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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 maj 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

No other detailed description.

Studietyp

Interventionell

Inskrivning (Beräknad)

350

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

  • Namn: GUODONG NIU
  • Telefonnummer: +86 0871-68279999
  • E-post: guodniu@163.com

Studieorter

  • Kina
    • Yunnan
      • Kunming, Yunnan, Kina
        • Fuwai Yunnan Hospital
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Beskrivning

Inclusion Criteria:

  1. Older than 18 years.
  2. 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.
  3. 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:

  1. Atrial fibrillation is secondary to thyroid disease or other reversible factors.
  2. Evidence of left atrial or left atrial appendage thrombus on imaging examination.
  3. Rheumatic heart disease or the presence of moderate to severe mitral stenosis or regurgitation.
  4. Left ventricular ejection fraction <40% or New York Heart Association (NYHA) class III/IV.
  5. Left atrial anteroposterior diameter >55 mm.
  6. Unstable angina.
  7. Myocardial infarction (MI), coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI) within 3 months prior to enrollment.
  8. Previous catheter ablation or surgical ablation for atrial fibrillation.
  9. History of prior left atrial appendage closure, patent foramen ovale closure, atrial septal defect closure, or repair surgery.
  10. Implantation of a mechanical mitral valve prosthesis or metallic annuloplasty rings.
  11. Presence of intracardiac thrombus, space-occupying lesions, or other abnormalities that preclude vascular access or catheter manipulation.
  12. Contraindications to anticoagulation or history of coagulation disorders/abnormal bleeding.
  13. Active systemic infection.
  14. Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m² or history of renal dialysis.
  15. Severe hepatic dysfunction.
  16. Pregnancy or breastfeeding.
  17. Life expectancy <12 months (e.g., advanced malignancy).
  18. Current or anticipated participation in other drug or device clinical trials.
  19. Any other condition or abnormality deemed by the investigator to warrant exclusion.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Procedur: 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 isolation will be conducted in the experimental group.
Aktiv komparator: 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.
Procedur: 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 isolation will be conducted in the experimental group.
Procedur: Abnormal left atrial substrate
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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
12-månaders förmaksflimmer (AF) ablationssuccesgrad
Tidsram: 12 månader efter proceduren
Definieras som frånvaro av AF, förmaksfladder (AFL) eller förmaks takykardi (AT) episoder ≥30 sekunder på dynamiskt elektrokardiogram (EKG) övervakning efter blankeringsperioden (90 dagar efter kateterablation)
12 månader efter proceduren

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Acute pulmonary vein ablation success rate and superior vena cava isolation rate.
Tidsram: 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
Immediate Success Rate of Left Atrial Posterior Wall Ablation (Abnormal Substrate Group Only)
Tidsram: 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.
Immediately post-procedure
Procedure-related time
Tidsram: 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)
Tidsram: Within 3 months post-procedure
Early recurrence rate of atrial arrhythmia (within the blanking period)
Within 3 months post-procedure
Incidence of symptomatic and asymptomatic atrial fibrillation events after the end of the blanking period.
Tidsram: 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
Incidence of repeat ablation after the blanking period
Tidsram: Within 12 months post-procedure
Incidence of repeat ablation after the blanking period
Within 12 months post-procedure
Rate of maintenance of pulmonary vein 、left atrial posterior wall and superior vena cava isolation in patients undergoing repeat ablation.
Tidsram: Within 12 months post-fist procedure.
Rate of maintenance of pulmonary vein 、left atrial posterior wall and superior vena cava isolation in patients undergoing repeat ablation.
Within 12 months post-fist procedure.
Improvement in Atrial fibrillation burden.
Tidsram: 3、6 and 12 months post-procedure.
Evaluate the improvement in postoperative atrial fibrillation burden via ambulatory electrocardiography.
3、6 and 12 months post-procedure.
Cardiac function assessment by NYHA
Tidsram: within 12 months post-procedure
Cardiac function was assessed relative to baseline using the NYHA classification.
within 12 months post-procedure
The postoperative quality of life was assessed using the Atrial Fibrillation-Specific Quality of Life Scale.
Tidsram: 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

Samarbetspartners och utredare

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Sponsor

Hangzhou Dinova EP Technology Co., Ltd

Studieavstämningsdatum

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Studera stora datum

Studiestart (Beräknad)

30 april 2026

Primärt slutförande (Beräknad)

1 februari 2029

Avslutad studie (Beräknad)

1 februari 2029

Studieregistreringsdatum

Först inskickad

20 april 2026

Först inskickad som uppfyllde QC-kriterierna

12 maj 2026

Första postat (Faktisk)

15 maj 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

15 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

12 maj 2026

Senast verifierad

1 maj 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • EP-CP-IIS-010

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