Evaluating a new catheter system for treating atrial fibrillation
Pragmatic Evaluation of a Pentaspline Pulsed Field Ablation System to Treat Atrial Fibrillation and Related Arrhythmias
This study is testing a new catheter system to see if it can safely and effectively treat atrial fibrillation with less sedation and better comfort for patients.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 275 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Icahn School of Medicine at Mount Sinai Academic / other |
| Locations | 2 sites (New York, New York and 1 other locations) |
| Trial ID | NCT06765356 on ClinicalTrials.gov |
What this trial studies
This pragmatic evaluation focuses on the safety, performance, and effectiveness of the FARAPULSE catheter system in treating patients with atrial fibrillation during clinically-indicated ablation procedures. The study aims to include a broader patient population compared to previous trials, allowing for a more comprehensive assessment of the technology's efficacy. The FARAPULSE system is designed to perform ablation with minimal sedation and without the need for intubation, potentially improving patient comfort and outcomes. The study will assess its effectiveness in various forms of atrial fibrillation, including persistent and paroxysmal types.
Who should consider this trial
Good fit: Ideal candidates include adults aged 18 and older diagnosed with atrial fibrillation who are scheduled for a catheter ablation procedure.
Not a fit: Patients who have not been diagnosed with atrial fibrillation or those who have contraindications to catheter ablation may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could provide a safer and more effective treatment option for patients suffering from atrial fibrillation.
How similar studies have performed: Previous observational studies in Europe have shown that the FARAPULSE catheter system is safe and effective for treating atrial fibrillation, indicating promise for this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 18 or older * Diagnosed with atrial fibrillation with or without concomitant atrial flutter by ECG at some point in the past, and by any criteria (ECG or clear symptoms within the past year) * Previous catheter ablation for other arrhythmias (including left-sided ablation, but not for AF) is allowed * Planned for a clinically-indicated catheter ablation procedure for managing paroxysmal or persistent atrial fibrillation in accordance with the following recommendations in the ACC/AHA/ACCP/HRS guidelines * In patients with symptomatic AF in whom antiarrhythmic drugs have been ineffective, contraindicated, not tolerated or not preferred, and continued rhythm control is desired, catheter ablation is useful to improve symptoms.(Class 1) * In selected patients (generally younger with few comorbidities) with symptomatic paroxysmal AF in whom rhythm control is desired, catheter ablation is useful as first-line therapy to improve symptoms and reduce progression to persistent AF. (Class 1) * In patients (other than younger with few comorbidities) with symptomatic paroxysmal or persistent AF who are being managed with a rhythm-control strategy, catheter ablation as first-line therapy can be useful to improve symptoms. (Class 2a) * In selected patients with asymptomatic or minimally symptomatic AF, catheter ablation may be useful for reducing progression of AF and its associated complications. (Class 2b) * In patients who present with a new diagnosis of HFrEF and AF, arrhythmia-induced cardiomyopathy should be suspected, and an early and aggressive approach to AF rhythm control is recommended. (Class 1) * In appropriate patients with AF and HFrEF who are on GDMT, and with reasonable expectation of procedural benefit, catheter ablation is beneficial to improve symptoms, QOL, ventricular function, and cardiovascular outcomes. (Class 1) * In appropriate patients with symptomatic AF and HFpEF with reasonable expectation of benefit, catheter ablation can be useful to improve symptoms and improve QOL. (Class 2a) * In athletes who develop AF, catheter ablation with PVI is a reasonable strategy for rhythm control because of its effectiveness and low risk of detrimental effect on exercise capacity. (Class 2a) * Have in place or have plans for implantation of a loop recorder, pacemaker or cardiac defibrillator capable of recording atrial rhythm (e.g. dual chamber) (ideally, this implantable device would be present for at least 4 weeks pre-PFA) * Able and willing to provide written consent and comply with all testing and follow-up requirements Exclusion Criteria: * Documented "active" left atrial thrombus (patients may later undergo the procedure if this is no longer present, eg, with anticoagulation treatment) * Reversible cause of AF (e.g., post-operative, thyroid disorder, etc.) * Conditions that make an AF ablation procedure unlikely to be successful (e.g., advanced infiltrative cardiomyopathies like amyloid, severe mitral stenosis or regurgitation, and cor pulmonale) * PCI/STEMI within the prior 1 month * Active systemic infection or sepsis * Contraindication to all anticoagulation * Significant congenital anomaly or medical problem that in the opinion of the investigator would preclude an ablation procedure * Women who are pregnant, lactating, or who are of childbearing age and plan on becoming pregnant during this trial. * Life expectancy or other disease processes likely to limit survival to less than 12 months * Currently, enrolled in an investigational study evaluating another device, biologic, or drug, that would interfere with this trial.
Where this trial is running
New York, New York and 1 other locations
- The Mount Sinai Hospital — New York, New York, United States (Recruiting)
- Trident Medical Center — North Charleston, South Carolina, United States (Recruiting)
Study contacts
- Principal investigator: Vivek Reddy, MD — The Mount Sinai Hospital, Icahn School of Medicine
- Study coordinator: Jerome A Tonog, MD
- Email: jerome.tonog@mountsinai.org
- Phone: 2122415214
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.