atrial fibrillation or atrial tachycardia after initial pulmonal vein isolation. Irregular heart rate
Conditions
Interventions
The standaard re-ablation approach involves antral re-isolation of the
pulmonary vein without any additional ablation.
The HD mapping guided ablation involves detailed LA voltage mapping in SR
and/
Sponsors
Maatschap Cardiologie Zwolle
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: - Previous PVI without any further ablation lesions other than cavo-tricuspid isthmus line due to atrial fibrillation. - Clinical indication for redo ablation due to documented symptomatic atrial fibrillation or atrial tachycardia lasting longer than 30 seconds - Age 18 years or older - Able and willing to comply with pre- and follow up testing and requirements - Patient is willing and capable to provide written informed consent
Exclusion criteria
Exclusion criteria: - LAVI > 60 ml/m2 - AF secondary to electrolyte imbalance, thyroid disease, or reversible or uncontrolled non-cardiac cause - Contraindication to anticoagulation therapy (i.e. Heparin, NOAC*s or acenocoumarol) - Life expectancy less than 12 months - Presence of intramural thrombus, tumor or other abnormality that precludes catheter ablation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Successful therapy defined as freedom from AF and AT, beyond three months of blanking period during 12 months follow up without class I or III AAD. | — |
Secondary
| Measure | Time frame |
|---|---|
| To determine whether HD mapping guided antral re-ablation of the PVs and additional tailored ablation improves AF related and general QoL as compared to standard re-ablation that targets PV reconnection and antral tissue only in patients with symptomatic AF requiring re-ablation after initial PVI during 6, 12 and 24 months follow up. To determine from the viewpoint of society whether HD mapping guided ablation as compared to standard re-ablation that targets PV reconnection and antral tissue only in patients with symptomatic AF requiring re-ablation after initial failed PVI can be preferred in terms of costs, effects and utilities. | — |
Countries
Netherlands
Outcome results
None listed