Personalized AF ablation: anatomy-based vs Emphasize map-guided substrate ablation
Official title: Empirical Anatomy-Based Ablation vs Emphasize Map-Guided Substrate Ablation in Persistent Atrial Fibrillation : (COMPASS-AF)
Run by Samsung Medical Center · NCT07726901 · Data updated 2026-11-12
We’re testing two catheter ablation approaches for persistent atrial fibrillation to see which one leads to fewer or shorter episodes of abnormal heart rhythms over a year.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 19 Years and up |
| Sex | All |
| Enrollment | 360 (estimated) |
| Sponsor | Samsung Medical Center Academic / other |
| Locations | 2 sites (Seoul, Seoul and 1 other locations) |
| Status | Recruiting |
| Started | May 19, 2026 |
| Main results expected | December 31, 2030 |
| Study ends | December 31, 2030 |
| Registry record updated | July 24, 2026 |
| Trial ID | NCT07726901 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are adults 19 and older with persistent AF planned for catheter ablation and no major exclusions.
✕Probably not a fit
Patients with prior AF ablation, severe structural heart disease, or high-risk conditions may not benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
Adults with persistent atrial fibrillation undergoing catheter ablation are randomized 1:1 to either anatomy-based pulmonary vein isolation using pulsed-field ablation or Emphasize map-guided substrate modification after PVI with radiofrequency. The Emphasize mapping system integrates voltage, frequency, and CFAE data to guide targeted ablation beyond PVI. Participants will be followed for 12 months to compare atrial tachyarrhythmia recurrence and other clinical outcomes. Pulsed-field ablation is used for PVI in the anatomy-based arm, while the map-guided arm relies on EnSite X with RF energy for substrate modification.
Why it matters
Potential benefit: If successful, the trial could identify a more effective or safer ablation strategy for persistent AF.
How similar studies have gone: Previous work suggests substrate-guided approaches may offer benefits, but evidence in persistent AF remains mixed and this study tests a direct comparison.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults aged 19 years or older who have voluntarily provided written informed consent to participate in the study * Patients diagnosed with persistent atrial fibrillation (AF) who are scheduled to undergo catheter ablation for AF. Exclusion Criteria: * History of prior catheter ablation or MAZE surgery for atrial fibrillation. * Left atrial (LA) diameter exceeding 60 mm. * Patients with end-stage renal disease (ESRD). * History of prior open-heart surgery. * Women who are pregnant, lactating, or of childbearing potential. * Heart failure corresponding to New York Heart Association (NYHA) functional class IV. * Acute coronary syndrome (ACS) experienced within the past 3 months. * Patients with terminal illness and a life expectancy of less than one year. * Any other condition that the investigator deems inappropriate for participation in the study.
Where it's running
-
Samsung Medical Center
Seoul, Seoul, South Korea Recruiting -
Samsung Medical Center
Seoul, Seoul, South Korea Not yet recruiting
Study contacts
- Study coordinator: Ju Youn Kim, Ph.D
- Email: kzzoo921@gmail.com
- Phone: 82+ 2-3410-3419
Similar studies
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.