Thoracoscopic vs Catheter Ablation as the First Rhythm Control in Atrial Fibrillation with a Large Left Atrium

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a prospective, single-center, open-label randomized trial enrolling adults with persistent atrial fibrillation and enlarged left atrium. Participants are assigned 1:1 to thoracoscopic ablation or percutaneous catheter ablation as the first rhythm-control procedure, with stratification by AF duration. The primary outcome is recurrence of atrial tachyarrhythmia after a 3-month blanking period. Secondary considerations include comparing detection of recurrence via 14-day patch monitoring versus conventional methods. Procedures may include epicardial isolation and other substrate modification in the thoracoscopic arm, with the catheter approach focusing on endocardial ablation techniques. The study is designed to determine if thoracoscopic ablation reduces recurrence compared with catheter ablation in this specific patient group.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 19 years or older
* Persistent atrial fibrillation refractory to antiarrhythmic drug therapy, or in whom antiarrhythmic drug therapy cannot be maintained
* European Heart Rhythm Association (EHRA) symptom score ≥ 2
* Considered suitable for rhythm-control therapy by either percutaneous catheter ablation or thoracoscopic ablation, at the investigator's medical discretion
* Enlarged left atrium, defined as left atrial diameter ≥ 50 mm or left atrial volume index ≥ 45 mL/m²

Exclusion Criteria:

* Previous percutaneous catheter ablation or thoracoscopic ablation for atrial fibrillation
* Previous thoracic or cardiac surgery
* Absolute contraindication to anticoagulation therapy
* Life expectancy less than 1 year due to non-cardiac disease, or anticipated poor adherence to treatment, at the investigator's medical discretion
* Refusal to participate in the study

Where it's running

• Samsung Medical Center
  Seoul, Seoul, South Korea Recruiting

Study contacts

• Study coordinator: Young Keun On, MD, PhD
• Email: yk.on@samsung.com
• Phone: +82-2-3410-2578

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.