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A Study of Multi-electrode Circular Irreversible Electroporation (IRE) Catheter and Multi-Channel IRE Generator in Paroxysmal Atrial Fibrillation (AF)

A Prospective, Multicenter, Single Arm With Performance Goal Study to Evaluate Safety and Effectiveness of Multi-electrode Circular IRE Catheter and Multi-Channel IRE Generator in Paroxysmal AF

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05552963
Acronym
AFIRE
Enrollment
142
Registered
2022-09-23
Start date
2022-12-07
Completion date
2024-12-18
Last updated
2026-01-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Refractory Paroxysmal Atrial Fibrillation

Brief summary

The purpose of this study is to evaluate the long term off-Antiarrhythmic Drug (AAD) effectiveness of Biosense Webster, Inc. Irreversible Electroporation (BWI IRE) system in treatment of participants with symptomatic drug refractory paroxysmal atrial fibrillation (PAF).

Interventions

DEVICEMulti-Channel Irreversible Electroporation (IRE) Generator

The multi-channel IRE Generator is intended for use during cardiac Pulsed Field Ablation (PFA) therapy. This device is used in conjunction with a compatible ablation catheter to create a closed electrical circuit capable of delivering pulsed electrical field energy.

DEVICEMulti-Channel Circular IRE Catheter

The multi-channel circular IRE Catheter is indicated for use in catheter-based cardiac electrophysiological mapping (stimulating and recording) and when used with an IRE Generator, for cardiac ablation.

Sponsors

Biosense Webster, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

* Diagnosed with symptomatic paroxysmal atrial fibrillation (PAF) (Physician's note indicating recurrent self-terminating atrial fibrillation \[AF\]). At least one electrocardiographically documented AF episode within twelve (12) months prior to enrollment. Electrocardiographic documentation may include, but is not limited to, electrocardiogram (ECG), Holter monitor, or telemetry strip * Failed at least one Class I or Class III antiarrhythmic drug (AAD) as evidenced by recurrent symptomatic AF, contraindicated or intolerable to both Class I and Class III AAD * Able and willing to comply with all pre-procedure, post-procedure, and follow-up testing and visit requirements * Willing and capable of providing consent

Exclusion criteria

* AF secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause (Example, untreated documented obstructive sleep apnea and acute alcohol toxicity) * Previous left atrium (LA) ablation or surgery * Participants known to require ablation outside the pulmonary vein (PV) region (atrioventricular reentrant tachycardia, atrioventricular nodal reentry tachycardia, atrial tachycardia, atrial flutter of unknown origin, ventricular tachycardia and Wolff-Parkinson-White) * Previously diagnosed with persistent AF (greater than \[\>\] 7 days in duration) * Severe dilatation of the LA (documented LAD \>50 millimeters \[mm\] antero-posterior diameter by transthoracic echocardiography (TTE) within 6 month prior to enrollment)

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Long-term EffectivenessFrom Day 91 up to Day 365 post-procedure on Day 0Long-term effectiveness was defined as freedom from documented asymptomatic and symptomatic atrial fibrillation (AF), atrial tachycardia (AT), or atrial flutter (AFL; of unknown origin) episodes based on electrocardiographic data (greater than equal to \[\>=\] 30 seconds on arrhythmia monitoring device) through the effectiveness evaluation period (Day 91 through Day 365 post index procedure) and freedom from the following failure modes : freedom from acute procedural failure, freedom from non-study catheter failure, freedom from repeat ablation failure, freedom from direct Current (DC) cardioversion failure, freedom from recurrence (captured on 12-lead electrocardiogram \[ECG\]) failure, and freedom from anti-arrhythmic drug failure. AFL of unknown origin was defined as all AFL except those Cavo-Tricuspid Isthmus (CTI) dependent AFL as confirmed by accepted electrophysiology (EP) maneuvers (for example, entrainment or activation mapping) in an EP study.

Secondary

MeasureTime frameDescription
Percentage of Participants Experiencing Serious Adverse Event (SAE) Within 7 Days, 8-30 Days and >30 Days of Initial Ablation ProcedureFrom day of procedure (Day 0) up to 12 monthsPercentage of participants with SAEs within 7 days (early-onset), 8-30 days (peri-procedural) and \>30 days (late onset) of initial ablation procedure were reported. A SAE was any adverse event (AE) that resulted in a death or a serious deterioration in the health of the participant during the clinical trial, including a life-threatening illness or injury, a permanent impairment of a body structure or a body function, in-patient hospitalization or prolongation of existing hospitalization, medical or surgical intervention to prevent permanent impairment of a body structure or a body function; or resulted in fetal distress, foetal death or congenital abnormality, congenital anomaly, etc.
Percentage of Participants With Acute Procedural SuccessOn the day of procedure (Day 0)Percentage of participants with acute procedural success were reported. Acute procedural success was defined as confirmation of entrance block in all clinically relevant targeted pulmonary veins (PVs) after adenosine/ isoproterenol challenge. Touching up with focal catheter was considered as acute procedural failure.
Percentage of Participants With Acute ReconnectionOn the day of procedure (Day 0)Percentage of participants with acute reconnection were reported. Acute reconnection was identified by adenosine/isoproterenol challenge among all clinically relevant targeted PVs and by participant.
Percentage of Participants Experiencing Primary Adverse Event (PAE)Within 7 days post-procedure on Day 0Percentage of participants experiencing PAE were reported. An AE is any untoward medical occurrence in a participant whether or not related to the investigational medical device. Primary AEs within seven days of the ablation procedure which used investigational devices per protocol, including the initial and repeat procedures were reported. PAEs included cardiac tamponade, perforation, myocardial infarction, stroke/cerebrovascular accident, thromboembolism, transient ischaemic attack, phrenic nerve injury/diaphragmatic paralysis, heart block, pulmonary vein stenosis, pulmonary oedema (respiratory insufficiency), vagal nerve injury/gastroparesis, pericarditis, major vascular access complication/bleeding, and atrio-esophageal fistula .
Percentage of Participants With Pulmonary Vein (PV) AblationOn day of procedure (Day 0)Percentage of participants with PV ablation by a non-study catheter (touch-up) among all clinically relevant targeted participants were reported.
Percentage of Participants With Repeated AblationFrom the day of procedure (Day 0) up to 12 monthsPercentage of participants with repeated ablation within the 12 months follow up period, including timing (blanking period or after blanking) were reported. Repeat procedures for AF/AT/AFL of unknown origin plus recurrences during the blanking period (90 days post index procedure) were conducted with the investigational device for ablating PV reconnections. Repeat procedures performed after the blanking period were managed per investigator discretion using a commercially available ablation catheter and generator.
Percentage of Pulmonary Veins (PVs) With Acute ReconnectionOn the day of procedure (Day 0)Percentage of PVs with acute reconnection were reported. Acute reconnection was identified by adenosine/isoproterenol challenge among all clinically relevant targeted PVs and by participant.

Countries

China

Participant flow

Participants by arm

ArmCount
Irreversible Electroporation (IRE) System
Participants with symptomatic drug refractory paroxysmal atrial fibrillation (PAF) and indicated for catheter ablation were treated with the IRE system which included multi-electrode circular IRE catheter and the multi-channel IRE generator.
142
Total142

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyLost to Follow-up1
Overall StudyStudy catheter was inserted, but PF energy was not delivered due to ECG interference1

Baseline characteristics

CharacteristicIrreversible Electroporation (IRE) System
Age, Continuous56.9 Years
STANDARD_DEVIATION 12.04
Age, Customized
<45 years
26 Participants
Age, Customized
>=65 years
49 Participants
Age, Customized
Between 45 to <65 years
67 Participants
Race and Ethnicity Not Collected— Participants
Sex: Female, Male
Female
61 Participants
Sex: Female, Male
Male
81 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 142
other
Total, other adverse events
13 / 142
serious
Total, serious adverse events
16 / 142

Outcome results

Primary

Percentage of Participants With Long-term Effectiveness

Long-term effectiveness was defined as freedom from documented asymptomatic and symptomatic atrial fibrillation (AF), atrial tachycardia (AT), or atrial flutter (AFL; of unknown origin) episodes based on electrocardiographic data (greater than equal to \[\>=\] 30 seconds on arrhythmia monitoring device) through the effectiveness evaluation period (Day 91 through Day 365 post index procedure) and freedom from the following failure modes : freedom from acute procedural failure, freedom from non-study catheter failure, freedom from repeat ablation failure, freedom from direct Current (DC) cardioversion failure, freedom from recurrence (captured on 12-lead electrocardiogram \[ECG\]) failure, and freedom from anti-arrhythmic drug failure. AFL of unknown origin was defined as all AFL except those Cavo-Tricuspid Isthmus (CTI) dependent AFL as confirmed by accepted electrophysiology (EP) maneuvers (for example, entrainment or activation mapping) in an EP study.

Time frame: From Day 91 up to Day 365 post-procedure on Day 0

Population: Full analysis set (FAS) included all enrolled non-roll-in participants who were ablated with investigational devices. Here, 'N' (overall number of participants analyzed) signifies participants evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants With Long-term Effectiveness74.6 Percentage of participants
Secondary

Percentage of Participants Experiencing Primary Adverse Event (PAE)

Percentage of participants experiencing PAE were reported. An AE is any untoward medical occurrence in a participant whether or not related to the investigational medical device. Primary AEs within seven days of the ablation procedure which used investigational devices per protocol, including the initial and repeat procedures were reported. PAEs included cardiac tamponade, perforation, myocardial infarction, stroke/cerebrovascular accident, thromboembolism, transient ischaemic attack, phrenic nerve injury/diaphragmatic paralysis, heart block, pulmonary vein stenosis, pulmonary oedema (respiratory insufficiency), vagal nerve injury/gastroparesis, pericarditis, major vascular access complication/bleeding, and atrio-esophageal fistula .

Time frame: Within 7 days post-procedure on Day 0

Population: Safety analysis set included all the enrolled participants (including both non roll-in and roll-in participants) who had the investigational devices inserted or treated.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants Experiencing Primary Adverse Event (PAE)2.1 Percentage of participants
Secondary

Percentage of Participants Experiencing Serious Adverse Event (SAE) Within 7 Days, 8-30 Days and >30 Days of Initial Ablation Procedure

Percentage of participants with SAEs within 7 days (early-onset), 8-30 days (peri-procedural) and \>30 days (late onset) of initial ablation procedure were reported. A SAE was any adverse event (AE) that resulted in a death or a serious deterioration in the health of the participant during the clinical trial, including a life-threatening illness or injury, a permanent impairment of a body structure or a body function, in-patient hospitalization or prolongation of existing hospitalization, medical or surgical intervention to prevent permanent impairment of a body structure or a body function; or resulted in fetal distress, foetal death or congenital abnormality, congenital anomaly, etc.

Time frame: From day of procedure (Day 0) up to 12 months

Population: Safety analysis set included all the enrolled participants (including both non roll-in and roll-in participants) who had the investigational devices inserted or treated.

ArmMeasureGroupValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants Experiencing Serious Adverse Event (SAE) Within 7 Days, 8-30 Days and >30 Days of Initial Ablation ProcedureWithin 7 days (early-onset) of index ablation procedure2.8 Percentage of participants
Irreversible Electroporation (IRE) SystemPercentage of Participants Experiencing Serious Adverse Event (SAE) Within 7 Days, 8-30 Days and >30 Days of Initial Ablation ProcedureWithin 8-30 days (peri-procedural)0.7 Percentage of participants
Irreversible Electroporation (IRE) SystemPercentage of Participants Experiencing Serious Adverse Event (SAE) Within 7 Days, 8-30 Days and >30 Days of Initial Ablation Procedure>30 days (late onset)6.3 Percentage of participants
Secondary

Percentage of Participants With Acute Procedural Success

Percentage of participants with acute procedural success were reported. Acute procedural success was defined as confirmation of entrance block in all clinically relevant targeted pulmonary veins (PVs) after adenosine/ isoproterenol challenge. Touching up with focal catheter was considered as acute procedural failure.

Time frame: On the day of procedure (Day 0)

Population: Full analysis set (FAS) included all enrolled non-roll-in participants who were ablated with investigational devices.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants With Acute Procedural Success100 Percentage of participants
Secondary

Percentage of Participants With Acute Reconnection

Percentage of participants with acute reconnection were reported. Acute reconnection was identified by adenosine/isoproterenol challenge among all clinically relevant targeted PVs and by participant.

Time frame: On the day of procedure (Day 0)

Population: Full analysis set (FAS) included all enrolled non-roll-in participants who were ablated with investigational devices.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants With Acute Reconnection10.6 Percentage of participants
Secondary

Percentage of Participants With Pulmonary Vein (PV) Ablation

Percentage of participants with PV ablation by a non-study catheter (touch-up) among all clinically relevant targeted participants were reported.

Time frame: On day of procedure (Day 0)

Population: Full analysis set (FAS) included all enrolled non-roll-in participants who were ablated with investigational devices.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants With Pulmonary Vein (PV) Ablation0 Percentage of participants
Secondary

Percentage of Participants With Repeated Ablation

Percentage of participants with repeated ablation within the 12 months follow up period, including timing (blanking period or after blanking) were reported. Repeat procedures for AF/AT/AFL of unknown origin plus recurrences during the blanking period (90 days post index procedure) were conducted with the investigational device for ablating PV reconnections. Repeat procedures performed after the blanking period were managed per investigator discretion using a commercially available ablation catheter and generator.

Time frame: From the day of procedure (Day 0) up to 12 months

Population: Full analysis set (FAS) included all enrolled non-roll-in participants who were ablated with investigational devices.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Participants With Repeated Ablation6.5 Percentage of participants
Secondary

Percentage of Pulmonary Veins (PVs) With Acute Reconnection

Percentage of PVs with acute reconnection were reported. Acute reconnection was identified by adenosine/isoproterenol challenge among all clinically relevant targeted PVs and by participant.

Time frame: On the day of procedure (Day 0)

Population: Full analysis set (FAS) included all enrolled non-roll-in participants who were ablated with investigational devices.

ArmMeasureValue (NUMBER)
Irreversible Electroporation (IRE) SystemPercentage of Pulmonary Veins (PVs) With Acute Reconnection4.7 Percentage of pulmonary veins

Source: ClinicalTrials.gov · Data processed: May 29, 2026