RecruitingNot ApplicableNCT07021313

Deliver mOre aPplications for More Durable Pulmonary Vein IsOlation


Sponsor

R&D Cardiologie

Enrollment

378 participants

Start Date

Jun 20, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

Pulmonary vein isolation (PVI) by catheter ablation (CA) has become a widely accepted interventional treatment for patients with symptomatic atrial fibrillation (AF) despite anti-arrhythmic drugs (AAD). Classic thermal ablation modalities use radiofrequency energy or cryo-energy to create cardiac tissue lesions. Irreversible electroporation (IRE) using pulsed field energy (PFA) is a novel technology for cardiac tissue ablation. Initial studies have shown favorable outcome data in patients with AF treated by performing PVI using PFA. However, the freedom of AF has not yet proven superior to existing thermal ablation methods and appears similarly associated with suboptimal lesion durability, leading to electrical reconnection. The purpose of this study is to determine if freedom of atrial fibrillation may be improved by delivering more and better targeted pulsed field ablations.


Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria3

  • Be scheduled for PVI with the use of the FARAPULSE catheter ablation system AND
  • Have paroxysmal atrial fibrillation (PAF) documented in the last 6 months prior to enrolment OR
  • Had persistent atrial fibrillation but maintained in SR or converted to paroxysmal by antiarrhythmic drugs with no more than 1 cardioversion beyond 7 days in the past

Exclusion Criteria12

  • Cerebrovascular accident (CVA) in the last 6 months
  • More than moderate valvular disease that would require intervention
  • Cardiac catheter/surgical intervention in the last 3 months or scheduled
  • Atrial septal defect (ASD)/ patent foramen ovale (PFO) closure in the past
  • Left atrial appendage (LAA) closure in the past
  • Mechanical mitral valve
  • Non-adherence to oral anticoagulation in the 3 weeks prior to ablation
  • Renal disease with known eGFR\<45 ml
  • Left atrial volume index (LAVI) \>50 ml/m2 or left atrial diameter (LAD) \>50 mm
  • Known contra-indication for catheter ablation
  • Known contra-indication for deep sedation or general anesthesia
  • Known pregnancy

Interventions

DEVICEPulmonary vein isolation by percutaneous endocardial catheter ablation using the FARAPULSE pulsed high voltage electrical field system in patients with atrial fibrillation

Standard of care 4 pulsed electrical field applications in basket shape and 4 applications in flower shape

DEVICEPulmonary vein isolation by percutaneous endocardial catheter ablation using a pentaspline pulsed high voltage electrical field system in patients with atrial fibrillation

Experimental treatment delivering 2 pulsed electrical field applications in olive shape, 4 in basket shape and 6 applications in flower shape


Locations(1)

St. Antonius Hospital

Nieuwegein, Netherlands

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NCT07021313


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