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Prospective Remapping With Concomitant Left Atrial Appendage Occlusion to Ensure Durable Electroporation Study (PRECLUDE)

2026年7月15日 更新者：Northwell Health
This is a single-arm, open label, clinical outcome study to research the durability (success) of receiving a pulsed field ablation (PFA) per standard of care for treatment of atrial fibrillation during a subsequent procedure for the insertion of a left atrial appendage occlusion (LAAO) device. The reassessment of the initial ablation will be performed with or without additional ablation if needed.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

Atrial fibrillation is a heart condition where the heart beats rapidly and/or irregularly. An ablation procedure is a form of treatment for atrial fibrillation to try to maintain or return the heart to a normal rhythm (called sinus rhythm). Ablation procedures can be done using heat (radiofrequency energy), cold (cryo energy), or electrical energy emitted by pulses (pulsed field ablation). Pulsed field ablation (PFA) is an invasive treatment procedure for which the doctor will deliver controlled energy through a PFA Catheter to destroy or scar the specific heart tissue causing the abnormal electrical signals. This scar helps to interrupt the abnormal electrical pathways and restore a normal heart rhythm. Ablation procedures are performed according to the standard of care.

The purpose of this study is to research the durability of receiving a PFA for the treatment of atrial fibrillation during a subsequent procedure performed at least 30 days after the initial ablation. The remapping procedure will utilize integrated electroanatomic mapping and intracardiac echocardiography to determine the index procedure technical success independent of arrhythmia recurrence.

研究类型

介入性

注册 (估计的)

50

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。

学习地点

  • 美国
    • New York
      • Bay Shore、New York、美国、11706
        • 招聘中
        • South Shore University Hospital
        • 接触：

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:

  • Participant is ≥ 18 years of age, or older if specified by local law
  • Participant has documented paroxysmal or persistent atrial fibrillation not related to a reversible cause
  • Participant has AF-related symptoms, and/or presence of CHF or LV dysfunction
  • Participant has a CHADSVASc>=3 in women and >=2 in men
  • There is appropriate rationale to seek a non-pharmacologic alternative to long-term oral anticoagulation for thromboembolic protection
  • Participant is willing and capable of providing informed consent
  • Participant is willing and capable of participating in all testing associated with this clinical investigation at an approved clinical investigational center

Exclusion Criteria:

  • Participant has had prior AF ablation (including surgical ablation)
  • Participant has had prior left atrial appendage occlusion or closure
  • Participant has an intracardiac mass or thrombus
  • Participant has had a bleeding disorder or inability to tolerate short-term oral anticoagulation
  • Participant has a life expectancy < 1 year
  • Participant has had recent MI, CVA, or cardiac surgery in preceding 90 days
  • Participant has an inability to comply with outpatient follow-up, or cognitive impairment that precludes understanding of procedure risks and benefits
  • Participant has an active systemic infection
  • Participant has a mechanical heart valve through which the catheter must pass, or severe mitral stenosis
  • Participant has a vena cava embolic protection filter devices and/or known femoral thrombus who require catheter insertion from the femoral approach
  • Participant had congenital heart disease where the underlying abnormality increases the risk of ablation (e.g. severe rotational anomalies of the heart or great vessels)
  • Participant is woman of childbearing potential who is pregnant, lactating, not using a reliable form of contraception, or who is planning to become pregnant during the anticipated study period
  • Participant has longstanding persistent AF ongoing for greater than 10 years
  • Participant has Left atrial appendage anatomy unsuitable for LAAO device
  • Participant has an LA diameter >6 cm

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：不适用
  • 介入模型：单组作业
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
实验性的：Single-arm, open label - all enrolled subjects
Remapping procedure with LAAO Implant with or without additional ablation.
设备：Remapping Procedure
Remapping procedure with LAAO Implant with or without additional ablation.

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
To prospectively assess durability of PFA ablation
大体时间：From Index Ablation to Subsequent Re-mapping procedure with concomitant LAAO implant. The remapping procedure will occur approximately 30-180 days after the index ablation.
Durability analysis will include % of patients with any PV reconnection, % of PVs reconnected, and % of patients with recovered conduction in the endocardial posterior wall (if posterior wall isolation performed at the index procedure).
From Index Ablation to Subsequent Re-mapping procedure with concomitant LAAO implant. The remapping procedure will occur approximately 30-180 days after the index ablation.

次要结果测量

结果测量
措施说明
大体时间
To assess arrhythmia-free survival in patients with confirmed durable PVI (+/-) posterior wall isolation
大体时间：6 months and 12 months post remapping procedure
Patients demonstrating durable PVI (+/- posterior wall isolation) confirmed during remapping procedure will be monitored for arrhythmia recurrence. Arrhythmia recurrence will be evaluated based on 1-week extended Holter monitoring performed at 6 months and 12 months post ablation.
6 months and 12 months post remapping procedure
Assess clinical outcomes following strategy of LAAO implant and potential for repeat AF ablation performed as consecutive procedures.
大体时间：From enrollment/index ablation to the 12month follow up post remapping procedure
Clinical outcomes following this novel prospective dual-procedure strategy will be analyzed, including assessment of clinical AT/AF recurrence and symptomatic arrhythmia recurrence.
From enrollment/index ablation to the 12month follow up post remapping procedure
Assess procedure related outcomes following strategy of LAAO implant and potential for repeat AF ablation performed as consecutive procedures.
大体时间：From enrollment/index ablation to the 12month follow up post remapping procedure
Procedural related outcomes following this novel prospective dual-procedure strategy will be analyzed, including assessment of ischemic stroke/TIA, bleeding complications, hospitalizations, and death.
From enrollment/index ablation to the 12month follow up post remapping 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

Northwell Health

合作者

Boston Scientific Corporation

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 (实际的)

2026年5月1日

初级完成 (估计的)

2028年5月1日

研究完成 (估计的)

2028年7月1日

研究注册日期

首次提交

2026年5月18日

首先提交符合 QC 标准的

2026年5月27日

首次发布 (实际的)

2026年6月2日

研究记录更新

最后更新发布 (实际的)

2026年7月17日

上次提交的符合 QC 标准的更新

2026年7月15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

  • 25-1100

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

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

是的

在美国制造并从美国出口的产品

是的

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