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临床试验/NCT06557876
NCT06557876招募中不适用

The Effect of Pulse Field Ablation on Atrial Mechanics Assessed by MRI and on Patient-related Outcomes in Catheter Ablation of Paroxysmal Atrial Fibrillation

Assistance Publique - Hôpitaux de Paris1 个研究点 分布在 1 个国家目标入组 80 人开始时间: 2024年10月9日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
招募中
入组人数
80
试验地点
1
主要终点
Difference between baseline (pre-ablation) and post-ablation in the amount of left atrial fibrosis such as quantified by 3D late gadolinium enhancement (g, %) (related to primary objective) (MRI measurement)

研究概览

简要总结

The goal of this clinical trial is to compare the effect of pulmonary vein isolation on atrial function between pulse-field and cryoablation in patients over the age of 18 with paroxysmal atrial fibrillation. The main question it aims to answer is:

• Is catheter ablation energy (pulse field ablation) revealing a better preservation of the atrial function architecture than with conventional catheter ablation technologies ?

Participants will performed 2 IRMs with injection and completed Quality of Life Questionnaires. They participate in the study for 4 months.

Researchers will compare 2 arms:

  • Pulse-Field Ablation
  • Cryoablation

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Basic Science
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patient age ≥ 18
  • Established diagnosis of paroxysmal fibrillation, with a I/IIa/IIb indication for catheter ablation (ESC 2020 guidelines)
  • Episode of AF documented by ECG within the last 12 months
  • Patient able to give written informed consent
  • If female of childbearing potential, have a negative serum pregnancy test and using effective contraception
  • Be affiliated with a French social security system or entitled

排除标准

  • Non-paroxysmal atrial fibrillation
  • Contraindication to oral anticoagulation
  • Intracardiac thrombus
  • Previous ablation in the left atrium
  • Previous heart surgery
  • Significant valvular heart disease defined as any moderate (grade 3) or severe (grade 4) mitral regurgitation, mitral stenosis, aortic regurgitation, aortic stenosis, tricuspid regurgitation, or tricuspid stenosis
  • Contraindication to perform MRI or using the DOTAREM™ contrast product (pacemaker, defibrillator, foreign body or prosthesis, old generation heart valves, old generation ferromagnetic vascular surgical clips, percutaneous devices for endocranial aneurysms, neurosimulator, cochlear implants, automated injection device such as insulin pump, and more generally any non-removable electronic device, severe kidney disease with GFR < 30 mL/min, documented hypersensitivity to gadoteric acid or to excipients, severe claustrophobia)
  • Patient on AME (state medical aid)
  • Pregnant or breast-feeding female
  • Patient protected by law (guardianship, tutelage measure, deprived of liberty)
  • Participation in another interventional study or being in the exclusion period at the end of a previous study.

研究组 & 干预措施

Pulmonary vein isolation by pulse field ablation

Active Comparator

干预措施: Pulmonary vein isolation by pulse field ablation (Procedure)

Pulmonary vein isolation by cryoablation

Active Comparator

干预措施: Pulmonary vein isolation by cryoablation (Procedure)

结局指标

主要结局

Difference between baseline (pre-ablation) and post-ablation in the amount of left atrial fibrosis such as quantified by 3D late gadolinium enhancement (g, %) (related to primary objective) (MRI measurement)

时间窗: 3 months

次要结局

  • Difference between baseline (pre-ablation) and post-ablation in global left atrial strain (%) (related to secondary objective 1) (MRI measurement)(3 months)
  • Difference between baseline (pre-ablation) and post-ablation in regional left atrial strains (%) (related to secondary objective 1) (MRI measurement)(3 months)
  • SF-36 (Short-Form-36) Physical Health Composite questionnaires measured 15 days after ablation (related to secondary objective 4). The minimum value is 0 and the maximum is 800; a higher score means a better result.(15 days)
  • Difference between baseline (pre-ablation) and post-ablation left atrial flow assessed by vortices number (related to secondary objective 3) (MRI measurement)(3 months)
  • Heart rate measured the day after ablation and 3 months after (related to secondary objective 4)(3 months)
  • Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaires measured 15 days after ablation (related to secondary objective 4). The minimum value is 0 and the maximum is 100; a higher score means a better result.(15 days)
  • Difference between baseline (pre-ablation) and post-ablation LA adipose tissue, measured by CT (cm2, mm3, %) (related to secondary objective 1 and 2) (CT measurement)(3 months)
  • Difference between baseline (pre-ablation) and post-ablation left atrial flow assessed by 4D-flow MRI (related to secondary objective 3) (MRI measurement)(3 months)
  • SF-36 (Short-Form-36) Physical Health Composite questionnaires measured before ablation (related to secondary objective 4). The minimum value is 0 and the maximum is 800; a higher score means a better result.(0 day)
  • Difference between baseline (pre-ablation) and post-ablation left atrial flow assessed by characterization (n) (related to secondary objective 3) (MRI measurement)(3 months)
  • Numeric rating pain scale (NRS) (0-10) measured 15 days after ablation (related to secondary objective 4)(15 days)
  • Difference between baseline (pre-ablation) and post-ablation left atrial flow assessed by duration (ms) (related to secondary objective 3) (MRI measurement)(3 months)
  • Difference between baseline (pre-ablation) and post-ablation left atrial flow assessed by LA stasis (related to secondary objective 3) (MRI measurement)(3 months)
  • Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaires measured before ablation (related to secondary objective 4). The minimum value is 0 and the maximum is 100; a higher score means a better result.(0 day)
  • Numeric rating pain scale (NRS) (0-10) measured 24 hours after ablation (related to secondary objective 4)(1 day)

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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