depolarization between each electrogram. In parallel, before any AF ablation, an injected cardiac CT scan is performed for three-dimensional atrial reconstruction. This scan also allows the quantification of the atrial epicardial fat in terms of volume and density. We therefore want to develop an algorithm allowing the construction of a map of velocities in sinus rhythm, fused to the three-dimensional reconstruction of the location of the atrial epicardial fat.
연구 유형
등록 (예상)
연락처 및 위치
연구 연락처
- 이름: Charles Guenancia, MD, PhD
- 전화번호: +33684693094
- 이메일: charles.guenancia@chu-dijon.fr
연구 장소
-
-
-
Vandoeuvre les nancy, 프랑스, 54500
- 모병
- University Hospital Of Nancy
-
연락하다:
- Christian De Chillou, MD, PhD
-
-
참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
설명
Inclusion Criteria:
- Persistant Atrial fibrillation ablation
- Voltage map in sinus rhythm and in atrial fibrillation
- Cardiac CT scan performed before ablation
Exclusion Criteria:
- Incomplete data, poor quality ECG recordings.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
---|---|
correlation between voltage map in sinus rhythm and the new voltage map in atrial fibrillation using total energy calculation
기간: through study completion, an average of 1 year
|
through study completion, an average of 1 year
|
2차 결과 측정
결과 측정 |
기간 |
---|---|
correlation between atrial epicardial fat deposits and atrial conduction velocities slowing
기간: through study completion, an average of 1 year
|
through study completion, an average of 1 year
|
공동 작업자 및 조사자
수사관
- 수석 연구원: Charles GUENANCIA, MD, PhD, CHRU Nancy
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
지속성 심방세동에 대한 임상 시험
-
Assistance Publique - Hôpitaux de Paris아직 모집하지 않음과도한 Supraventricular Ectopies 또는 Short Atrial Runs(ESVEA)
-
University of Pennsylvania빼는전형적인 심방 조동 | Atrial Flutter의 향후 개발 위험 요소미국
atrial fibrillation ablation에 대한 임상 시험
-
Biosense Webster, Inc.완전한심방세동캐나다, 벨기에, 오스트리아, 크로아티아, 체코, 프랑스, 이탈리아, 리투아니아
-
University of AdelaideBoston Scientific Corporation; Medtronic; Abbott Medical Devices완전한
-
Farapulse, Inc.모집하지 않고 적극적으로
-
Medtronic Cardiac Rhythm and Heart Failure완전한