A Left Atrial Pressure-Triggered Pathway for Heart Failure Therapy Optimization at Atrial Fibrillation Ablation
试验速览
- 阶段
- 不适用
- 状态
- 进行中(未招募)
- 入组人数
- 300
- 试验地点
- 1
研究概览
简要总结
This study examines whether measuring blood pressure inside the left upper chamber of the heart during a procedure to treat an irregular heartbeat called atrial fibrillation can help identify patients who would benefit from heart failure medications. During atrial fibrillation ablation, a catheter crosses into the left atrium, allowing direct measurement of left atrial pressure. When the pressure is elevated (15 mmHg or higher), it may indicate that the heart is under strain from unrecognized or undertreated heart failure. Patients with elevated left atrial pressure during ablation are referred for heart failure evaluation and medication optimization within 24 hours of the procedure. The study compares outcomes in these patients to a group of patients who had the same elevated pressures but received standard care without a structured heart failure evaluation. The study measures whether the heart failure treatment pathway leads to greater use of recommended heart failure medications, improvements in heart pumping function and heart chamber size, and reduction in irregular heartbeat episodes over the following year
详细描述
Single-center prospective pathway study with historical standard-care controls at the Medical College of Wisconsin/Froedtert Hospital. Consecutive patients undergoing catheter ablation for atrial fibrillation with intraprocedural mean left atrial pressure of 15 mmHg or greater measured at transseptal puncture are enrolled. Prospective Pathway patients (2024-2025) receive heart failure consultation within 24 hours and structured guideline-directed medical therapy optimization. Historical controls (2022-2023) met identical procedural and hemodynamic criteria but received standard post-ablation care. Guideline-directed medical therapy implementation is quantified serially through 180 days using a guideline adherence index. Echocardiographic remodeling is assessed at 3 to 18 months. Atrial fibrillation burden is assessed by clinically directed rhythm monitoring beyond a 90-day blanking period.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Referred and presented for catheter ablation of atrial fibrillation
- •Able to provide written informed consent
- •Intraprocedural mean left atrial pressure 15 mmHg or greater measured immediately after transseptal puncture -- Written informed consent (prospective cohort 2024- onwards) or institutional review board waiver of consent (historical cohort 2022-2023)
排除标准
- •- No additional exclusion criteria
研究者
Marcie G. Berger, MD
Professor of Medicine
Medical College of Wisconsin
