persistent atrial fibrillation
Conditions
Sponsors
Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Aged 18–80 years; 2. Diagnosed with persistent atrial fibrillation confirmed by ambulatory electrocardiogram or standard 12-lead electrocardiogram; 3. Scheduled for first-time catheter ablation for atrial fibrillation; 4. Able to understand and provide written informed consent.
Exclusion criteria
Exclusion criteria: 1. Duration of persistent atrial fibrillation >5 years, or echocardiography demonstrating left atrial anteroposterior diameter >=50 mm; 2. Atrial fibrillation secondary to reversible causes (e.g., hyperthyroidism, acute infection, post-cardiac surgery); 3. Presence of severe structural heart disease (e.g., hypertrophic cardiomyopathy, rheumatic valvular heart disease, dilated cardiomyopathy); 4. Current use of any mineralocorticoid receptor antagonist (MRA) (e.g., spironolactone, eplerenone, or finerenone); 5. Class I indication for finerenone: chronic kidney disease (CKD) associated with type 2 diabetes and albuminuria; 6. Contraindications or high-risk features for finerenone: (1) Baseline serum potassium >5.0 mmol/L; (2) Severe renal impairment (eGFR <25 mL/min/1.73m^2) or patients with end-stage renal disease on dialysis; (3) Severe hepatic impairment (Child-Pugh class C); (4) Addison's disease; (5) Concomitant use of strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin, etc.); 7. Severe hypotension (systolic blood pressure <90 mmHg) or hypovolemia; 8. Planned major other surgery within 3 months; 9. Presence of thrombus in the left atrium / left atrial appendage; 10. Pregnant women, or women of childbearing potential who may become pregnant without effective contraception.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in atrial fibrillation burden at 3 months after catheter ablation; | — |
Secondary
| Measure | Time frame |
|---|---|
| Changes in left atrial anterior posterior diameter, LVEF and other echocardiographic indicators;Overall atrial fibrillation recurrence rate;Composite endpoint of hospitalization or cardiovascular death due to cardiovascular reasons;AFEQT Quality of Life Score;First recurrence of atrial tachycardia; | — |
Countries
China
Contacts
Public ContactWenzhi Shen
Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University
Outcome results
None listed