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Cerebral Microembolization During Pulmonary Vein Isolation: Comparison of Different Pulsed Field Ablation Systems (MICROPFA)

2026年5月21日 更新者：Ivan Zeljkovic

Cerebral Microembolization During Pulmonary Vein Isolation: a Randomized Comparison of Different Pulsed Field Ablation Systems

This prospective, randomized, parallel-group interventional study will compare cerebral microembolization during pulmonary vein isolation between different pulsed field ablation systems in patients with paroxysmal or persistent atrial fibrillation. Adult patients with an indication for catheter ablation will be randomized to one of the included ablation systems: PulseSelect, Varipulse, Farapulse, Sphere-9, or Sphere-360. Microembolic signals will be assessed using transcranial Doppler before and after the procedure. The primary outcome will be the difference in the change in microembolic signal burden, expressed as ΔMES, between the different ablation systems.

研究概览

地位

尚未招聘

条件

干预/治疗

详细说明

This study is designed as a prospective, randomized, parallel-group interventional trial conducted at Clinical Hospital Dubrava, Zagreb, Croatia and University Hospital Center Sisters of Charity, Zagreb, Croatia. The study will include adult patients with paroxysmal or persistent atrial fibrillation who have a clinical indication for catheter ablation with pulmonary vein isolation.

Eligible patients will be randomized using a computer-generated randomization sequence to undergo pulmonary vein isolation with one of the following pulsed field ablation systems: PulseSelect, Varipulse, Farapulse, Sphere-9, or Sphere-360. All procedures will be performed according to standard clinical practice, with continuous periprocedural anticoagulation in accordance with current guidelines.

Cerebral microembolization will be assessed using transcranial Doppler. The examination will be performed immediately before the ablation procedure and repeated after the procedure. The presence and number of microembolic signals will be recorded. This will allow assessment of changes in microembolic signal burden within each group and comparison of these changes between different pulsed field ablation systems.

Demographic, clinical, and procedural data will be collected, including age, sex, type of atrial fibrillation, comorbidities, procedure duration, number of ablation applications, and procedural complications. The study will also record procedure-related clinical neurological events.

The primary outcome will be the difference in the change in the number of microembolic signals before and after the procedure, expressed as ΔMES, between the different pulsed field ablation systems. Secondary outcomes will include within-group changes in microembolic signal burden, incidence of new microembolic signals after the procedure, association between procedural parameters and ΔMES, and occurrence of procedure-related neurological events.

研究类型

介入性

注册 (估计的)

100

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

  • 姓名：Mihovil Santini, MD
  • 电话号码：+385958101778
  • 邮箱：023miho@gmail.com

学习地点

  • 克罗地亚
      • Zagreb、克罗地亚、10000
        • UH Dubrava
        • 首席研究员：
          • Ivan Zeljković, MD, Phd
        • 副研究员：
          • Mihovil Santini, MD
      • Zagreb、克罗地亚、10000
        • University Hospital Center Sisters of Charity, Zagreb, Croatia

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

Inclusion Criteria:

  • Age 18 years or older
  • Paroxysmal or persistent atrial fibrillation
  • Indication for catheter ablation with pulmonary vein isolation
  • Feasibility of transcranial Doppler assessment
  • Signed informed consent

Exclusion Criteria:

  • Recent stroke or transient ischemic attack
  • Significant cerebrovascular disease preventing reliable transcranial Doppler assessment
  • Severe valvular or structural heart disease
  • Pregnancy or breastfeeding
  • Inability to receive anticoagulation

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
有源比较器：PulseSelect PFA
Participants randomized to this arm will undergo clinically indicated pulmonary vein isolation using the PulseSelect pulsed field ablation system. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
设备：Pulsed field ablation using PulseSelect system
Pulmonary vein isolation will be performed using the PulseSelect pulsed field ablation system in patients with paroxysmal or persistent atrial fibrillation undergoing clinically indicated catheter ablation. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
有源比较器：Varipulse PFA
Participants randomized to this arm will undergo clinically indicated pulmonary vein isolation using the Varipulse pulsed field ablation system. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
设备：Pulsed field ablation using Varipulse system
Pulmonary vein isolation will be performed using the Varipulse pulsed field ablation system in patients with paroxysmal or persistent atrial fibrillation undergoing clinically indicated catheter ablation. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
有源比较器：Farapulse PFA
Participants randomized to this arm will undergo clinically indicated pulmonary vein isolation using the Farapulse pulsed field ablation system. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
设备：Pulsed field ablation using Farapulse system
Pulmonary vein isolation will be performed using the Farapulse pulsed field ablation system in patients with paroxysmal or persistent atrial fibrillation undergoing clinically indicated catheter ablation. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedu
有源比较器：Sphere-9 PFA
Participants randomized to this arm will undergo clinically indicated pulmonary vein isolation using the Sphere-9 pulsed field ablation system. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
设备：Pulsed field ablation using Sphere-9 system
Pulmonary vein isolation will be performed using the Sphere-9 pulsed field ablation system in patients with paroxysmal or persistent atrial fibrillation undergoing clinically indicated catheter ablation. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure.
有源比较器：Sphere-360 PFA
Participants randomized to this arm will undergo clinically indicated pulmonary vein isolation using the Sphere-360 pulsed field ablation system. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure
设备：Pulsed field ablation using Sphere-360 system
Pulmonary vein isolation will be performed using the Sphere-360 pulsed field ablation system in patients with paroxysmal or persistent atrial fibrillation undergoing clinically indicated catheter ablation. Cerebral microembolic signals will be assessed by transcranial Doppler before and after the procedure

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Change in microembolic signal burden after pulmonary vein isolation
大体时间：During procedure
Difference in the number of cerebral microembolic signals detected by transcranial Doppler before and after pulmonary vein isolation, expressed as ΔMES, compared between the different pulsed field ablation systems.
During procedure

次要结果测量

结果测量
措施说明
大体时间
Within-group change in microembolic signal burden
大体时间：During procedure
Change in the number of cerebral microembolic signals detected by transcranial Doppler before and after pulmonary vein isolation within each pulsed field ablation system group.
During procedure
Incidence of new microembolic signals after ablation
大体时间：Immediately after the ablation procedure
Proportion of participants with newly detected cerebral microembolic signals on transcranial Doppler after pulmonary vein isolation.
Immediately after the ablation procedure
Procedure-related clinical neurological events
大体时间：From the start of the ablation procedure through 72 hours after the procedure
Occurrence of clinically evident neurological events related to the ablation procedure, including stroke or transient ischemic attack.
From the start of the ablation procedure through 72 hours after the procedure
Association between procedure duration and ΔMES
大体时间：During procedure
Association between total procedure duration and the change in cerebral microembolic signal burden before and after pulmonary vein isolation.
During procedure
Association between number of ablation applications and ΔMES
大体时间：During procedure
Association between the number of pulsed field ablation applications delivered during pulmonary vein isolation and the change in cerebral microembolic signal burden before and after the procedure.
During procedure

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Ivan Zeljkovic

合作者

University Hospital Dubrava
University Hospital Center Sisters of Charity, Zagreb, Croatia

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年6月1日

初级完成 (估计的)

2027年1月1日

研究完成 (估计的)

2027年1月20日

研究注册日期

首次提交

2026年5月14日

首先提交符合 QC 标准的

2026年5月21日

首次发布 (实际的)

2026年5月27日

研究记录更新

最后更新发布 (实际的)

2026年5月27日

上次提交的符合 QC 标准的更新

2026年5月21日

最后验证

2026年5月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • 2026/0423-11

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

未定

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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