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A Study on the Therapeutic Value of Additional Left Atrial Posterior Wall Isolation Guided by Voltage Mapping in Persistent Atrial Fibrillation.
12 mei 2026 bijgewerkt door: Hangzhou Dinova EP Technology Co., Ltd
Prospective, Multicenter, Randomized Controlled Study on the Therapeutic Value of Additional Left Atrial Posterior Wall Isolation Guided by Voltage Mapping in Persistent Atrial Fibrillation.
This prospective, multicenter, randomized controlled study was designed to investigate the feasibility, efficacy and safety of pulsed field ablation (PFA) strategies for persistent atrial fibrillation.
For patients with persistent atrial fibrillation and normal left atrial substrate, pulmonary vein isolation combined with superior vena cava isolation will be performed.
For those with abnormal left atrial substrate, two strategies will be adopted: pulmonary vein isolation plus superior vena cava isolation, and pulmonary vein isolation combined with superior vena cava isolation and left atrial posterior wall isolation.
Long-term follow-up will be conducted to observe the long-term clinical outcomes.
Studie Overzicht
Toestand
Nog niet aan het werven
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
No other detailed description.
Studietype
Ingrijpend
Inschrijving (Geschat)
350
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: GUODONG NIU
- Telefoonnummer: +86 0871-68279999
- E-mail: guodniu@163.com
Studie Locaties
-
-
Yunnan
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Kunming, Yunnan, China
- Fuwai Yunnan Hospital
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Contact:
- Guodong Niu, PhD
- Telefoonnummer: +860871-68279999
- E-mail: guodniu@163.com
-
-
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Ja
Beschrijving
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.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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.
|
|
Actieve vergelijker: 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.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
12-maanden atriale fibrillatie (AF) ablatie-succespercentage
Tijdsspanne: 12 maanden post-procedure
|
Gedefinieerd als de afwezigheid van AF, atriale flutter (AFL) of atriale tachycardie (AT) afleveringen ≥30 seconden op dynamisch elektrocardiogram (ECG) monitoring na de blankingsperiode (90 dagen na de katheter ablatie)
|
12 maanden post-procedure
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Acute pulmonary vein ablation success rate and superior vena cava isolation rate.
Tijdsspanne: 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
|
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Immediate Success Rate of Left Atrial Posterior Wall Ablation (Abnormal Substrate Group Only)
Tijdsspanne: 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.
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Immediately post-procedure
|
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Procedure-related time
Tijdsspanne: 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)
Tijdsspanne: Within 3 months post-procedure
|
Early recurrence rate of atrial arrhythmia (within the blanking period)
|
Within 3 months post-procedure
|
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Incidence of symptomatic and asymptomatic atrial fibrillation events after the end of the blanking period.
Tijdsspanne: 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
|
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Incidence of repeat ablation after the blanking period
Tijdsspanne: Within 12 months post-procedure
|
Incidence of repeat ablation after the blanking period
|
Within 12 months post-procedure
|
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Rate of maintenance of pulmonary vein 、left atrial posterior wall and superior vena cava isolation in patients undergoing repeat ablation.
Tijdsspanne: Within 12 months post-fist procedure.
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Rate of maintenance of pulmonary vein 、left atrial posterior wall and superior vena cava isolation in patients undergoing repeat ablation.
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Within 12 months post-fist procedure.
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Improvement in Atrial fibrillation burden.
Tijdsspanne: 3、6 and 12 months post-procedure.
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Evaluate the improvement in postoperative atrial fibrillation burden via ambulatory electrocardiography.
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3、6 and 12 months post-procedure.
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Cardiac function assessment by NYHA
Tijdsspanne: within 12 months post-procedure
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Cardiac function was assessed relative to baseline using the NYHA classification.
|
within 12 months post-procedure
|
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The postoperative quality of life was assessed using the Atrial Fibrillation-Specific Quality of Life Scale.
Tijdsspanne: 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
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Geschat)
30 april 2026
Primaire voltooiing (Geschat)
1 februari 2029
Studie voltooiing (Geschat)
1 februari 2029
Studieregistratiedata
Eerst ingediend
20 april 2026
Eerst ingediend dat voldeed aan de QC-criteria
12 mei 2026
Eerst geplaatst (Werkelijk)
15 mei 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
15 mei 2026
Laatste update ingediend die voldeed aan QC-criteria
12 mei 2026
Laatst geverifieerd
1 mei 2026
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- EP-CP-IIS-010
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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