Substrate remodelling and targeted ablation for persistent atrial fibrillation
Official title: Understanding Substrate Evolution in Persistent Atrial Fibrillation to Develop Tailored Ablation Strategies
Run by Barts & The London NHS Trust · NCT07047235 · Data updated 2026-11-12
This project will try using detailed 3D electrical mapping of the left atrium to guide targeted ablation (pulmonary vein reisolation, ganglionic plexi, and substrate ablation) for people with persistent atrial fibrillation undergoing their first catheter ablation.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 160 (estimated) |
| Sponsor | Barts & The London NHS Trust Academic / other |
| Locations | 1 site (London) |
| Status | Recruiting |
| Started | November 7, 2025 |
| Main results expected | November 18, 2029 |
| Study ends | August 18, 2030 |
| Registry record updated | November 18, 2025 |
| Trial ID | NCT07047235 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults aged 18 or older with a clinical diagnosis of persistent atrial fibrillation who are scheduled for their first catheter ablation and can give informed consent are ideal candidates.
✕Probably not a fit
People with prior left atrial ablation, those under 18, or anyone with clinical contraindications to catheter ablation are not expected to benefit from joining this programme.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
Patients with persistent atrial fibrillation will undergo electroanatomical mapping to create a high-resolution 3D picture of the left atrium, including measurements of voltage and conduction velocity. The mapping data will be used to identify low-voltage areas and regions of autonomic ganglia for targeted ablation in addition to pulmonary vein reisolation as indicated. The procedures are performed at St Bartholomew's Hospital and are intended for patients having their first left atrial catheter ablation. Outcomes will focus on whether this mapping-guided, substrate-directed approach reduces recurrence compared with standard strategies.
Why it matters
Potential benefit: If successful, this approach could reduce the chance of atrial fibrillation coming back after a first-time ablation by tailoring treatment to each patient’s electrical substrate.
How similar studies have gone: Previous work targeting low-voltage substrate and autonomic ganglia has produced mixed results, so the technique shows promise but has not been definitively proven yet.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Able and willing to provide written informed consent * Age: 18 years or older * Clinical diagnosis: Persistent atrial fibrillation * Treatment status: Scheduled to undergo first-time catheter ablation for persistent AF Exclusion Criteria: * Inability or unwillingness to provide informed consent * Under 18 years of age * Previous left atrial ablation for AF or other atrial arrhythmias * Any clinical contraindications to undergoing AF catheter ablation
Where it's running
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St Bartholomew's Hospital
London, United Kingdom Recruiting
Study contacts
- Study coordinator: Shohreh Honarbakhsh, MBBS, MRCP, PhD
- Email: shohreh.honarbakhsh@nhs.net
- Phone: 02037658682
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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.