Persistent atrial fibrillation
Conditions
Interventions
Combined Ablation Group: Marshall Vein Ethanol Infusion + CPVI (Circumferential Pulmonary Vein Isolation) + Left Atrial Roofline Ablation + Left Atrial Bottom Line Ablation:Initially, perform Marshall
then proceed with pacing to verify the presence of mitral isthmus block. If a mitral isthmus block is confirmed, sequentially perform CPVI, left atrial roofline ablation, and left atrial bottom line a
Single catheter ablation group: CPVI + left atrial roof line ablation + left atrial bottom line ablation:Sequential CPVI, left atrial roofline ablation, and left atrial bottom line ablation.
Sponsors
The First Hospital of Jilin University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: - Symptomatic persistent atrial fibrillation (AF) confirmed by routine 12-lead electrocardiogram or 24-hour Holter monitoring, with a duration of more than 7 days but less than 3 years (diagnosed according to the **2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation**). - Male and female patients aged 18 to 75 years. - Patients requiring catheter ablation due to persistent arrhythmia despite using antiarrhythmic drugs for more than 6 weeks. - Patients with no evidence of thrombus in the atrium or left atrial appendage, as confirmed by transesophageal echocardiography (TEE). - Patients who voluntarily decide to participate in the study and provide written informed consent. - Patients able to understand, follow instructions, and participate throughout the study period.
Exclusion criteria
Exclusion criteria: - Paroxysmal atrial fibrillation; - Patients who have previously undergone atrial fibrillation ablation or maze surgery; - Patients who have undergone cardiac surgery within the past 3 months; - Patients diagnosed with acute coronary syndrome within the past 3 months, or who have received stent implantation or coronary artery bypass grafting in the proximal coronary arteries along the anticipated surgical pathway at the time of the study; - Patients with severe heart failure or cardiogenic shock; - Patients with hypertrophic cardiomyopathy; - Patients with contraindications to contrast agents or anticoagulants; - Patients with imaging examinations (CT, TEE, or MRI) within the past month confirming the presence of thrombus in the atrium or left atrial appendage; - Patients with evidence of atrial thrombus; - Patients with malignant intracardiac tumors; - Patients with an expected life expectancy of 12 months or less; - Patients with severe renal insufficiency (creatinine clearance <30 ml/min); - Pregnant women, breastfeeding mothers, and women planning to conceive or who may become pregnant during the study but are not using medically acceptable contraceptive measures; - Patients with chronic symptomatic restrictive or chronic obstructive pulmonary disease; - Patients with acute illness or active infection; - Patients with a history of coagulation or bleeding disorders; - Patients with contraindications to anticoagulation; - Patients with diseases that impair vascular access; - Patients who have participated in other clinical trials within 30 days prior to screening; - Patients unwilling or unable to provide informed consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Atrial Arrhythmias Within 12 Months Post-Surgery; | — |
Countries
China
Contacts
Public ContactShuyan Li
The First Hospital of Jilin University
Outcome results
None listed