Use of Volta Medical AI-software During Atrial Fibrillation Ablation to Identify Patients Who May Need More Than Pulmonary Vein Isolation. (DISPLAY-AF)
Relationship Between Spatiotemporal Dispersion Areas DISPLAYed by Volta Medical Artificial Intelligence Software and Atrial Arrhythmia Recurrence After Pulmonary Vein Isolation-Only Ablation for Persistent Atrial Fibrillation
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Atrial fibrillation (AF) recurrence remains frequent after pulmonary vein isolation (PVI), particularly in patients with persistent AF, suggesting a role for non-pulmonary vein arrhythmogenic substrates. Spatiotemporal dispersion of intracardiac electrograms has been associated with AF maintenance and may provide insights into mechanisms underlying treatment failure.
Volta AF-Xplorer II is a CE-marked artificial intelligence-based software that assists electrophysiologists by identifying and displaying areas exhibiting spatiotemporal dispersion during AF ablation procedures. Previous studies have demonstrated the feasibility and clinical relevance of AI-guided dispersion analysis and ablation strategies in patients with persistent AF.
The DISPLAY-AF study was designed to investigate the relationship between spatiotemporal dispersion characteristics detected by Volta AF-Xplorer II and atrial arrhythmia recurrence following a standard PVI-only ablation strategy in patients undergoing de novo ablation for persistent AF. The study also aims to further characterize the distribution and evolution of dispersion patterns during AF ablation procedures.
Participants will be followed for 12 months after the index procedure, with scheduled visits at 3, 6, and 12 months. Follow-up assessments include ECGs, Holter monitoring, recurrence assessment, quality-of-life evaluation using the EQ-5D-3L questionnaire, symptom evaluation, medication review, and adverse event monitoring.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Paola MILPIED
- Número de telefone: +33768025499
- E-mail: paola.milpied@volta-medical.com
Estude backup de contato
- Nome: Cécile BIELMANN
- E-mail: cecile.bielmann@volta-medical.com
Locais de estudo
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Avignon, França, 84000
- Clinique Rhône Durance
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Contato:
- Francois-Xavier HAGER, MD
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Bron, França, 69677
- Hôpital Cardiologique Louis Pradel - HCL
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Contato:
- Francis BESSIERE, MD
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Dijon, França, 21079
- CHU Dijon
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Contato:
- Charles GUENANCIA, MD
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Marseille, França, 13008
- Hôpital Saint-Joseph Marseille
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Contato:
- Clément BARS, MD
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Strasbourg, França, 67000
- Clinique Rhéna
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Contato:
- Babé BAKOUBOULA, MD
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Patient aged 18 years or older.
- De novo patient candidate for catheter ablation of persistent atrial fibrillation (AF episode >7 days).
- Continuous anticoagulation for more than 4 weeks before ablation.
- Patient giving his signed consent form to participate in the clinical study.
- Patient affiliated to the French social security.
Exclusion Criteria:
- Contraindication to AF/AT catheter ablation.
- Major bleeding disorder.
- Contraindication to anticoagulation (Heparin, Warfarin or NOAC…) or lack of anticoagulation for 4 weeks prior to the procedure.
- Presence of a LA thrombus on transesophageal echocardiography (TEE) prior to the procedure.
- History of blood clotting or bleeding abnormalities
- Acute illness or active systemic infection or sepsis
- Any cardiac surgery within the past 2 months (60 days) (includes PCI)
- Myocardial infarction within the past 2 months (60 days)
- Awaiting cardiac transplantation or other cardiac surgery within the next 12 months (365 days)
- Diagnosed atrial myxoma
- Presence of intramural thrombus, tumor or other abnormality or condition that precludes vascular access, or manipulation of the catheter
- Documented thromboembolic event (including TIA) within the past 12 months (365 days)
- Unstable angina within the past month
- Significant severe pulmonary disease, (e.g. patients with restrictive pulmonary disease, constrictive or chronic obstructive pulmonary disease in GOLD stage IV) or any other disease or malfunction of the lungs or respiratory system that produces chronic symptoms (e.g. unstable or untreated sleep apnea)
- Patient who is or could potentially be pregnant.
- Person deprived of liberty or under guardianship.
- Patient's refusal to participate in the study.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Diagnóstico
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Intervention: Complete biatrial mapping before and after PVI using Volta AF-Xplorer II
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All enrolled patients undergo catheter ablation for persistent atrial fibrillation. During the mapping phases of the procedure, the CE-marked Volta AF-Xplorer II artificial intelligence software is used according to its intended use to identify and display areas exhibiting spatiotemporal dispersion. Complete biatrial mappings of spatiotemporal dispersion areas are performed before and after Pulmonary Vein Isolation using Volta AF-Xplorer II connected to a compatible electroanatomical 3D mapping system (EnSite or CARTO). For the abation, Pulmonary vein isolation (PVI) is performed using radiofrequency (RF) or pulsed field ablation (PFA), consisting of the creation of contiguous circumferential lesions around each pulmonary vein antrum. The main phases of the ablation procedure are:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Prazo |
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PVI non-responder rate defined as the proportion of patients experiencing atrial arrhythmia recurrence (documented AF/AT episode ≥30 seconds) within 12 months following a PVI-only ablation procedure according to the extra-PV/Perivenous Dispersion ratio.
Prazo: 12 months
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12 months
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Medidas de resultados secundários
Medida de resultado |
Prazo |
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PVI non-responder rate per type of atrial arrythmia recurrence within 12 months following a PVI-only ablation procedure according to the extra-PV/Perivenous Dispersion ratio.
Prazo: 12 months
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12 months
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PVI non-responder rate within 12 months following a PVI-only ablation procedure according to the dispersion localization.
Prazo: 12 months
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12 months
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Volta AF-Xplorer II-related Serious Incident rate.
Prazo: 12 months
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12 months
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Spatio-temporal dispersion extent and distribution obtained before and after PVI (LA, RA, biatrial)
Prazo: 12 months
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12 months
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Spatio-temporal dispersion areas (extent and distribution) between index and repeat ablation procedures in the study
Prazo: 12 months
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12 months
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Clément BARS, MD, Hôpital Saint Joseph Marseille
Publicações e links úteis
Publicações Gerais
- Deisenhofer I, Albenque JP, Busch S, Gitenay E, Mountantonakis SE, Roux A, Horvilleur J, Bakouboula B, Oza S, Abbey S, Theodore G, Lepillier A, Guyomar Y, Bessiere F, Jan Smit J, Mohr Durdez T, Milpied P, Appetiti A, Guerrero D, De Potter T, De Chillou C, Goldbarg S, Verma A, Hummel JD; TAILORED-AF Investigators. Artificial intelligence for individualized treatment of persistent atrial fibrillation: a randomized controlled trial. Nat Med. 2025 Apr;31(4):1286-1293. doi: 10.1038/s41591-025-03517-w. Epub 2025 Feb 14.
- Hummel JD, Zei PC, Metzl M, Deisenhofer I, Rashid H, Morales G, Horvilleur J, Mountantonakis S, Albenque JP, Vasaiwala S, De Potter T, Lador A, Magnano A, Chicos AB, Silverstein J, Guerrero D, Beguin S, El-Benna A, Nguyen-Tu MS, Lotteau S, Milpied P, Durdez TM, Kalifa J, Bars C, Seitz J, D'Souza B, Cooper DH, Nair D, Lakkireddy D. Reablation of atrial fibrillation targeting electrogram dispersion in patients with isolated veins: The RESTART trial. Heart Rhythm. 2026 May;23(5):1083-1090. doi: 10.1016/j.hrthm.2026.01.042. Epub 2026 Feb 2.
- Deisenhofer I, Seitz J, Nguyen-Tu MS, Lotteau S, Bars C, Albenque JP, Busch S, Gitenay E, Mountantonakis S, Roux A, Horvilleur J, Bakouboula B, Oza S, Abbey S, Theodore G, Lepillier A, Guyomar Y, Bessiere F, Smit JJ, Rajendra A, Cooper DH, Rashid H, De Potter T, De Chillou C, Goldbarg S, Verma A, Morales G, Milpied P, Hummel JD, Kalifa J. Women with persistent atrial fibrillation need more than pulmonary vein isolation: personalised extra-pulmonary vein ablation strategy vs. pulmonary vein isolation alone in the TAILORED-AF trial. Europace. 2025 Oct 31;27(11):euaf281. doi: 10.1093/europace/euaf281.
- Deisenhofer I, Seitz J, Lotteau S, Albenque JP, Busch S, Nguyen-Tu MS, Dayot A, Dalmau M, Leukovich H, Bars C, De Potter T, de Chillou C, Goldbarg S, Appetiti A, Milpied P, Durdez TM, Hummel JD, Kalifa J. Targetable atrial tachycardias after artificial intelligence-guided ablation of persistent atrial fibrillation. Heart Rhythm. 2026 Mar;23(3):e357-e367. doi: 10.1016/j.hrthm.2025.11.018. Epub 2025 Nov 14.
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- CLIPL-05-003
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