Computed Tomography of Pulse-Field Ablation

Atrial Remodeling Associated With Pulse-Field Ablation of Atrial Fibrillation: a Computed Tomography Study

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07395089

Acronym

CT-PFA

Enrollment

Registered

2026-02-09

Start date

2026-04-15

Completion date

2026-06-30

Last updated

2026-09-08

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

Conditions

Arrhythmia, Atrial Fibrillation (AF)

Keywords

Ablation, Reverse Atrial Remodeling, Radiofrequency Catheter Ablation, Pulse Field Ablation, Pulmonary Vein Reconnexion, Epicardial Adipose Tissue

Brief summary

Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) reduces left atrial (LA) volume post-ablation, a phenomenon termed reverse atrial remodeling, indicative of successful reversal of atrial cardiomyopathy progression. In contrast, pulse field ablation (PFA), a novel non-thermal technology, offers a promising efficacy and safety profile without inducing persistent atrial fibrosis. While RFCA-associated reverse atrial remodeling is well-documented, it remains uncertain whether PFA, operating on a non-thermal paradigm, also promotes this remodeling, which would enhance its physiological relevance in AF treatment. Additionally, RFCA studies show that LA wall thickness at the pulmonary vein (PV) antrum can predict PV reconnection and arrhythmia recurrence, but whether PFA affects LA thinning or enables similar predictions from post-treatment computed tomography (CT) scans is unknown. Moreover, epicardial adipose tissue (EAT), strongly linked to LA abnormalities and AF recurrence, can be quantified via CT, yet the impact of PFA on LA EAT remains unexplored. Finally, PFA's versatility, particularly in isolating the LA posterior wall (LAPW) in non-paroxysmal AF, raises questions about its effect on posterior wall thinning or EAT changes, factors associated with post-ablation recurrence

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

OTHER

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

1. Age≥18 years at the time of AF ablation 2. AF ablation by pulse-field ablation (BOSTON SCIENTIFIC FARAPULSE) or by radiofrequency (any manufacturer) between 2020 and 2024 3. Paroxysmal or non-paroxysmal AF 4. Pre-ablation CT data available and of high quality 5. Post-ablation CT data available and of high quality 6. Post-ablation CT performed 3-months (+- 2 weeks) after AF ablation

Exclusion criteria

1. Low quality CT, non-homogeneous contrast agent perfusion 2. Post-ablation CT performed in another center 3. Patients in which pre- and post-ablation CTs do not share common phases 4. Patients who underwent ethanol infusion in the vein of Marshall

Design outcomes

Primary

Measure	Time frame
Difference between baseline and post-ablation LA indexed volume (ml/cm^2)	Post-procedural (3-months)

Secondary

Measure	Time frame
Difference between baseline and post-ablation mean wall thickness, mm	Post-procedural (3-months)
Difference between baseline and post-ablation Epicardial adipose tissue , mm^3	Post-procedural (3-months)
Difference between baseline and post-ablation left atrial appendage indexed volume, ml/cm^2	Post-procedural (3-months)
Difference between baseline and post-ablation left atrial appendage dimensions (long-axis, short-axis, ostium long-axis, ostium short-axis), mm	Post-procedural (3-months)
Difference between baseline and post-ablation mean LA wall thickness at the LAPW, mm	Post-procedural (3-months)
Difference between baseline and post-ablation epicardial adipose tissue at the PW, mm^3	Post-procedural (3-months)
Recurrence of sustained atrial arrhythmia	Post-procedural (3-months)

Countries

France

Contacts

STUDY_DIRECTORCarine Paré

Assistance Publique - Hôpitaux de Paris

Outcome results