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Efficacy and Safety of Superior Vena Cava Isolation and Pulmonary Vein Isolation for Treatment of Atrial Fibrillation (SAVE-AF)

23 juli 2026 uppdaterad av: Qiang Hu

Efficacy and Safety of Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation by Pulsed Field Ablation for Treatment of Atrial Fibrillation

Atrial fibrillation (AF) is one of the most concerning diseases in the field of cardiac arrhythmias. It is a type of rapid supraventricular arrhythmia characterized by rapid and disorganized contraction of the atria, which leads to ventricular rate disturbance, impaired cardiac function, and an increased risk of atrial mural thrombus formation. AF severely reduces patients' quality of life and can cause complications such as heart failure, stroke, and sudden death. Currently, the vast majority of AF episodes are triggered by pulmonary vein (PV) ectopic foci. Therefore, catheter ablation is the preferred treatment strategy, with pulmonary vein isolation (PVI) being the cornerstone procedure. However, a small proportion of patients may have non-PV triggers, particularly originating from the superior vena cava (SVC). Conventional radiofrequency ablation (RFA) for SVC isolation carries unpredictable risks, including damage to the sinus node and the phrenic nerve. Therefore, this study aims to investigate the impact of empirical SVC electrical isolation in addition to PVI on the success rate of AF ablation, using pulsed field ablation (PFA)-a non-thermal ablation modality with tissue selectivity and a favorable safety profile.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Beräknad)

200

Fas

  • Inte tillämpbar

Kontakter och platser

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

Studiekontakt

Studieorter

    • Sichuan
      • Chengdu, Sichuan, Kina, 610000

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

Nej

Beskrivning

Inclusion Criteria:

  • Age ≥ 18 years;
  • Patients with documented atrial fibrillation (AF), confirmed by at least one episode of AF recorded on a 12-lead surface electrocardiogram (ECG) or ambulatory ECG monitoring within the past 12 months;
  • Subjects who agree to undergo treatment for AF using a pulsed field ablation (PFA) system that is currently commercially available in China;
  • Patients who have shown an inadequate response to, or intolerance of, at least one class of antiarrhythmic drug therapy;
  • Subjects or their legally authorized representatives who have been informed of the nature of this study, have agreed to all terms and conditions of the study, and have provided written informed consent, and who are willing to complete all required clinical follow-up visits in accordance with the study protocol.

Exclusion Criteria:

  • Prior surgical or catheter ablation for any type of cardiac arrhythmia;
  • AF secondary to electrolyte imbalance, valvular heart disease, thyroid disease, or other reversible causes;
  • Known requirement for ablation outside the pulmonary vein ostia or beyond the cavotricuspid isthmus;
  • Sinus node dysfunction or other indications for permanent pacemaker implantation;
  • Myocardial infarction, or prior coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) within the past 6 months;
  • Left atrial anteroposterior diameter ≥ 50 mm;
  • Evidence of left atrial or left atrial appendage thrombus confirmed by transesophageal echocardiography (TEE) or left atrial computed tomography (CT) within 24 hours prior to the procedure;
  • Serum creatinine > 2 times the upper limit of normal, or currently on dialysis;
  • History of prior cardiothoracic surgery;
  • History of permanent pacemaker implantation;
  • History of malignancy;
  • Long-term use of a central venous catheter;
  • Contraindications to anticoagulation therapy (including allergy to anticoagulants, thrombocytopenia, severe bleeding tendency, or coagulation disorders);
  • History of allergy to contrast;
  • Women who are pregnant, lactating, or who are unwilling to use adequate contraception during the study period;
  • Subjects or their legally authorized representatives who are unwilling to provide written informed consent;
  • Subjects who, for any reason, are unable to comply with the study protocol or complete all required clinical follow-up visits;
  • Subjects deemed by the investigator to be unsuitable for PFA treatment of AF.

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: Trippel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: superior vena cava isolation plus pulmonary vein isolation
Eligible patients with atrial fibrillation who are randomized to the experimental group will undergo superior vena cava (SVC) electrical isolation in addition to pulmonary vein isolation (PVI) during the pulsed field ablation procedure
Aktiv komparator: pulmonary vein isolation
Eligible patients with atrial fibrillation who are randomized to the control group will undergo pulmonary vein isolation (PVI) during the pulsed field ablation procedure

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
the success rate of atrial fibrillation ablation
Tidsram: at 3 month
it is assessed by 7-day Holter monitoring
at 3 month

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
the success rate of atrial fibrillation ablation
Tidsram: at 6 month and 12 month
it is assessed by 7-day Holter monitoring
at 6 month and 12 month
left ventricular end-systolic diameter
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left ventricular end-diastolic diameter
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left ventricular posterior wall thickness
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
interventricular septal thickness
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left ventricular ejection fraction
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
E/A
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
E/e'
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left atrial volume index
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left atrial anteroposterior diameter
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
left atrial strain
Tidsram: at 3 month, 6 month and 12 month
it is measured by echocardiography
at 3 month, 6 month and 12 month
New York Heart Association class
Tidsram: at 3 month, 6 month and 12 month
The NYHA is measured by Classification of NYHA heart function
at 3 month, 6 month and 12 month
Major adverse events
Tidsram: at 3 month, 6 month and 12 month
Major adverse events is a composite endpoint of death, stroke, and myocardial infarction.
at 3 month, 6 month and 12 month
6-min walk distance
Tidsram: at 3 month, 6 month and 12 month
During the test, patients were asked to walk for 6 minutes on a long corridor with a length of 37.5 meters between the 2 marks
at 3 month, 6 month and 12 month
red blood cell count
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
hemoglobin
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
white blood cell count
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
platelet count
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the routine blood test.
at 3 month, 6 month and 12 month
alanine aminotransferase
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the liver function test.
at 3 month, 6 month and 12 month
aspartate aminotransferase
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the liver function test.
at 3 month, 6 month and 12 month
creatinine
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the renal function test
at 3 month, 6 month and 12 month
urea
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the renal function test
at 3 month, 6 month and 12 month
estimated glomerular filtration rate
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the renal function test
at 3 month, 6 month and 12 month
activated partial thromboplastin time
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the coagulation function test
at 3 month, 6 month and 12 month
prothrombin time
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the coagulation function test
at 3 month, 6 month and 12 month
international normalized ratio
Tidsram: at 3 month, 6 month and 12 month
It is obtained from the coagulation function test
at 3 month, 6 month and 12 month
B-type natriuretic peptide
Tidsram: at 3 month, 6 month and 12 month
It is obtained from a blood sample.
at 3 month, 6 month and 12 month
Atrial Fibrillation Effect on Quality of Life Questionnaire
Tidsram: at 3 month, 6 month and 12 month
AFEQT questionnaire was used to assess the quality of life of patients with atrial fibrillation.
at 3 month, 6 month and 12 month
readmission
Tidsram: at 3 month, 6 month and 12 month
Rehospitalization was indicated for atrial fibrillation.
at 3 month, 6 month and 12 month

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Sponsor

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

20 juli 2026

Primärt slutförande (Beräknad)

31 mars 2029

Avslutad studie (Beräknad)

31 mars 2029

Studieregistreringsdatum

Först inskickad

21 juli 2026

Först inskickad som uppfyllde QC-kriterierna

21 juli 2026

Första postat (Faktisk)

24 juli 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

27 juli 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

23 juli 2026

Senast verifierad

1 juli 2026

Mer information

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