Optimized posterior wall ablation for persistent atrial fibrillation
Optimized Ablation of the Posterior Wall in Persistent Atrial Fibrillation
This study tests whether adding posterior wall ablation and electrogram-guided ablation to standard pulmonary vein isolation helps people with persistent atrial fibrillation who are having their first ablation.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 384 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | Shanghai Chest Hospital Academic / other |
| Locations | 1 site (Shanghai) |
| Trial ID | NCT07122336 on ClinicalTrials.gov |
What this trial studies
This randomized, controlled trial compares three approaches for first-time catheter ablation in persistent atrial fibrillation: pulmonary vein isolation (PVI) alone, PVI plus posterior wall isolation (PWI), and PVI+PWI with additional electrogram-guided (EGM) ablation. Eligible adults have symptomatic persistent AF lasting between 7 days and 3 years and have not had prior ablation. Participants are randomized to one of the three intervention groups and followed for arrhythmia recurrence and safety outcomes. The study will compare rhythm outcomes, need for repeat procedures, and procedural safety across the three arms.
Who should consider this trial
Good fit: Adults (≥18 years) with symptomatic persistent atrial fibrillation lasting 7 days to 3 years, intolerant of at least one antiarrhythmic drug, and undergoing their first ablation are ideal candidates.
Not a fit: People with paroxysmal AF, long-standing persistent AF (>3 years), prior left atrial ablation, or contraindications to anticoagulation are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, the approach could lower AF recurrence rates and reduce the need for repeat ablations, improving symptoms and quality of life.
How similar studies have performed: Previous studies of posterior wall isolation have shown mixed results and electrogram-guided ablation strategies remain experimental with limited consistent evidence.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Age ≥18 years 2. First-time ablation for persistent atrial fibrillation (PsAF) 3. Persistent AF definition: Sustained episodes lasting ≥7 days but ≤3 years (including episodes requiring pharmacologic or electrical cardioversion after ≥7 days) 4. Symptomatic AF with intolerance to at least one antiarrhythmic drug (AAD) 5. Documented PsAF episode: At least one recorded PsAF episode within the last 2 years prior to enrollment, confirmed by: ECG,Holter monitorin, Loop recorder, Telemetry, Transtelephonic monitoring (TTM),Implantable device 6. Ability and willingness to provide written informed consent 7. Compliance with all study follow-up requirements Exclusion Criteria: 1. Paroxysmal AF: Episodes lasting \<7 days (or requiring pharmacologic/electrical cardioversion \<7 days) 2. Long-standing persistent AF: Continuous AF duration \>3 years 3. No prior attempt/pursuit of cardioversion or sinus rhythm maintenance 4. Contraindications to systemic anticoagulation 5. Pregnancy 6. Advanced renal or hepatic failure 7. Severe valvular heart disease or cyanotic congenital heart disease 8. Hypertrophic cardiomyopathy (HCM)
Where this trial is running
Shanghai
- Shanghai Chest Hospital — Shanghai, China (Recruiting)
Study contacts
- Study coordinator: Mu Qin
- Email: qinmuae@163.com
- Phone: 13052320103
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.