Inhibition of Atrial Fibrillation by Elimination of Transitional Mechanisms
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 试验地点
- 2
- 主要终点
- Changes in AF threshold induction from ablation of transitional rotors
研究概览
简要总结
There is growing awareness of the importance of electrical rotors to the maintenance of atrial fibrillation (AF). Recent work in our laboratory has found that AF evolves over time, from rapid, focal activation, next to transitional rotors, and finally to stable, long duration rotors, whose locations are frequently separate from the transitional rotor sites. This project will test the hypothesis that mapping and ablation of the transitional rotors sites may prevent atrial fibrillation from progressing to sustained atrial fibrillation, and therefore increase the AF initiation threshold. The investigators will test this hypothesis during clinically-indicated electrophysiology study prior to ablation of symptomatic AF.
详细描述
A. Patient Enrollment:
UCSD will enroll subjects with symptomatic AF undergoing clinically-indicated ablation at the Sulpizio Cardiovascular Center.
B. Research Study Data UCSD will record patient demographics (e.g. age, gender, echocardiographic information), AF history (AF duration, previous and current antiarrhythmic medications, prior ablations), medical history (current medication regimen, lab values, etc.), and other relevant history. All recorded digital data such as electrocardiograms and intracardiac recordings will be exported from the recorder stripped of patient identifying information.
C. Electrophysiology (EP) Study and Catheter Placement:
EP study will be performed in the fasting state and after antiarrhythmic medications are discontinued for 5 half-lives (>60 days for amiodarone). Catheters are advanced to the right atrium (RA), coronary sinus, and transseptally to left atrium (LA). A 64-pole basket catheter (FIRMap, Topera, Menlo Park, CA) will map the LA. RA recordings are made using a second basket, simultaneously when possible. Heparin will be infused to maintain activated clotting time >350 seconds.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients with symptomatic atrial fibrillation (AF) undergoing clinically-indicated ablation
- •either persistent or paroxysmal AF
排除标准
- •decompensated heart failure;
- •non-revascularized coronary ischemia
- •LA diameter > 60mm
- •inability or refusal to provide consent
结局指标
主要结局
Changes in AF threshold induction from ablation of transitional rotors
时间窗: 1 day
In patients presenting for AF ablation, the investigator will prospectively determine whether ablation of AF-initiating sites renders AF more difficult to induce, as measured by the rapid pacing cycle length required to initiate AF during two induction attempts consisting of rapid pacing of 15 seconds duration at decreasing cycle lengths.
次要结局
未报告次要终点