Comparing catheter ablation and lifestyle changes for treating atrial fibrillation

Catheter Ablation vs. Antiarrhythmic Drugs and Risk Factor Modification. PRAGUE-25 Randomized Study

Phase 3 Interventional Charles University, Czech Republic · NCT04011800

This study is testing whether making lifestyle changes and taking medication can help people with atrial fibrillation as effectively as catheter ablation.

Quick facts

PhasePhase 3
Study typeInterventional
Enrollment212 (estimated)
Ages18 Years to 75 Years
SexAll
SponsorCharles University, Czech Republic Academic / other
Locations1 site (Prague)
Trial IDNCT04011800 on ClinicalTrials.gov

What this trial studies

This trial aims to compare the effectiveness of catheter ablation versus a non-invasive approach involving antiarrhythmic drugs and lifestyle modifications in patients with symptomatic atrial fibrillation. The study will be conducted as a prospective, multicenter, randomized, non-inferiority trial, focusing on patients with a BMI of 30 or higher. Primary outcomes will include the recurrence of atrial fibrillation, while secondary outcomes will assess AF burden, exercise capacity, quality of life, and metabolic changes. The goal is to determine if lifestyle changes can achieve similar rhythm outcomes as catheter ablation.

Who should consider this trial

Good fit: Ideal candidates for this study are individuals with symptomatic atrial fibrillation and a BMI of 30 or higher.

Not a fit: Patients with permanent atrial fibrillation, severe heart conditions, or significant physical limitations may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide an effective non-invasive treatment option for patients with atrial fibrillation, potentially reducing the need for invasive procedures.

How similar studies have performed: While there have been observational studies on lifestyle modifications for atrial fibrillation, this direct comparison of catheter ablation and lifestyle changes is novel.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria (all three must be met):

* symptomatic atrial fibrillation
* BMI ≥ 30, and
* signed informed content

Exclusion Criteria:

* permanent AF
* severe valve disease (significant aortic stenosis, mitral regurgitation ≥ 3)
* left ventricular ejection fraction \< 40%
* severe pulmonary hypertension (PAP \> 40 mm Hg)
* history of tachycardia-induced cardiomyopathy
* manifest coronary artery disease
* pregnancy
* left atrial size ≥ 60 mm
* indication for surgical treatment of obesity
* BMI ≥ 40
* diabetes mellitus on insulintreatment
* age ≥ 75 let
* a significant physical limitation that could affect physical activity (musculoskeletal disorders, COPD)
* life expectancy less than 2 years

Where this trial is running

Prague

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Atrial Fibrillationatrial fibrillationcatheter ablationrisk factor modification
Last reviewed 2026-06-13 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.