None listed
Conditions
Brief summary
Atrial fibrillation (AF) is a disorganised abnormal heart rhythm which causes the heart to beat in an irregular fashion. Current curative ablation methods are based on targeted circles of burns around the openings of the pulmonary veins which are connected to the left atrium (or “top chamber”) of the heart. We call this part of the procedure pulmonary vein isolation. In some patients, pulmonary vein isolation alone is not enough to cure their AF. In this case, the conventional strategy is to apply additional burns in special sites in the atrium with irregular local electrical signals. These areas are called complex fractionated atrial electrogram sites (or CFAE, pronounced like ‘café’). We believe, however, that other areas that may be selected with novel computational algorithms may be important to sustaining AF in many patients. The aim of this project is to examine whether burns targeting these sites in the atrium will improve control of AF, and improve cure rates for ablation.
Interventions
Pulmonary vein isolation(PVI)+/- linear left atrial compartmental ablation with roof line +/- dominant frequency ablation targeting the 5 mapped sites using novel computation algorithms, including Shannon entropy. Linear compartmental ablation will be determined on an individualised basis by operator. Allocation to dominant frequency ablation will be randomised.Mitral isthmus line will be permitted but discouraged. Atrial tachcyardia ablation will be permitted. Endpoint of ablation is PVI +/- t
Pulmonary vein isolation(PVI)+/- linear left atrial compartmental ablation with roof line +/- dominant frequency ablation targeting the 5 mapped sites using novel computation algorithms, including Shannon entropy. Linear compartmental ablation will be determined on an individualised basis by operator. Allocation to dominant frequency ablation will be randomised.Mitral isthmus line will be permitted but discouraged. Atrial tachcyardia ablation will be permitted. Endpoint of ablation is PVI +/- termination of AF during the procedure. The procedure is individualised and the duration can vary widely depending on patient anatomy and technical factors.
Sponsors
Prof Prash Sanders, Dr Anand Ganesan
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The study population will be patients undergoing curative catheter ablation for atrial fibrillation defined according to the HRS/ACC consensus statement at Royal Adelaide Hospital. The planned recruitment is 20patients over a study period of 18 months.
Exclusion criteria
The following exclusion criteria will apply: (i) age <18 years; (ii) pregnancy (iii) left atrial appendage thrombus on transoesophageal echocardiography (iv)previous AF ablation.
Outcome results
None listed