Intensive Molecular and Electropathological Characterization of Patients Undergoing Atrial Fibrillation Ablation

Conditions

Atrial Fibrillation, Atrial Fibrillation Paroxysmal, Atrial Fibrillation, Persistent

Keywords

Pulmonary Vein Isolation, Cryoballoon ablation, Radiofrequency ablation, Atrial fibrillation

Brief summary

Rationale: Although there are several individual factors which are known to influence the chances of successful atrial fibrillation (AF) ablation, it remains a challenge to identify patients at risk for ablation failure with satisfactory certainty. Objectives: To identify predictors of success of AF ablation including clinical factors, AF recurrence patterns, anatomical and electrophysiological characteristics, circulating biomarkers and individual genetic background. Study design: Prospective registry of patients undergoing AF ablation. Clinical characteristics and results of routine tests are collected. In addition, the following (non-standard) tests are performed: extended surface electrocardiogram (extECG), extended rhythm monitoring, biomarker testing, genetic analysis, questionnaires. In subgroups of patients transesophageal electrocardiogram (TE-ECG), epicardial electroanatomical mapping and/or left atrial appendage (LAA) biopsy is performed. Study population: Patients aged 18 years and older with documented AF, scheduled for AF ablation. Main study endpoints: Ablation success after 12 and 24 months, defined as freedom from any episode of documented atrial arrhythmia after the blanking period.

Z Habibi, D V M Verhaert, Konstanze Betz, B J M Hermans, Joris Winters et al. (15 authors)

EP Europace2025-05-01

10.1093/europace/euaf085.260

Association of atrial fibrillation burden and clinical profile with blood biomarkers: Results from the ISOLATION Ablation Cohort.

Habibi Z, Verhaert DVM, Betz K, Hermans BJM, Winters J, Philippens SAM, Chaldoupi SM, Maesen B, Maessen JG, Isaacs A, Westra SW, Nijveldt R, Gillet L, Wienhues-Thelen UH, Koehler M, Zeemering S, Vernooy K, Linz D, Schotten U.

2025-02-28

10.1016/j.hroo.2025.02.017

Biomarker BMP10 profiles suggest an association of female and age with atrial endomysial fibrosis: Results from the ISOLATION AF ablation registry

Z Habibi, D V M Verhaert, B J M Hermans, S Philippens, Sjoerd Westra et al. (12 authors)

European Heart Journal2023-11-01

10.1093/eurheartj/ehad655.416

Left atrial strain is associated with atrial fibrillation recurrence after catheter ablation: Data from the ISOLATION registry

Monika Gawałko, Bouke P. Adriaans, Z Habibi, Jerremy Weerts, P Posea et al. (15 authors)

EP Europace2023-05-243 citations

10.1093/europace/euad122.731

Integration of preprocedural computed tomography scan findings into atherosclerotic cardiovascular disease risk estimation in patients with atrial fibrillation scheduled for catheter ablation

D V M Verhaert, Mijke Kerperien, Z Habibi, Sjoerd Westra, Theo Lankveld et al. (12 authors)

EP Europace2023-05-24

10.1093/europace/euad122.223

Atrial fibrillation-specific refinement of the STOP-Bang sleep apnoea screening questionnaire: insights from the Virtual-SAFARI study.

Betz K, Verhaert DVM, Gawalko M, Hermans ANL, Habibi Z, Pluymaekers NAHA, van der Velden RMJ, Homberg M, Philippens S, Hereijgers MJM, Vorstermans B, Simons SO, den Uijl DW, Chaldoupi SM, Luermans JGLM, Westra SW, Lankveld T, van Steenwijk RP, Hol B, Schotten U, Vernooy K, Hendriks JM, Linz D.

2023-02-115 citations

10.1007/s00392-023-02157-9

Rationale and Design of the ISOLATION Study: A Multicenter Prospective Cohort Study Identifying Predictors for Successful Atrial Fibrillation Ablation in an Integrated Clinical Care and Research Pathway

D V M Verhaert, Dominik Linz, Sevasti Maria Chaldoupi, Sjoerd Westra, Dennis W. den Uijl et al. (35 authors)

Frontiers in Cardiovascular Medicine2022-06-3023 citations

10.3389/fcvm.2022.879139

Interventions

PROCEDUREPulmonary vein isolation

Participation in this study does not influence the choice of ablation technique. Usually, cryoballoon ablation is chosen for patients with paroxysmal AF and no previous ablations. Radiofrequency ablation is often used for redo procedures or for patients with persistent AF. Hybrid ablations are most applied in persistent AF patients. However, physicians may deviate from these standard approaches for a variety of reasons, including personal experience or preference.

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Inclusion criteria

* 18 years of age or older; * Documented atrial fibrillation; * Scheduled for AF ablation or redo AF ablation; * Able and willing to provide written informed consent.

Exclusion criteria

* Serious patient condition before ablation; * Physically or mentally unable to provide written informed consent.

Design outcomes

Primary

Measure	Time frame	Description
Ablation success	12 months	Ablation success is defined as freedom from documented recurrence of atrial arrhythmia after 12 months. Recurrences in the first 3 months after the index procedure (blanking period) are exempted. Atrial arrhythmias are AF, atrial tachycardia (AT) and non-isthmus dependent atrial flutter (AFl), lasting more than 30 seconds, documented on ECG or Holter monitoring.

Secondary

Measure	Time frame
Early recurrences of AF or atrial arrhythmia, defined as any episode of AF AT or non-isthmus dependent AFl during the blanking period.	3 months
Disease progression to persistent or permanent AF.	24 months
Time to recurrence of AF or atrial arrhythmia after the blanking period	24 months
Use of antiarrhythmic drugs (AADs) one year after ablation.	12 months
Number of veins with pulmonary vein reconnection at redo procedure.	24 months
Changes in circulating biomarkers and non-invasive electrophysiological markers for substrate quantification.	12 months

Countries

Netherlands

Contacts

Primary ContactDominique VM Verhaert, MD

dominique.verhaert@radboudumc.nl+31 24 30 92470

Outcome results

None listed