Ablation of focal activation in atrial fibrillation
Ablation of Focal Activation During Persistent Atrial Fibrillation to Determine the Characteristics of Focal Drivers
This study is testing a new method to find specific electrical signals that may be causing ongoing atrial fibrillation in patients, to see if targeting these signals can improve their treatment.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 110 (estimated) |
| Ages | 18 Years to 85 Years |
| Sex | All |
| Sponsor | Imperial College London Academic / other |
| Locations | 1 site (London) |
| Trial ID | NCT06402617 on ClinicalTrials.gov |
What this trial studies
This study investigates the use of RETRO-Mapping, a novel algorithmic approach, to identify focal electrical activations that may drive persistent atrial fibrillation (AF). By generating activation maps during AF, the study aims to determine whether these focal drivers contribute to the maintenance of AF. Participants will undergo pulmonary vein isolation and may receive adjunctive ablation guided by RETRO-Mapping. The goal is to improve the understanding of AF mechanisms and enhance treatment outcomes for patients with persistent AF.
Who should consider this trial
Good fit: Ideal candidates for this study are individuals with persistent atrial fibrillation who are clinically suitable for catheter ablation.
Not a fit: Patients with previous atrial fibrillation ablation procedures or significant comorbidities may not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could lead to more effective treatment options for patients with persistent atrial fibrillation.
How similar studies have performed: While other studies have shown success with pulmonary vein isolation, the use of RETRO-Mapping for persistent AF is a novel approach that has not been extensively tested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Persistent atrial fibrillation with clinical indication for catheter ablation * Clinically suitable candidate for catheter ablation * Signed informed consent Exclusion Criteria: * Previous atrial fibrillation or other catheter ablation procedure * Clinical contraindication to catheter ablation or general anaesthetic, including history of adverse reaction to contrast media, or presence of intracardiac thrombus, or inadequate anticoagulation in the preceding 6 weeks * Valvular disease graded moderate or greater, or presence of a prosthetic valve * Moderate-to-severe heart failure, defined as left ventricular ejection fraction \<35% and/or New York Heart Association class III-IV * Any form of cardiomyopathy * Active infection or fever * Severe cerebrovascular disease * Active gastrointestinal bleeding * Bleeding or clotting disorders, clinically high bleeding risk, or clinical contraindication to receiving heparin * Baseline serum creatinine \>200umol/L * Currently receiving or at risk of requiring renal replacement therapy * Uncontrolled diabetes (HbA1c ≥73mmol/mol or HbA1c ≤64mmol/mol and fasting blood glucose ≥9.2mmol/L) * Malignancy necessitating therapy * Life expectancy shorter than the duration of the trial * Pregnancy, or childbearing potential and not using a highly effective method of contraception * Inability to provide informed consent to participate in the trial
Where this trial is running
London
- Hammersmith Hospital — London, United Kingdom (Recruiting)
Study contacts
- Principal investigator: Prapa Kanagaratnam, FRCP PhD — Imperial College London
- Study coordinator: Prapa Kanagaratnam, FRCP PhD
- Email: p.kanagaratnam@imperial.ac.uk
- Phone: 020 3312 6666
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.