Clinical trial Recruiting at 1 site Interventional Ages 18 to 85

Comparing cardioversion and ablation for persistent atrial fibrillation

Official title: Objective Randomised Blinded Investigation of Cardioversion Versus Ablation for Persistent Atrial Fibrillation (ORBICA-AF)

Run by Barts & The London NHS Trust · NCT06096246 · Data updated 2026-11-12

This study is testing whether a heart procedure called catheter ablation works better than a shock treatment to keep people with persistent atrial fibrillation from having their heart rhythm go out of sync again.

Quick facts

Study typeInterventional
Ages18 Years to 85 Years
SexAll
Enrollment208 (estimated)
SponsorBarts & The London NHS Trust
Academic / other
Locations1 site (London)
StatusRecruiting
StartedJuly 26, 2024
Main results expectedJuly 26, 2027
Study endsDecember 5, 2027
Registry record updatedSeptember 22, 2026
Trial IDNCT06096246 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Ideal candidates are adults aged 18-85 with persistent atrial fibrillation lasting more than 7 days and less than 2 years.

Probably not a fit

Patients with severe renal impairment, uncontrolled hypertension, or contraindications for anticoagulation or catheter ablation may not benefit from this study.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This research investigates whether pulmonary vein isolation through catheter ablation leads to lower rates of atrial fibrillation (AF) recurrence compared to direct current (DC) cardioversion in patients with persistent AF. The study will involve a blinded, randomized trial design to compare the effectiveness of these two treatment strategies. Patients will be monitored for AF recurrence and other outcomes following their assigned treatment. The trial aims to provide clarity on the optimal first-line treatment for persistent AF, which has not been established in previous studies.

Why it matters

Potential benefit: If successful, this study could provide a more effective treatment option for patients with persistent atrial fibrillation, potentially reducing recurrence rates.

How similar studies have gone: This approach is novel as no previous blinded randomized controlled trials have compared early-ablation strategies to cardioversion-led strategies for persistent AF.

Who can join: the full rules

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Ability to give informed consent
* Age 18-85 years
* Persistent AF (atrial fibrillation lasting \> 7days) of total continuous duration \<2 years as documented in medical notes.
* Patients being considered for cardioversion.

Exclusion Criteria:

* Creatinine clearance (eGFR) \< 30mls/min
* Contraindication or unable to take anticoagulation
* Uncontrolled hypertension
* Contraindication for catheter ablation
* BMI \> 40
* Patients in Persistent AF who have had more than one previous cardioversion.
* Established diagnosis of Hypertrophic cardiomyopathy

Where it's running

  • Barts Heart Centre
    London, United Kingdom
    Recruiting

Study contacts

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.