The objective of the current study proposal is to gain insight in the effect of pulmonary vein isolation on the electrophysiological properties nearby the ablation lines on the posterior sight of the left atrium and further away, especially in the…
ID
Source
Brief title
Condition
- Cardiac arrhythmias
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
1) Return of AF on routine holterscan, control surface ECG or holterscan or ECG
during complaints. Blinded period 0 to 3 months after ablation
2) Restart of anti arithmic drugs because of atrial arrhythmia, consisting of
AF, atrial flutter or atrial tachycardia.
Secondary outcome
na
Background summary
Catheter based ablation of atrial fibrillation (AF) has come of infancy since
1998. Currently the procedure is most often based on electrical isolation of
the pulmonary veins alone or as part of an ablation also targeting the left
atrial tissue surrounding the pulmonary veins and/or additional linear lines of
ablation between right and left pulmonary veins and between the pulmonary veins
and the mitral annulus. This is to prevent electrical impulses from within and
around the pulmonary veins to trigger the onset of AF. The succesrate of this
approach in paroxysmal AF is 70-90%. Normally the procedure is based on
electrical isolation of the pulmonary veins to prevent triggers within the
pulmonary veins to reach the atrial tissue and initiate AF. Recently a new
approach is developed, targeting areas of atrial tissue showing fractionated
electrical potentials. The new approach is based on the theory that the
underlying slow conduction velocity and disturbed conduction patterns of these
sites play an important role in the maintenance of AF. Preliminary data show
this approach to be succesful in about 90% of patients.
Study objective
The objective of the current study proposal is to gain insight in the effect of
pulmonary vein isolation on the electrophysiological properties nearby the
ablation lines on the posterior sight of the left atrium and further away,
especially in the right atrium. The second objective is to gain more insight in
the role of areas with abnormal conduction, evidenced by fractionated
potentials, in the maintenance of AF. We will focus on the identification of
predilection sites of fractionated potentials.
Study design
The design of the study is observational. We will include 30 patients with AF
(paroxysmal or persistent). During the catheter based intervention we will
record unipolar electrical signals to identify sites with abnormal conduction ,
as evidenced by fractionated potentials.
Study burden and risks
Nature and extent of the burden and risks associated with participation
We don*t anticipate an increase in periprocedural complications of the
circumferential pulmonary vein isolation or accessory pathway ablation.
However, the duration of the procedure will be lengthened by approximately 30
minutes, The follow up of the patients will be in accordance with usual care.
Groot Wezenland 20
8011 JW Zwolle
Nederland
Groot Wezenland 20
8011 JW Zwolle
Nederland
Listed location countries
Age
Inclusion criteria
Paroxysmal or persistent AF
Structurally normal heart
accepted for catheterablation of atrial fibrillation
Exclusion criteria
age >75 years or < 18 years.
Thyroid dysfunction
unable to give informed consent
critical illness
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL12629.075.06 |